A pair of Republicans has filed legislation to ban sex change therapy for children, to require three doctors' approval for teens to receive any such treatment, and to put criminal penalties in place.

The bill, filed by Rep. John Ragan, R-Oak Ridge, and Sen. Janice Bowling, R-Tullahoma, would charge parents and medical providers with child abuse for taking part in the treatment process.

House Bill 2576 defines "sexual identity change therapy" as treatment involving hormone replacement, puberty blockers "or other medical intervention to change the sexual identity or physical appearance of a patient" to one that "does not correspond to the anatomy and chromosomal makeup with which the patient was born."

"Any prepubescent child, especially one who isn’t old enough to cross the street by themselves, is probably not old enough to decide they want to change their sex," Ragan said of the legislation.

It's the first time he has filed a bill banning children from receiving sex change hormone therapy. Per the legislation, it's unclear whether medically necessary treatments for intersex children would be included.

Ragan said was inspired to bring the legislation after hearing from a constituent who was concerned about a recent court case in Texas in which divorced parents disagreed over whether their 7-year-old child should receive puberty-blocking hormones.

He said he has not heard of any such case in Tennessee, but wanted to be proactive.

Adults could be charged with child abuse

In addition to prohibiting children who have not reached puberty from being able to receive sex change treatments, his legislation would require that minors who have reached puberty receive written parental consent and a recommendation from three doctors, including a psychiatrist.

An adult helping the child receive such a treatment outside of those requirements could be charged with child abuse, and a physician be subject to discipline for professional misconduct by his or her medical board.

South Dakota's House of Representatives, which like Tennessee is Republican controlled, last week passed the "Vulnerable Child Protection Act." That legislation would ban sex change therapy for children under 16.

Ragan said he was not aware of any Tennessee state laws currently regulating hormone therapy for children.

"I typically do a lot of my own legal research," Ragan said. "I did not find one already on the books in that respect."

Vanderbilt currently requires mental health provider's recommendation

Vanderbilt Children's Hospital's transgender clinic, which provides treatments for transgender children and teens, has specified a set of requirements in order to begin receiving services.

"Before we begin such treatments as pubertal blocking or gender-affirming therapy, we require a letter from a mental health provider and informed consent," the hospital states on its website. "Treatment will be tailored to the child's specific needs and will depend on age, stage of puberty and desire for future treatments."

Vanderbilt notes that doctors "take into account your child’s support system and other health challenges."

Through a Senate Republican spokesperson, Bowling referred questions about the bill to Ragan.

Bill is not the first this year pertaining to transgender youth

Chris Sanders, executive director of the pro-LGBTQ rights Tennessee Equality Project, said the organization will fight against the legislation.

"They're going to pit parents and physicians and counselors against these children whenever the law becomes involved and penalties become involved," Sanders said.

"I think what you'll see is that the number of trans and gender nonconforming youth who self-harm and attempt to take their lives will increase if this bill becomes law."

Ragan and Bowling's bills have not yet received a committee assignment.

Other lawmakers this year have filed two other bills limiting transgender youth's participation in school sports and penalizing schools found to be in violation.

Reach Natalie Allison at nallison@tennessean.com. Follow her on Twitter at @natalie_allison.

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