Senate Bill 164, sponsored by Sen. John Fuller, R-Kalispell, cleared an initial hurdle in the Republican-controlled chamber Monday afternoon by a 30-20 vote, with two Republicans joining Democrats in opposition.
The bill would expand Montana’s criminal child endangerment statute to include penalties for any adult who “knowingly procures or provides” puberty blockers, hormone therapies or surgeries to minors under 16 years old for the purpose of aligning the youth’s appearance with their gender identity if it is not the same as their “biological sex,” a term that the legislation does not define.
A bill Fuller sponsored in 2023 to bar medical practitioners from providing similar treatments for gender dysphoria with the threat of fines and license penalties was temporarily blocked in September of that year in state district court in Missoula.
The Montana Supreme Court upheld that preliminary injunction last December, finding that the law appears to violate Montana’s constitutional privacy rights and prohibit “individualized care tailored to the needs of each patient based on the exercise of professional medical judgment and informed consent.” Litigation at the district court level is set to continue this year.
Fuller appealed to his colleagues for their support for the new legislation during a debate on the Senate floor Monday, calling SB 164 “very simple” and a protection against child abuse.
“Gender dysphoria is real. Children that suffer from this are real. And they need to be taken care of with care and compassion,” Fuller said, advocating for mental health counseling rather than medical treatments.
Democrats pushed back against the idea that the medical treatments listed in the bill constituted child abuse, calling the legislation “harmful” and an example of “government overreach.”
Opponents, including some Republicans, also questioned the legislation’s implications, such as the price tag that could come from prosecuting and imprisoning parents and a possible expansion of the state’s foster care caseload. The bill has not received a fiscal note from Republican Gov. Greg Gianforte’s Office of Budget and Program Planning.
Fuller countered that prosecutors have discretion about what penalties to recommend when someone violates the law. Other bill supporters suggested that the threat of a felony alone would deter parents from accessing medical treatments for their child, avoiding much cost to state and local law enforcement systems.
Sen. Wendy McKamey, R-Great Falls, was the only member of her party to explicitly speak against the bill.
“Folks, what I’m hearing here is that, in spite of the fact it doesn’t say specifically, it does sound like we’re going to be creating some felons out of some parents,” she said. “This is not something I would be doing for my children, but it is something that someone else is trying to — they’re trying to find answers for their children … They’re just trying to get help.”
Opponents of the current proposal outnumbered supporters during the bill’s hearing before the Senate Judiciary Committee in late January.
Trans Montanans testified to the importance of available treatments for gender dysphoria and their positive effect on depression and suicidality rates among youth. Doctors and representatives of major medical organizations said that surgeries for minors diagnosed with gender dysphoria in Montana are very rare and that more common treatments of puberty blockers and estrogen or testosterone therapies are only considered after thoughtful deliberation with families and patients.
But Republicans, during the committee’s vote last week and Monday’s floor debate, have continuously framed the treatments as dangerous and damaging. Fuller at times objected to the use of the word “treatment” to describe the medical protocols.
In documents and email correspondence associated with drafting SB 164, commonly referred to as the bill’s “junque file,” Fuller told his assigned legislative attorney that the criminal aspect of the legislation was meant to respond to the Montana Supreme Court decision about the 2023 law restricting similar medical care. Among other points, justices noted that the treatments the Legislature was attempting to bar medical providers from administering were not illegal under Montana law.
But Fuller told the bill drafter that SB 164 should restrain the actions of a much broader category of adults, including school teachers and counselors. His previous measure from 2023 only applies to medical providers.
“This would hold accountable under criminal statutes any and all complicit to include parents, those having knowledge of such actions (to include teachers, counselors and any/all medical practitioners),” Fuller wrote.
School associations and educator groups — who are not specifically named in the bill text — were notably absent from the bill’s first committee hearing, as were parents of trans youth. Some SB 164 opponents read letters or spoke on behalf of parents and guardians, testifying that they did not appear out of a fear of future prosecution.
The legislation must pass another vote by the full Senate before being transmitted to the House.