The Pediatric Secretive Transitions Parental Rights Act, soon to be codified at Idaho Code section 32-1016, takes effect on July 1, 2026. This law materially changes how therapists, schools and other health care professionals may provide gender transition-related care to minors in Idaho.
Idaho law will now require certain disclosures to a minor’s parents by entities covered under the law whenever a minor expresses interest in “sex transition procedures” or a “social transition.” Consequently, Idaho providers—especially mental health providers—should familiarize themselves with the new disclosure requirements and prepare to implement new policies, as well as update workflows and documentation in anticipation of the law’s implementation.
Background
The statute imposes new requirements for covered entities in their interactions with minors. A “covered entity” is defined under the statute as a “primary or secondary educational institution, a child care provider, or a medical, behavioral, or mental health care provider.” “Child” is also defined as an individual under eighteen (18) and not married or “legally emancipated.”
The law addresses two separate categories of transition-related activities of minors, “sex transition procedures” and “social transition” as defined by statute.
- A sex transition procedure is defined as a practice prohibited by Idaho Code section 18-1506C which prohibits performing gender transition related surgeries on minors, including those involving sterilization, genital mutilation or reconstruction, mastectomies, removing tissue, or administering puberty-blocker medications or other medications that induce changes in a minor’s genitalia.
- A social transition is defined more amorphously as “the process by which an individual goes from identifying with and living as a gender that corresponds to the individual’s sex to identifying with and living as a gender different from the individual’s sex and may involve social, legal, or physical changes, including adopting a name, pronouns, appearance, or dress that does not correspond to the individual’s sex.”
The operative clauses in the statute now require that a covered entity:
(1) “shall not withhold information from a child’s parent or guardian related to the parent’s child’s expressed interest in or desire for sex transition procedures[;]”
(2) “shall notify a minor student’s parent within seventy-two (72) hours of receiving any request by the minor student to participate in or facilitate the social transition of the minor student, including[;]”
(a) referring to the minor by pronouns not corresponding with the minor’s biological sex;
(b) referring to the minor by names other than the minor’s legal name, nickname, or a derivative;
(c) use restrooms, locker rooms, changing rooms, or overnight lodging for the opposite sex; or
(d) participate in an athletic team or any other sex-separated school activities designated for the opposite sex [and],
(3) shall not aid or abet “a child’s efforts to socially transition” without parental consent or efforts “to obtain sex transition procedures” regardless of parental consent. (Emphasis added).
Providers should note, in particular, that they have an affirmative duty to report a minor patient’s request to socially transition. This is an unusual mandate that should not be ignored. We are aware that some mental health providers are presumptively cautioning clients that if this topic is raised, it will have to be disclosed.
In short, the statute applies broadly to a wide range of “covered entities,” from schools to therapists, and now requires affirmative disclosures to a minor’s parents for activities regarding a social transition. Importantly, the statute permits the attorney general to investigate allegations under this section—as well as private actors—with civil penalties of up to $100,000 for a violation.
HIPAA Considerations
Overlaying this law, and further complicating compliance, are the federal HIPAA requirements. Generally, HIPAA preempts contrary state law unless an applicable exception applies. The listed exceptions are unlikely to apply, so HIPAA likely preempts Idaho law under these circumstances. HIPAA does typically permit a provider to disclose health information to a minor’s parent or personal representative when those records are requested, especially when a state’s law requires it, but there is a key exception to this rule.
Notably, a provider may decline to treat a parent or other person as the minor’s personal representative (and therefore may decline to disclose the minor’s confidential health information) if, in the provider’s reasonable professional judgment, doing so is in the minor’s best interest because the minor has been subjected to domestic violence, abuse or neglect by such person.
In practice, this exception should be used cautiously given the statute’s disclosure requirements. In some cases, a determination that a minor is subjected to abuse or neglect may be clear cut, but that may not always be the case. Accordingly, providers should maintain clear guidelines and policies to document such encounters to reduce liability when such disclosures are withheld pursuant to HIPAA.
Key Takeaways
The new law is not a beacon of clarity with respect to the type of conduct that may or may not be subject to disclosure. Although “sex transition procedure” is more clearly defined with reference to a detailed list of procedures, the definition of “social transition,” however, is less precise. As a result, there may be circumstances where a minor’s conduct or request could be viewed as a social transition, but whether such conduct or request falls within the statute’s disclosure requirements may be open to interpretation.
For example, suppose that in a therapy session with a minor female, she tells her therapist that she is thinking about cutting her hair short (like a male typically would) because she likes the look. Suppose further that the same minor is also considering wearing clothing more commonly worn by minor males even though she typically wears clothing more commonly worn by minor females. Is this a scenario in which the therapist must affirmatively disclose and receive written consent before providing any professional advice or otherwise encourage her to go through with those changes?
Notably absent from the foregoing example is any indication from the minor that she intends to transition but instead presents certain questions to her therapist regarding adopting an “appearance” or “dress” that may not typically correspond to the individual’s sex. It is unclear whether this type of discussion or request would trigger the disclosure requirements within the statute. This ambiguity creates risk because if the provider concludes incorrectly and does not obtain written consent from the minor’s parents, then it may result in a civil lawsuit from the minor’s parents or the attorney general.
Accordingly, providers must be prepared to address the compliance issues this law is likely to create. Providers should update and maintain clear written policies, including documentation standards for disclosures, consent and related clinical communications. Additionally, providers should also consider implementing either a standardized blanket consent form that complies Idaho’s requirements or otherwise adopting a consistent process for obtaining written parental consent before engaging in discussions implicated by the statute. These new policies and procedures must be implemented for current patients as well as any future patients. Lastly, providers should be prepared to identify, document and adequately support any decision to withhold information under HIPAA when there is a circumstance in which it may be in the minor patient’s best interest to do so.
This law is new, so additional guidance may emerge from litigation, licensing boards or the attorney general. Providers should monitor any developments to ensure they are maintaining compliance while also serving their patients’ best interests.
Parsons Behle & Latimer attorneys can assist your practice in maintaining compliance with Idaho law and developing policies and procedures to address the requirements with the new law.
