ALBANY, N.Y. (NEXSTAR) The New York State Assembly joined the Senate to pass a bill that would expand legal protections for those seeking or providing abortions or gender-affirming care. The Shield Law 2.0 measure, blocking legal actions from other states, now heads to Governor Kathy Hochul’s desk for her signature.

Supporters of S4914B/A5480C say it closes loopholes to make the state a safe haven for anyone who needs reproductive health care or gender-affirming care. That includes medical treatment, surgical procedures, or counseling related to their reproductive system or medical care related to someone’s gender identity.

Kei Williams, Executive Director of the LGBTQIA+ advocacy group NEW Pride Agenda, said, “We are proud to see New York continue its commitment to affirming the dignity, rights, and humanity of trans people.” Williams added that the bill “sends a clear message: gender-affirming care is essential healthcare, and it will be protected here.”

Nose job, jaw implant can be form of gender-affirming care

While often discussed in the context of transgender people, “gender-affirming care” is a broader term. Non-trans examples of gender-affirming care already include plastic surgery like breast reductions for men with gynecomastia, breast reconstruction after a mastectomy for breast cancer, penile implants after testicular cancer, hormone replacement therapy for menopause, or hair removal or transplants. In some cases, even a nose job or jaw implant could be a form of gender-affirming care.

The bill defines “gender-affirming care” as “any type of care provided to an individual to affirm their gender identity or gender expression, including but not limited to care an individual provides to themself.” It’s supposed to help someone feel more comfortable and authentic in their own bodies and how they present themselves in society, regardless of gender identity.

The bill requires affirmation for any subpoenas coming into New York from other states that ask for information about legally protected health activity. It defines “legally protected health activity” as actions by patients, health care providers, and those who help them, if these actions follow New York state law. And it defines an “out-of-state subpoena” as a legal document from a court in another state asking for information or testimony.

Bill expands legal protections for doctors, nurses

The affirmation is a sworn statement, under penalty of perjury, that the subpoena won’t penalize someone over a protected health activity. If not, it has to articulate an exception, like a lawsuit brought by the patient themselves for a tort or contract issue. Anyone with a false affirmation could face a $15,000 fine for each violation, and the New York State Attorney General can pursue them legally.

The bill also expands legal protections for doctors, nurses, therapists, and pharmacists. They’d be able to avoid professional misconduct charges or losing their license over a legally protected health activity, even if their patient lives in another state where such care is illegal.

Attorneys following New York’s laws would similarly escape prosecution for advising their clients on reproductive health care or gender-affirming care. Malpractice and liability insurers also wouldn’t be able to move against health care providers for engaging in a protected health activity.

Bill changes the ability to give out-of-state investigations information

The law further limits what information about protected health activities can be shared with other states. New York businesses and government employees wouldn’t be able to cooperate with out-of-state investigations trying to penalize legally protected health activity.

Under the shield, a New York entity that asks for such information has to notify the Attorney General within 72 hours and try to notify the affected patients at least 30 days before sharing any information. The attorney general’s office could also sue to stop sharing such information, and companies that comply with such an illegal request could be fined $15,000 per violation.

The law also could represent a shield against extradition. Under the legislation, the governor wouldn’t approve requests from other states to arrest and transfer a person for providing or receiving a legally protected health activity, except if they were physically present in the other state during the alleged crime.

Bill protects parents of children who undergo protected health activity

For families, the bill would prevent courts from removing a child from their parent or guardian—or from considering it abuse or neglect—when the child undergoes a protected health activity. The bill also makes it clear that New York law applies in any case around legally protected health activities heard in New York, regardless of other state law.

The bill was sponsored by State Senator Brad Hoylman-Sigal and Assemblymember Harry Bronson. Hoylman-Sigal previously stated New York must “stand firm against the federal onslaught of hatred” aimed at transgender youth. Opponents of the bill have argued that other states have a right to enforce their own laws and that the types of care outlined in the bill shouldn’t be protected.