SB873

SECTION 1. The legislature finds that persons born with variations in their physical sex characteristics in the United States are subject to medical practices that can inflict irreversible physical and psychological harm on them starting in infancy, harms that can last throughout their lives. Many of these procedures are done with the stated aim of making it easier for children to grow up "normal" and integrate more easily into society by helping them conform to a particular sex assignment. The results are often catastrophic as the supposed benefits are largely unproven, and there are generally no urgent health considerations at stake.

The legislature further finds that persons with variations in their physical sex characteristics, many of whom identify with the term "intersex", are subjected to nonemergency surgeries and justified by generalized assumptions about people's preferences about their bodies' appearance and function. These assumptions perpetuate gender stereotypes and may not reflect an individual's actual preferences when the individual is capable of articulating the individual's wishes.

The legislature recognizes that leading pediatric hospitals have begun to institute partial bans on these surgeries on patients who are too young to participate in a meaningful discussion of the implications of these surgeries.

The legislature also recognizes the importance of ensuring the bodily autonomy of persons in Hawaii, including those who are trans or gender nonconforming and are born with variations in their sex characteristics.

The legislature hereby finds and declares that the State has a compelling interest in protecting the physical and psychological well-being of children, including those born with variations in their physical sex characteristics. The enactment of legislation is necessary to safeguard the bodily autonomy of people born with variations in their physical sex characteristics and to ensure patient-centered care that conforms with best practices in the medical profession.

Accordingly, the purpose of this Act is to prohibit the performance of certain procedures on individuals born with variations in their physical sex characteristics who are under one year of age, unless the procedure is a surgery required to address an immediate risk of physical harm.

SECTION 2. Chapter 453, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§453- Prohibited procedures on infants. (a) No physician or surgeon shall authorize or perform the following procedures on an individual born with variations in the individual's physical sex characteristics who is under one year of age, unless the procedure is a surgery required to address an immediate risk of physical harm:

(1) Clitoroplasty, clitoral reduction, and clitoral recession, including corporal-sparing procedures;

(2) Gonadectomy;

(3) Any procedure that lengthens or reroutes a urethra from its native orifice; or

(4) Vaginoplasty, urogenital sinus mobilization, and vaginal exteriorization.

(b) As used in this section:

"Individual born with variations in the individual's physical sex characteristics" means an individual born with physical traits, including genitals, gonads, hormone function, or chromosomal patterns, that vary from stereotypical notions regarding the development, appearance, or function of sex characteristics, including those variations resulting from androgen insensitivity syndrome and congenital adrenal hyperplasia.

"Surgery required to address an immediate risk of physical harm" means any of the following:

(1) Surgery to remove tissue that poses a significant heightened clinical risk of malignancy relative to that of the general population;

(2) Surgery to allow urine to exit the body, to treat urinary incontinence, or to make a minimally invasive adjustment to urinary function in order to decrease a risk of infection or renal complication in a patient whose current urinary function puts them at a demonstrated clinical risk of infection or renal complication;

(3) Surgery that is required to treat complications of a previous surgery and cannot be delayed without increasing physical health risks to the patient; and

(4) Any other surgery necessary to preserve life in the event of a medical emergency."

SECTION 3. New statutory material is underscored.

SECTION 4. This Act shall take effect on July 1, 2025.

INTRODUCED BY:	_____________________________

THE SENATE	S.B. NO.	873
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII