S 2598Children

Health and Safety - Rhode Island's Children Deserve Help Not Harm Act - Minor's Gender Transition

This bill bans gender transition surgeries and medications for anyone under eighteen and prohibits insurance coverage for these procedures.

Introduced

Population
Affected

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Introduced Feb 13, 2026Committee Senate Judiciary

Plain-English Summary

The "Rhode Island's Children Deserve Help Not Harm Act" prohibits healthcare professionals from providing gender transition procedures to individuals under eighteen years of age. This ban includes puberty-blocking drugs, cross-sex hormones, and gender reassignment surgeries. The legislation also forbids public funds and health insurance plans, including Medicaid, from covering these procedures for minors. Furthermore, it establishes a private cause of action allowing individuals who received such procedures as minors to sue medical providers for damages up to thirty years after reaching adulthood. The act requires currently treated minors to taper off medications by January 1, 2027.

For younger readers

This law creates new rules for doctors regarding children. It says that doctors are not allowed to give kids medicine or do surgeries that change their bodies to look like a different gender (boy or girl) than they were born as. It also says that insurance companies and the government will not pay for these medicines or surgeries for kids. If doctors break this rule, they can get in trouble or lose their jobs, and people can sue them later. The law would start in 2027 to give kids time to stop taking these medicines safely.

Who & Where It Applies

Impacted groups

Transgender youthPhysicians and healthcare professionalsHealth insurance companiesParents of transgender youthPharmacists

Impacted communities

All

Constitutional & Fiscal Check

There is a high probability that parts of this bill are unconstitutional. Federal courts have enjoined similar bans in other states (e.g., Arkansas, Alabama) ruling that they likely violate the Equal Protection Clause of the 14th Amendment by discriminating due to sex and transgender status. Additionally, the ban infringes on the Due Process rights of parents to direct the medical care of their children. The "aiding and abetting" clause may also face scrutiny regarding First Amendment speech protections.

Estimated cost

None

Estimated revenue

None

Bill Analysis

Both viewpoints

For Progressives

Challenges the profit-driven motives of the pharmaceutical industry by restricting the off-label use of powerful drugs on children without long-term longitudinal safety studies.
Emphasizes the necessity of mental healthcare services for youth experiencing distress, aligning with the progressive goal of expanding access to psychological support rather than immediate medicalization.
Protects vulnerable minors from making potentially irreversible physical changes before they have the legal capacity and cognitive maturity to provide fully informed consent.
Denies transgender youth access to gender-affirming healthcare that major medical associations deem medically necessary, potentially increasing risks of depression and suicide among marginalized youth.
Disproportionately impacts low-income families by explicitly banning Medicaid coverage for these procedures, thereby exacerbating socioeconomic and healthcare inequalities.
Violates bodily autonomy and interferes with the private patient-doctor-parent relationship by mandating government control over personal medical decisions.

For Conservatives

Protects children from making irreversible medical decisions regarding their biological sex before they possess the maturity to understand the long-term lifelong consequences.
Ensures that taxpayer money and public funds are not utilized to subsidize elective gender transition procedures or controversial medical interventions for minors.
Holds medical professionals accountable by establishing a robust private cause of action, allowing individuals to sue for damages if they were subjected to these procedures as minors.
Imposes significant government regulations on private insurance companies by dictating coverage mandates, which conflicts with free-market principles and corporate freedom.
Establishes an extended statute of limitations (30 years) for lawsuits, which creates a litigious environment that benefits trial lawyers and could drive up medical liability costs.
Expands the power of the state to interfere in the confidential decision-making process between private citizens and their physicians, setting a potential precedent for future government overreach.

Votes

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Full Bill Text

Changes to existing Rhode Island law · 195 additions

SECTION 1. Legislative findings and purpose. The general assembly finds that:

(1) Rhode Island has a compelling government interest protecting the health and safety of its citizens, especially vulnerable children;

(2) Only a small percentage of the American population experiences distress identifying with their biological sex;

(3) For the small percentage of children who are gender nonconforming or experience distress identifying with their biological sex, studies consistently demonstrate that the majority come to embrace their biological sex in adolescence or adulthood, thereby rendering most medical physiological interventions unnecessary;

(4) Scientific studies show that individuals experiencing distress identifying with their biological sex have often experienced severe psychopathology preceding their gender dysphoria, which indicates these individuals could benefit greatly from access to mental healthcare services;

(5) Even among individuals who have undergone inpatient gender reassignment procedures, suicide rates, psychiatric morbidities, and mortality rates remain markedly elevated above the background population;

(6) Some healthcare professionals are prescribing puberty-blocking drugs such as gonadotropin-releasing hormone analogues, in order to delay the natural onset or progression of puberty in children, who experience distress identifying with their biological sex:

(i) Puberty-blocking drugs are being prescribed, despite the lack of any long-term longitudinal studies evaluating the risks and benefits of using these drugs for the treatment of such distress or gender dysphoria; and

(ii) Puberty-blocking drugs are being prescribed in an off-label and experimental manner on children;

(7) Some healthcare professionals are also prescribing cross-sex hormones for children who are experiencing distress identifying with their biological sex, despite the fact no randomized clinical trials have been conducted on the efficacy or safety of the use of cross-sex hormones in adults or children for the purpose of gender transition;

(8) The use of cross-sex hormones comes with serious known risks:

(i) For biological females, some risks may include;

(A) Irreversible infertility;

(B) Severe liver dysfunction;

(D) Increased risk of breast, cervical, and uterine cancers;

(E) Cerebrovascular disease, including strokes;

(F) Hypertension;

(G) Erythrocytosis, which is an increase in red blood cells;

(H) Sleep apnea;

(I) Type 2 diabetes;

(J) Loss of bone density; and

(K) Destabilization of psychiatric disorders;

(ii) For biological males, some risks may include:

(A) Irreversible infertility;

(B) Thromboembolic disease, including blood clots;

(D) Coronary artery disease, including heart attacks;

(E) Type 2 diabetes;

(F) Breast cancer;

(G) Macroprolactinoma, which is a tumor of the pituitary gland;

(H) Cerebrovascular disease, including strokes; and

(I) Hypertriglyceridemia, which is an elevated level of triglycerides in the blood;

(9) Genital and non-genital gender reassignment surgeries are generally not recommended for children, although evidence indicates referrals for children to have such surgeries are becoming more frequent;

(10) Genital gender reassignment surgery includes several irreversible invasive procedures for males and females and involves the alteration of biologically healthy and functional body parts. These procedures are generally irreversible;

(i) For biological males, surgery may involve:

(A) Genital reconstruction, including a penectomy, which is the removal of the penis;

(B) Orchiectomy, which is the removal of the testicles;

(D) Clitoroplasty which is the construction of a clitoris-like structure; and

(E) Vulvoplasty, which is the construction of a vulva-like structure;

(ii) For biological females, surgery may involve:

(A) Hysterectomy or oophorectomy;

(B) Reconstruction of the urethra;

(C) Genital reconstruction including metoidioplasty or phalloplasty, which is the construction of a penis-like structure;

(D) Vaginectomy, which is the removal of the vagina;

(E) Scrotoplasty, which is the construction of a scrotum-like structure; and

(F) Implantation of erection and/or testicular prosthesis;

(iii) The complications, risks, and long-term care concerns associated with genital sex reassignment surgery, for both males and females, are numerous and complex;

(iv) Non-genital sex reassignment surgery includes various invasive procedures for males and females and also involves the alteration or removal of biologically healthy, and functional body parts:

(A) For biological males, this surgery may involve:

(I) Augmentation mammoplasty;

(II) Facial feminization surgery;

(III) Liposuction;

(IV) Lipofilling;

(V) Voice feminization surgery;

(VI) Thyroid cartilage reduction;

(VII) Gluteal augmentation;

(VIII) Hair reconstruction; and

(IX) Other aesthetic procedures;

(B) For biological females, this surgery may involve:

(I) Subcutaneous mastectomy;

(II) Voice masculinization surgery;

(III) Liposuction;

(IV) Lipofilling;

(V) Pectoral implants; and

(VI) Other aesthetic procedures;

(11) It is an accepted principle of economics and public policy that when a service or product is subsidized or reimbursed, demand for that service or product increases; and

(12) It is of grave concern to this general assembly that the medical community is allowing individuals, who experience distress identifying with their biological sex, to be subjects of irreversible and drastic non-genital gender reassignment surgery and irreversible, permanently sterilizing genital gender reassignment surgeries, despite the lack of studies showing that such extreme interventions have benefits that outweigh their risks or chances of cure. In fact, they may increase the risk of suicide.

SECTION 2. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is hereby amended by adding thereto the following chapter: 23-106-1. Short title. This chapter shall be known and may be cited as the "Rhode Island's Children Deserve Help Not Harm Act". 23-106-2. Definitions. The following definitions apply in the interpretation of the provisions of this chapter:

(1) "Biological sex" means the biological indication of male and female in the context of reproductive potential or capacity, such as sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia, present at birth, including secondary sex characteristics.

(2) "Cross-sex hormones" means:

(i) Testosterone or other androgens given to biological females in amounts that create serum levels greater than would normally occur naturally in healthy biological females, which may include without limitation, the following risks:

(A) Irreversible infertility;

(B) Severe liver dysfunction;

(D) Increased risk of breast, cervical, and uterine cancers;

(E) Cerebrovascular disease, including strokes;

(F) Hypertension;

(G) Erythrocytosis, which is an increase in red blood cells;

(H) Sleep apnea;

(I) Type 2 diabetes;

(J) Loss of bone density; and

(K) Destabilization of psychiatric disorders;

(ii) Estrogen given to biological males, in amounts that create serum levels greater than would normally occur naturally in healthy biological males, which may include without limitation the following risks:

(A) Irreversible infertility;

(B) Thromboembolic disease, including blood clots;

(D) Coronary artery disease, including heart attacks;

(E) Type 2 diabetes;

(F) Breast cancer;

(G) Macroprolactinoma, which is a tumor of the pituitary gland;

(H) Cerebrovascular disease, including strokes; and

(I) Hypertriglyceridemia, which is an elevated level of triglycerides in the blood.

(3) "Gender" means the psychological, behavioral, social and cultural aspects of being male and female.

(4) "Gender reassignment surgery" means any surgical service that seeks to surgically alter or remove healthy physical or anatomical characteristics or features, that are typical for the individual's biological sex, in order to instill or create physiological or anatomical characteristics, that resemble a sex different from the individual's biological sex, including, without limitation, genital or non-genital gender reassignment surgery performed for the purpose of assisting an individual with a gender transition.

(5) "Gender transition" means the process in which a person goes from identifying with and living as a gender that corresponds to their biological sex, and may involve social, legal, or physical changes.

(6) "Gender transition procedures" means any medical or surgical service provided or performed for the purpose of assisting an individual with a physical gender transition:

(i) Gender transition procedures include, without limitation, physician's services, inpatient and outpatient hospital services, puberty-blocking drugs, cross-sex hormones, or genital or non- genital gender reassignment surgery;

(ii) Gender transition procedures do not include:

(A) Services to persons born with a medically verifiable disorder of sex development, including a person with external biological sex characteristics that are irresolvably ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue;

(B) Services provided when a physician has otherwise diagnosed a disorder of sexual development, that the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid production, or sex steroid hormone action;

(C) The acute and chronic treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of gender transition procedures, whether or not the gender transition procedure, was performed in violation of state or federal law or whether or not funding for the gender transition procedure is prohibited pursuant to the provisions of this chapter; or

(D) Any procedure undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function, unless surgery is performed.

(7) "Genital gender reassignment surgery" means a surgical procedure performed for the purpose of assisting an individual with a physical gender transition, including, without limitation:

(i) Surgical procedures such as a penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for biologically male patients; or

(ii) Surgical procedures such as hysterectomy, oophorectomy, reconstruction of the urethra, metoidioplasty or phalloplasty, vaginectomy, scrotoplasty, or implantation of erection and/or testicular protheses for biologically female patients.

(8) "Non-genital gender reassignment surgery" means surgical procedures performed for the purpose of assisting an individual with a physical gender transition, including, without limitation:

(i) Surgical procedures for biologically male patients, such as augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice feminization surgery, thyroid cartilage reduction, gluteal augmentation, hair reconstruction, or various aesthetic procedures; or

(ii) Surgical procedures for biologically female patients, such as subcutaneous mastectomy, voice masculinization surgery, liposuction, lipofilling, pectoral implants, or various aesthetic procedures.

(9) "Physician" means a person who is licensed to practice medicine in this state.

(10) "Puberty-blocking drugs" means gonadotropin-releasing hormone analogues or other synthetic drugs used in biological males to stop luteinizing hormone secretion and therefore testosterone production, or synthetic drugs used in biological females, which stop the production of estrogen and progesterone, when used to delay or suppress pubertal development in children, for the purpose of assisting an individual with a gender transition.

(11) "Public funds" means state or local government monies, in addition to any department, agency, or instrumentality authorized or appropriated under state law or derived from any fund in which monies are deposited. 23-106-3. Gender transition procedures for minors prohibited.

(a) A physician or other healthcare professional shall not provide gender transition procedures to any individual under eighteen (18) years of age.

(b) A healthcare institution or entity shall not facilitate the provision of gender transition procedures to any individual under eighteen (18) years of age. 23-106-4. Insurance coverage for gender transition procedures for minors prohibited.

(a) A health benefit plan under an insurance policy or other plan providing healthcare coverage in this state shall not include reimbursement for gender transition procedures for a person under eighteen (18) years of age.

(b) A health benefit plan under an insurance policy or other plan providing healthcare coverage in this state is not required to provide coverage for gender transition procedures.

(c) A federal health benefit plan under an insurance policy or other plan providing healthcare coverage, such as TRICare or Veterans Administration Healthcare, shall not include reimbursement for gender transition procedures for a person under eighteen (18) years of age in this state. 23-106-5. Prohibition on aiding or abetting.

(a) A person or entity shall not knowingly engage in conduct that aids or abets the performance or inducement of gender transition procedures, to any individual under eighteen (18) years of age, including employees of other state governments, the federal government, or foreign governments.

(b) This provision shall not apply to any first amendment-protected speech.

(c) No parent of a child victim shall be held liable under this section. 23-106-6. Prohibition on use of public funds for gender transition.

(a) Public funds shall not be directly or indirectly used, granted, paid, or distributed to any entity, organization, or individual that provides gender transition procedures to an individual under eighteen (18) years of age.

(b) Healthcare services furnished in the following situations shall not include gender transition procedures to an individual under eighteen (18) years of age:

(1) By or in a facility owned by the state or a local government; or

(2) By a physician or other healthcare professional employed by the state or local government.

(c) An amount paid by an individual or an entity, during a taxable year, for provision of gender transition procedures or as premiums for healthcare coverage, that includes coverage for gender transition procedures, is not tax-deductible.

(d) The state Medicaid program shall not reimburse or provide coverage for gender transition procedures to an individual under eighteen (18) years of age. 23-106-7. Gender transition procedures on minors constitute unprofessional and reckless conduct. Any referral for or provision of gender transition procedures to an individual, under eighteen (18) years of age, is unprofessional conduct and is subject to discipline by the appropriate licensing entity or disciplinary review board, with competent jurisdiction in this state. 23-106-8. Private cause of action. Every person who subjects or causes to be subjected any citizen of this state or other person within the jurisdiction to suffer injury by violating the provisions of this chapter shall be liable to the party injured in an action at law, suit in equity, or other appropriate proceedings for redress in the superior court of this state. The court may award attorney fees and costs to a prevailing plaintiff. 23-106-9. Enforcement actions for recovery of damages suffered as a result of gender transition procedures on minors.

(a) Statute of limitations:

(1) Notwithstanding any other provision of law, an individual under eighteen (18) years of age may bring an action, throughout their minority, through a parent or next friend, and may bring an action in their own name, upon reaching the age of majority at any time from that point until thirty (30) years after reaching the age of majority.

(2) Exceptions:

(i) If at the time the person abused or suffering damages as a result of acts violating the provisions of this chapter, attains the age of eighteen (18) years and is under disability by reason of mental incompetence or under other legal disability, the limitation period under subsection (a)(1) of this section does not begin to run until the removal of the disability; and

(ii) The limitation period in subsection (a)(1) of this section does not run during a time period when the individual is subject to threats, intimidation, manipulation, fraudulent concealment, or fraud perpetrated by the physician or other healthcare professional, who prescribed or otherwise provided gender transition procedures or by any person, acting in the interest of the physician or other healthcare professional.

(b) A person may assert an actual or threatened violation of this chapter, as a claim or defense in a judicial or administrative proceeding.

(1) The following damages may be awarded to the claimant:

(i) Compensatory damages, including, but not limited to:

(A) Pain and suffering;

(B) Loss of reputation;

(D) Loss of consortium, including, but not limited to, the loss of expectation of sharing parenthood;

(ii) Injunctive relief;

(iii) Declaratory relief;

(iv) Punitive damages;

(v) Any other appropriate relief; and

(vi) A prevailing party, who establishes a violation of this chapter shall recover reasonable attorneys' fees and cost.

(c) Notwithstanding any other provision of law, an action under this chapter, may be commenced, and relief may be granted, in a judicial proceeding, without regard to whether the person commencing the action has sought or exhausted available administrative remedies.

(d) The attorney general may bring an action to enforce compliance with this chapter.

(e) This chapter does not deny, impair, or otherwise affect any right or authority of the attorney general, the State of Rhode Island, or any agency, officer, or employee of the state, acting under any law, other than this chapter, to institute or intervene in any proceeding. 23-106-10. Right of intervention. The general assembly, by joint resolution, may appoint one or more of its members who sponsored or cosponsored this chapter in their official capacity, to intervene or defend the chapter as a matter of right, in any case in which the constitutionality or enforceability of this chapter, any portion thereof, or any rule or regulation adopted pursuant hereto, is challenged. 23-106-11. Severability. Any provision of this chapter held to be invalid or unenforceable by its terms, or as applied to any person or circumstance, shall be construed so as to give it the maximum effect, permitted by law, unless such holding, shall be one of utter invalidity or unenforceability, in which event such provision shall be deemed severable herefrom and shall not affect the remainder hereof or the application of such provision to other persons not similarly situated to or to other, dissimilar circumstances. 23-106-12. Effective date. This act shall take effect on January 1, 2027, in order that minors in this state currently using puberty-blocking drugs or cross-sex hormones, shall have the time for appropriate medication tapering and discontinuation, under the care of their physician or other healthcare professional.

SECTION 3. This act shall take effect on January 1, 2027.