1     
MEDICAL PRACTICE AMENDMENTS

2     
2021 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Rex P. Shipp

5     
Senate Sponsor: Curtis S. Bramble

6     

7     LONG TITLE
8     General Description:
9          This bill prohibits a physician or surgeon from performing a transgender procedure on a
10     minor.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     makes it unprofessional conduct to perform a medically unnecessary puberty
15     inhibition procedure or a sex characteristic-altering procedure on a minor; and
16          ▸     makes technical changes.
17     Money Appropriated in this Bill:
18          None
19     Other Special Clauses:
20          None
21     Utah Code Sections Affected:
22     AMENDS:
23          58-67-102, as last amended by Laws of Utah 2017, Chapter 299
24          58-67-502, as last amended by Laws of Utah 2020, Chapter 25
25          58-68-102, as last amended by Laws of Utah 2017, Chapter 299
26          58-68-502, as last amended by Laws of Utah 2020, Chapter 25
27     

28     Be it enacted by the Legislature of the state of Utah:
29          Section 1. Section 58-67-102 is amended to read:
30          58-67-102. Definitions.
31          In addition to the definitions in Section 58-1-102, as used in this chapter:
32          (1) "Ablative procedure" means a procedure that is expected to excise, vaporize,
33     disintegrate, or remove living tissue, including the use of carbon dioxide lasers and erbium:
34     YAG lasers, and excluding hair removal.
35          (2) "ACGME" means the Accreditation Council for Graduate Medical Education of the
36     American Medical Association.
37          (3) "Administrative penalty" means a monetary fine or citation imposed by the division
38     for acts or omissions determined to constitute unprofessional or unlawful conduct, in
39     accordance with a fine schedule established by the division in collaboration with the board, as a
40     result of an adjudicative proceeding conducted in accordance with Title 63G, Chapter 4,
41     Administrative Procedures Act.
42          (4) "Associate physician" means an individual licensed under Section 58-67-302.8.
43          (5) "Attempted sex change" means an attempt or effort to change an individual's body
44     to present that individual as being of a sex or gender that is different from the individual's
45     biological sex at birth.
46          (6) "Biological sex at birth" means an individual's sex, as being male or female,
47     according to distinct reproductive roles as manifested by sex and reproductive organ anatomy,
48     chromosomal makeup, and endogenous hormone profiles.
49          [(5)] (7) "Board" means the Physicians Licensing Board created in Section 58-67-201.
50          [(6)] (8) "Collaborating physician" means an individual licensed under Section
51     58-67-302 who enters into a collaborative practice arrangement with an associate physician.
52          [(7)] (9) "Collaborative practice arrangement" means the arrangement described in
53     Section 58-67-807.
54          [(8)] (10) (a) "Cosmetic medical device" means tissue altering energy based devices
55     that have the potential for altering living tissue and that are used to perform ablative or
56     nonablative procedures, such as American National Standards Institute (ANSI) designated
57     Class IIIb and Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic
58     devices, and excludes ANSI designated Class IIIa and lower powered devices.
59          (b) Notwithstanding Subsection [(8)] (10)(a), if an ANSI designated Class IIIa and
60     lower powered device is being used to perform an ablative procedure, the device is included in
61     the definition of cosmetic medical device under Subsection [(8)] (10)(a).
62          [(9)] (11) "Cosmetic medical procedure":
63          (a) includes the use of cosmetic medical devices to perform ablative or nonablative
64     procedures; and
65          (b) does not include a treatment of the ocular globe such as refractive surgery.
66          [(10)] (12) "Diagnose" means:
67          (a) to examine in any manner another person, parts of a person's body, substances,
68     fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
69     body, to determine the source, nature, kind, or extent of a disease or other physical or mental
70     condition;
71          (b) to attempt to conduct an examination or determination described under Subsection
72     [(10)] (12)(a);
73          (c) to hold oneself out as making or to represent that one is making an examination or
74     determination as described in Subsection [(10)] (12)(a); or
75          (d) to make an examination or determination as described in Subsection [(10)] (12)(a)
76     upon or from information supplied directly or indirectly by another person, whether or not in
77     the presence of the person making or attempting the diagnosis or examination.
78          [(11)] (13) "LCME" means the Liaison Committee on Medical Education of the
79     American Medical Association.
80          [(12)] (14) "Medical assistant" means an unlicensed individual working under the
81     indirect supervision of a licensed physician and surgeon and engaged in specific tasks assigned
82     by the licensed physician and surgeon in accordance with the standards and ethics of the
83     profession.
84          [(13)] (15) "Medically underserved area" means a geographic area in which there is a
85     shortage of primary care health services for residents, as determined by the Department of
86     Health.
87          [(14)] (16) "Medically underserved population" means a specified group of people
88     living in a defined geographic area with a shortage of primary care health services, as
89     determined by the Department of Health.
90          (17) (a) "Medically unnecessary puberty inhibition procedure" means administering or
91     supplying to an individual younger than 18 years old, alone or in combination with aromatase
92     inhibitors:
93          (i) gonadotropin-releasing hormone agonists;
94          (ii) progestins; or
95          (iii) androgen receptor inhibitors.
96          (b) "Medically unnecessary puberty inhibition procedure" does not include
97     administering or supplying a treatment described in Subsection (17)(a) to an individual younger
98     than 18 years old if the treatment is medically necessary as a treatment for:
99          (i) precocious puberty;
100          (ii) idiopathic short stature;
101          (iii) endometriosis; or
102          (iv) a sex hormone-stimulated cancer.
103          [(15)] (18) (a) (i) "Nonablative procedure" means a procedure that is expected or
104     intended to alter living tissue, but is not intended or expected to excise, vaporize, disintegrate,
105     or remove living tissue.
106          (ii) Notwithstanding Subsection [(15)] (18)(a)(i), nonablative procedure includes hair
107     removal.
108          (b) "Nonablative procedure" does not include:
109          (i) a superficial procedure as defined in Section 58-1-102;
110          (ii) the application of permanent make-up; or
111          (iii) the use of photo therapy and lasers for neuromusculoskeletal treatments that are
112     performed by an individual licensed under this title who is acting within the individual's scope
113     of practice.
114          [(16)] (19) "Physician" means both physicians and surgeons licensed under Section
115     58-67-301, Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under
116     Section 58-68-301, Utah Osteopathic Medical Practice Act.
117          [(17)] (20) (a) "Practice of medicine" means:
118          (i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
119     disease, ailment, injury, infirmity, deformity, pain or other condition, physical or mental, real
120     or imaginary, including to perform cosmetic medical procedures, or to attempt to do so, by any
121     means or instrumentality, and by an individual in Utah or outside the state upon or for any
122     human within the state;
123          (ii) when a person not licensed as a physician directs a licensee under this chapter to
124     withhold or alter the health care services that the licensee has ordered;
125          (iii) to maintain an office or place of business for the purpose of doing any of the acts
126     described in Subsection [(17)] (20)(a) whether or not for compensation; or
127          (iv) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
128     treatment of human diseases or conditions in any printed material, stationery, letterhead,
129     envelopes, signs, or advertisements, the designation "doctor," "doctor of medicine,"
130     "physician," "surgeon," "physician and surgeon," "Dr.," "M.D.," or any combination of these
131     designations in any manner which might cause a reasonable person to believe the individual
132     using the designation is a licensed physician and surgeon, and if the party using the designation
133     is not a licensed physician and surgeon, the designation must additionally contain the
134     description of the branch of the healing arts for which the person has a license, provided that an
135     individual who has received an earned degree of doctor of medicine degree but is not a licensed
136     physician and surgeon in Utah may use the designation "M.D." if it is followed by "Not
137     Licensed" or "Not Licensed in Utah" in the same size and style of lettering.
138          (b) The practice of medicine does not include:
139          (i) except for an ablative medical procedure as provided in Subsection [(17)]
140     (20)(b)(ii), the conduct described in Subsection [(17)] (20)(a)(i) that is performed in
141     accordance with a license issued under another chapter of this title;
142          (ii) an ablative cosmetic medical procedure if the scope of practice for the person
143     performing the ablative cosmetic medical procedure includes the authority to operate or
144     perform a surgical procedure; or
145          (iii) conduct under Subsection 58-67-501(2).
146          [(18)] (21) "Prescription device" means an instrument, apparatus, implement, machine,
147     contrivance, implant, in vitro reagent, or other similar or related article, and any component
148     part or accessory, which is required under federal or state law to be prescribed by a practitioner
149     and dispensed by or through a person or entity licensed under this chapter or exempt from
150     licensure under this chapter.
151          [(19)] (22) "Prescription drug" means a drug that is required by federal or state law or
152     rule to be dispensed only by prescription or is restricted to administration only by practitioners.
153          (23) (a) "Sex characteristic-altering procedure" means, for the purpose of effectuating
154     or facilitating an individual's attempted sex change:
155          (i) castration, orchiectomy, penectomy, vaginoplasty, vulvoplasty, breast augmentation
156     surgery, or facial feminization surgery on an individual whose biological sex at birth is male;
157          (ii) mastectomy, hysterectomy, oophorectomy, metoidioplasty, phalloplasty, or chest or
158     facial masculinization procedures on an individual whose biological sex at birth is female;
159          (iii) any surgical procedure that is related to or necessary for a procedure described in
160     Subsection (23)(a)(i) or (ii), that would result in the sterilization of an individual who is
161     non-sterile;
162          (iv) administering or supplying:
163          (A) doses of testosterone or other androgens to an individual whose biological sex at
164     birth is female at levels above those normally found in an individual whose biological sex at
165     birth is female; or
166          (B) doses of estrogens or synthetic compounds with estrogenic activity or effect to an
167     individual whose biological sex at birth is male at levels above those normally found in an
168     individual whose biological sex at birth is male; or
169          (v) removing any otherwise healthy or non-diseased body part or tissue.
170          (b) "Sex characteristic-altering procedure" does not include:
171          (i) surgery or other procedures or treatments performed on an individual who:
172          (A) is born with external biological sex characteristics that are irresolvably ambiguous;
173          (B) is born with 46, XX chromosomes with virilization;
174          (C) is born with 46, XY chromosomes with undervirilization;
175          (D) has both ovarian and testicular tissue; or
176          (E) has been diagnosed by a physician, based on genetic or biochemical testing, with a
177     sex development disorder characterized by abnormal sex chromosome structure, sex steroid
178     hormone production, or sex steroid hormone action for a male or female; or
179          (ii) removing a body part:
180          (A) because it is cancerous or diseased; or
181          (B) for a reason that is medically necessary, other than to effectuate or facilitate an
182     individual's attempted sex change.
183          [(20)] (24) "SPEX" means the Special Purpose Examination of the Federation of State
184     Medical Boards.
185          [(21)] (25) "Unlawful conduct" means the same as that term is defined in Sections
186     58-1-501 and 58-67-501.
187          [(22)] (26) "Unprofessional conduct" means the same as that term is defined in
188     Sections 58-1-501 and 58-67-502, and as may be further defined by division rule.
189          Section 2. Section 58-67-502 is amended to read:
190          58-67-502. Unprofessional conduct.
191          (1) "Unprofessional conduct" includes, in addition to the definition in Section
192     58-1-501:
193          (a) using or employing the services of any individual to assist a licensee in any manner
194     not in accordance with the generally recognized practices, standards, or ethics of the
195     profession, state law, or division rule;
196          (b) making a material misrepresentation regarding the qualifications for licensure under
197     Section 58-67-302.7 or Section 58-67-302.8;
198          (c) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
199     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
200          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act; or
201          (e) falsely making an entry in, or altering, a medical record with the intent to conceal:
202          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
203     or an individual under the direction or control of an individual licensed under this chapter; [or]
204          (ii) conduct described in Subsections (1)(a) through (d) or Subsection 58-1-501(1)[.];
205     or
206          (f) performing, or causing to be performed, a sex characteristic-altering procedure or
207     medically unnecessary puberty inhibition procedure upon an individual who is less than 18
208     years old.
209          (2) "Unprofessional conduct" does not include:
210          (a) in compliance with Section 58-85-103:
211          (i) obtaining an investigational drug or investigational device;
212          (ii) administering the investigational drug to an eligible patient; or
213          (iii) treating an eligible patient with the investigational drug or investigational device;
214     or
215          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
216          (i) when registered as a qualified medical provider, as that term is defined in Section
217     26-61a-102, recommending the use of medical cannabis;
218          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
219     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
220          (iii) when registered as a state central patient portal medical provider, as that term is
221     defined in Section 26-61a-102, providing state central patient portal medical provider services.
222          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
223     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
224     unprofessional conduct for a physician described in Subsection (2)(b).
225          Section 3. Section 58-68-102 is amended to read:
226          58-68-102. Definitions.
227          In addition to the definitions in Section 58-1-102, as used in this chapter:
228          (1) "Ablative procedure" means a procedure that is expected to excise, vaporize,
229     disintegrate, or remove living tissue, including the use of carbon dioxide lasers and erbium:
230     YAG lasers, and excluding hair removal.
231          (2) "ACGME" means the Accreditation Council for Graduate Medical Education of the
232     American Medical Association.
233          (3) "Administrative penalty" means a monetary fine imposed by the division for acts or
234     omissions determined to constitute unprofessional or unlawful conduct, as a result of an
235     adjudicative proceeding conducted in accordance with Title 63G, Chapter 4, Administrative
236     Procedures Act.
237          (4) "AOA" means the American Osteopathic Association.
238          (5) "Associate physician" means an individual licensed under Section 58-68-302.5.
239          (6) "Attempted sex change" means an attempt or effort to change an individual's body
240     to present that individual as being of a sex or gender that is different from the individual's
241     biological sex at birth.
242          (7) "Biological sex at birth" means an individual's sex, as being male or female,
243     according to distinct reproductive roles as manifested by sex and reproductive organ anatomy,
244     chromosomal makeup, and endogenous hormone profiles.
245          [(6)] (8) "Board" means the Osteopathic Physician and Surgeon's Licensing Board
246     created in Section 58-68-201.
247          [(7)] (9) "Collaborating physician" means an individual licensed under Section
248     58-68-302 who enters into a collaborative practice arrangement with an associate physician.
249          [(8)] (10) "Collaborative practice arrangement" means the arrangement described in
250     Section 58-68-807.
251          [(9)] (11) (a) "Cosmetic medical device" means tissue altering energy based devices
252     that have the potential for altering living tissue and that are used to perform ablative or
253     nonablative procedures, such as American National Standards Institute (ANSI) designated
254     Class IIIb and Class IV lasers, intense pulsed light, radio frequency devices, and lipolytic
255     devices and excludes ANSI designated Class IIIa and lower powered devices.
256          (b) Notwithstanding Subsection [(9)] (11)(a), if an ANSI designated Class IIIa and
257     lower powered device is being used to perform an ablative procedure, the device is included in
258     the definition of cosmetic medical device under Subsection [(9)] (11)(a).
259          [(10)] (12) "Cosmetic medical procedure":
260          (a) includes the use of cosmetic medical devices to perform ablative or nonablative
261     procedures; and
262          (b) does not include a treatment of the ocular globe such as refractive surgery.
263          [(11)] (13) "Diagnose" means:
264          (a) to examine in any manner another person, parts of a person's body, substances,
265     fluids, or materials excreted, taken, or removed from a person's body, or produced by a person's
266     body, to determine the source, nature, kind, or extent of a disease or other physical or mental
267     condition;
268          (b) to attempt to conduct an examination or determination described under Subsection
269     [(11)] (13)(a);
270          (c) to hold oneself out as making or to represent that one is making an examination or
271     determination as described in Subsection [(11)] (13)(a); or
272          (d) to make an examination or determination as described in Subsection [(11)] (13)(a)
273     upon or from information supplied directly or indirectly by another person, whether or not in
274     the presence of the person making or attempting the diagnosis or examination.
275          [(12)] (14) "Medical assistant" means an unlicensed individual working under the
276     indirect supervision of a licensed osteopathic physician and surgeon and engaged in specific
277     tasks assigned by the licensed osteopathic physician and surgeon in accordance with the
278     standards and ethics of the profession.
279          [(13)] (15) "Medically underserved area" means a geographic area in which there is a
280     shortage of primary care health services for residents, as determined by the Department of
281     Health.
282          [(14)] (16) "Medically underserved population" means a specified group of people
283     living in a defined geographic area with a shortage of primary care health services, as
284     determined by the Department of Health.
285          (17) (a) "Medically unnecessary puberty inhibition procedure" means administering or
286     supplying to an individual younger than 18 years old, alone or in combination with aromatase
287     inhibitors:
288          (i) gonadotropin-releasing hormone agonists;
289          (ii) progestins; or
290          (iii) androgen receptor inhibitors.
291          (b) "Medically unnecessary puberty inhibition procedure" does not include
292     administering or supplying a treatment described in Subsection (17)(a) to an individual younger
293     than 18 years old if the treatment is medically necessary as a treatment for:
294          (i) precocious puberty;
295          (ii) idiopathic short stature;
296          (iii) endometriosis; or
297          (iv) a sex hormone-stimulated cancer.
298          [(15)] (18) (a) (i) "Nonablative procedure" means a procedure that is expected or
299     intended to alter living tissue, but is not expected or intended to excise, vaporize, disintegrate,
300     or remove living tissue.
301          (ii) Notwithstanding Subsection [(15)] (18)(a)(i), nonablative procedure includes hair
302     removal.
303          (b) "Nonablative procedure" does not include:
304          (i) a superficial procedure as defined in Section 58-1-102;
305          (ii) the application of permanent make-up; or
306          (iii) the use of photo therapy lasers for neuromusculoskeletal treatments that are
307     preformed by an individual licensed under this title who is acting within the individual's scope
308     of practice.
309          [(16)] (19) "Physician" means both physicians and surgeons licensed under Section
310     58-67-301, Utah Medical Practice Act, and osteopathic physicians and surgeons licensed under
311     Section 58-68-301, Utah Osteopathic Medical Practice Act.
312          [(17)] (20) (a) "Practice of osteopathic medicine" means:
313          (i) to diagnose, treat, correct, administer anesthesia, or prescribe for any human
314     disease, ailment, injury, infirmity, deformity, pain, or other condition, physical or mental, real
315     or imaginary, or to attempt to do so, by any means or instrumentality, which in whole or in part
316     is based upon emphasis of the importance of the musculoskeletal system and manipulative
317     therapy in the maintenance and restoration of health, by an individual in Utah or outside of the
318     state upon or for any human within the state;
319          (ii) when a person not licensed as a physician directs a licensee under this chapter to
320     withhold or alter the health care services that the licensee has ordered;
321          (iii) to maintain an office or place of business for the purpose of doing any of the acts
322     described in Subsection [(17)] (20)(a) whether or not for compensation; or
323          (iv) to use, in the conduct of any occupation or profession pertaining to the diagnosis or
324     treatment of human diseases or conditions, in any printed material, stationery, letterhead,
325     envelopes, signs, or advertisements, the designation "doctor," "doctor of osteopathic medicine,"
326     "osteopathic physician," "osteopathic surgeon," "osteopathic physician and surgeon," "Dr.,"
327     "D.O.," or any combination of these designations in any manner which might cause a
328     reasonable person to believe the individual using the designation is a licensed osteopathic
329     physician, and if the party using the designation is not a licensed osteopathic physician, the
330     designation must additionally contain the description of the branch of the healing arts for which
331     the person has a license, provided that an individual who has received an earned degree of
332     doctor of osteopathic medicine but is not a licensed osteopathic physician and surgeon in Utah
333     may use the designation "D.O." if it is followed by "Not Licensed" or "Not Licensed in Utah"
334     in the same size and style of lettering.
335          (b) The practice of osteopathic medicine does not include:
336          (i) except for an ablative medical procedure as provided in Subsection [(17)]
337     (20)(b)(ii), the conduct described in Subsection [(17)] (20)(a)(i) that is performed in
338     accordance with a license issued under another chapter of this title;
339          (ii) an ablative cosmetic medical procedure if the scope of practice for the person
340     performing the ablative cosmetic medical procedure includes the authority to operate or
341     perform a surgical procedure; or
342          (iii) conduct under Subsection 58-68-501(2).
343          [(18)] (21) "Prescription device" means an instrument, apparatus, implement, machine,
344     contrivance, implant, in vitro reagent, or other similar or related article, and any component
345     part or accessory, which is required under federal or state law to be prescribed by a practitioner
346     and dispensed by or through a person or entity licensed under this chapter or exempt from
347     licensure under this chapter.
348          [(19)] (22) "Prescription drug" means a drug that is required by federal or state law or
349     rule to be dispensed only by prescription or is restricted to administration only by practitioners.
350          (23) (a) "Sex characteristic-altering procedure" means, for the purpose of effectuating
351     or facilitating an individual's attempted sex change:
352          (i) castration, orchiectomy, penectomy, vaginoplasty, vulvoplasty, breast augmentation
353     surgery, or facial feminization surgery on an individual whose biological sex at birth is male;
354          (ii) mastectomy, hysterectomy, oophorectomy, metoidioplasty, phalloplasty, or chest or
355     facial masculinization procedures on an individual whose biological sex at birth is female;
356          (iii) any surgical procedure that is related to or necessary for a procedure described in
357     Subsection (23)(a)(i) or (ii), that would result in the sterilization of an individual who is
358     non-sterile;
359          (iv) administering or supplying:
360          (A) doses of testosterone or other androgens to an individual whose biological sex at
361     birth is female at levels above those normally found in an individual whose biological sex at
362     birth is female; or
363          (B) doses of estrogens or synthetic compounds with estrogenic activity or effect to an
364     individual whose biological sex at birth is male at levels above those normally found in an
365     individual whose biological sex at birth is male; or
366          (v) removing any otherwise healthy or non-diseased body part or tissue.
367          (b) "Sex characteristic-altering procedure" does not include:
368          (i) surgery or other procedures or treatments performed on an individual who:
369          (A) is born with external biological sex characteristics that are irresolvably ambiguous;
370          (B) is born with 46, XX chromosomes with virilization;
371          (C) is born with 46, XY chromosomes with undervirilization;
372          (D) has both ovarian and testicular tissue; or
373          (E) has been diagnosed by a physician, based on genetic or biochemical testing, with a
374     sex development disorder characterized by abnormal sex chromosome structure, sex steroid
375     hormone production, or sex steroid hormone action for a male or female; or
376          (ii) removing a body part:
377          (A) because it is cancerous or diseased; or
378          (B) for a reason that is medically necessary, other than to effectuate or facilitate an
379     individual's attempted sex change.
380          [(20)] (24) "SPEX" means the Special Purpose Examination of the Federation of State
381     Medical Boards.
382          [(21)] (25) "Unlawful conduct" means the same as that term is defined in Sections
383     58-1-501 and 58-68-501.
384          [(22)] (26) "Unprofessional conduct" means the same as that term is defined in
385     Sections 58-1-501 and 58-68-502 and as may be further defined by division rule.
386          Section 4. Section 58-68-502 is amended to read:
387          58-68-502. Unprofessional conduct.
388          (1) "Unprofessional conduct" includes, in addition to the definition in Section
389     58-1-501:
390          (a) using or employing the services of any individual to assist a licensee in any manner
391     not in accordance with the generally recognized practices, standards, or ethics of the
392     profession, state law, or division rule;
393          (b) violating the dispensing requirements of Chapter 17b, Part 8, Dispensing Medical
394     Practitioner and Dispensing Medical Practitioner Clinic Pharmacy, if applicable;
395          (c) making a material misrepresentation regarding the qualifications for licensure under
396     Section 58-68-302.5;
397          (d) violating the requirements of Title 26, Chapter 61a, Utah Medical Cannabis Act;
398     [or]
399          (e) falsely making an entry in, or altering, a medical record with the intent to conceal:
400          (i) a wrongful or negligent act or omission of an individual licensed under this chapter
401     or an individual under the direction or control of an individual licensed under this chapter; or
402          (ii) conduct described in Subsections (1)(a) through (d) or Subsection 58-1-501(1)[.];
403     or
404          (f) performing, or causing to be performed, a sex characteristic-altering procedure or
405     medically unnecessary puberty inhibition procedure upon an individual who is younger than 18
406     years old.
407          (2) "Unprofessional conduct" does not include:
408          (a) in compliance with Section 58-85-103:
409          (i) obtaining an investigational drug or investigational device;
410          (ii) administering the investigational drug to an eligible patient; or
411          (iii) treating an eligible patient with the investigational drug or investigational device;
412     or
413          (b) in accordance with Title 26, Chapter 61a, Utah Medical Cannabis Act:
414          (i) when registered as a qualified medical provider, as that term is defined in Section
415     26-61a-102, recommending the use of medical cannabis;
416          (ii) when registered as a pharmacy medical provider, as that term is defined in Section
417     26-61a-102, providing pharmacy medical provider services in a medical cannabis pharmacy; or
418          (iii) when registered as a state central patient portal medical provider, as that term is
419     defined in Section 26-61a-102, providing state central patient portal medical provider services.
420          (3) Notwithstanding Subsection (2)(b), the division, in consultation with the board and
421     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, shall define
422     unprofessional conduct for a physician described in Subsection (2)(b).