Bill
HB 4190
The bill would ban new gender-affirming care for minors in Michigan, including surgeries, hormones, and puberty blockers, with a limited exception for ongoing cases.
Status and context
- Bill: HB 4190 — proposes to amend Michigan’s Public Health Code (1978 PA 368; MCL 333.1101–333.25211) by adding sections 17019 and 17519.
- Action: Introduced in early March 2025; read a first time and referred to the House Committee on Health Policy. Primary sponsor listed as Rep. Martin McLaughlin (other filings show Rep. Jason Woolford as introducer). As of the documents provided, the bill has not been enacted.
- Note: the package of materials included an unrelated Illinois income-tax bill text (conflicting HB 4190 content). This summary focuses only on the Michigan Public Health Code provisions pertaining to minors’ gender-related medical care.
Purpose and intent
- To prohibit physicians in Michigan from performing gender reassignment surgery on minors or prescribing cross‑sex hormones or puberty‑blocking drugs to minors for the purpose of gender transition, with a narrow limited continuation exception for ongoing treatments started before the law’s effective date.
Key provisions
- Prohibitions (Sec. 17019(1)):
- A physician shall not knowingly:
- Perform gender reassignment surgery on a minor.
- Prescribe a cross‑sex hormone or a puberty‑blocking drug to a minor with the intent to assist gender transition.
- Limited continuation exception (Sec. 17019(2)):
- A physician may continue prescribing such drugs for a minor only if:
- The minor has been a resident of Michigan since the law’s effective date; and
- The physician initiated the course of treatment that included the prohibited prescription before the law’s effective date; and
- The physician documents in the minor’s medical record that stopping the prescription would cause harm to the minor.
- Compliance requirement (Sec. 17519):
- States simply that a physician shall comply with Section 17019.
- Definitions (provided in the bill):
- “Biological sex,” “cross‑sex hormone” (testosterone, estrogen, progesterone above endogenous levels for the minor’s sex/age), “gender reassignment surgery” (includes genital and nongenital procedures), “genital gender reassignment surgery” (includes sterilizing procedures and construction of genitalia), “nongenital gender reassignment surgery” (e.g., augmentation mammoplasty, facial feminization, voice surgery, etc.), “gender transition,” and “puberty‑blocking drug” (e.g., GnRH analogs, antiandrogens).
Who is affected
- Directly: physicians and other prescribing clinicians who provide gender-affirming surgeries, hormones, or puberty blockers to persons under 18; minors receiving or seeking such care; parents/guardians and clinics providing pediatric gender‑related care.
- Indirectly: hospitals and health systems, insurers (coverage/utilization), and mental-health providers involved in multidisciplinary care.
Procedural/timeline aspects and uncertainties
- The bill text does not specify an explicit effective date clause within the provided excerpt; the continuation exception references “the effective date of the amendatory act that added this section.” The bill was in committee at the time of the latest actions.
- The bill requires physician compliance but does not specify criminal penalties, civil remedies, licensing sanctions, or enforcement mechanisms in the supplied text.
- The continuation exception applies only to minors who were residents at the law’s effective date and whose treatment began before that date.
Potential impacts (summary)
- Would ban new gender‑affirming medical interventions (surgeries, hormones, puberty blockers) for minors in Michigan, with a narrow grandfathering path for certain ongoing prescriptions. This could lead to changes in clinical practice, possible discontinuation or transfer of care for minors starting treatment after the effective date, and legal/administrative questions about enforcement, professional discipline, and coordination with federal law and insurer policies.
Sponsor & referral
- Primary sponsor: Rep. Martin McLaughlin (materials also show Rep. Jason Woolford as introducer).
- Referred to: House Committee on Health Policy.
Compiled from official sources — confirm details with the bill’s official record.
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