In this chapter:
I. "Ambiguous genitalia" means a malformation in which a person is not born with clearly male or clearly female external genitalia.
II. "Disorders of sex development" includes:
(a)Forty-six XX chromosomes with or without virilization;
(b)Presence of both ovarian and testicular tissue;
(c)Other abnormal sex chromosome structure;
(d)Abnormal sex steroid hormone production or action; or
(e)Ambiguous genitalia.
III. "Female genitalia" means:
(a)Internal female genitalia which are the ovaries, Fallopian tubes, uterus, cervix and vagina; and
(b)External female genitalia which are the labia minora and majora, also known as the vulva, and the clitoris.
[Paragraph III-a effective January 1, 2026.]
III-a. "Gender surgery" includes genital gender reassignment surgery, transgen
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In this chapter:
I. "Ambiguous genitalia" means a malformation in which a person is not born with clearly male or clearly female external genitalia.
II. "Disorders of sex development" includes:
(a) Forty-six XX chromosomes with or without virilization;
(b) Presence of both ovarian and testicular tissue;
(c) Other abnormal sex chromosome structure;
(d) Abnormal sex steroid hormone production or action; or
(e) Ambiguous genitalia.
III. "Female genitalia" means:
(a) Internal female genitalia which are the ovaries, Fallopian tubes, uterus, cervix and vagina; and
(b) External female genitalia which are the labia minora and majora, also known as the vulva, and the clitoris.
[Paragraph III-a effective January 1, 2026.]
III-a. "Gender surgery" includes genital gender reassignment surgery, transgender chest surgery as defined in RSA 329:52, VI, facial feminization or masculinization surgery, and/or removal of the reproductive organs for the purposes of gender identity including hysterectomy, oophorectomy, salpingo-oophorectomy, and/or orchiectomy.
IV. "Genital" and "genitalia" means the male or female reproductive organs, in singular and plural form.
V. "Genital gender reassignment surgery" means surgical procedures in people born without disorders of sex development including but not limited to metoidioplasty, phalloplasty, or vaginoplasty which seek to change genitalia:
(a) From male genitalia to female genitalia;
(b) From female genitalia to male genitalia;
(c) To form a combination of male and female genitalia or absence of genitalia in those born with exclusively male or exclusively female genitalia; or
(d) By removing non-malignant genitalia.
VI. "Male circumcision" means surgery which removes all or a portion of the foreskin covering the glans of the penis, performed for religious, cultural or health reasons.
VII. "Male genitalia" means:
(a) Internal male genitalia which are the testes, epididymis, and vas deferens; and
(b) External male genitalia which are the penis and scrotum.
VIII. "Malignant" means cancerous or otherwise dangerous to the physical health of the person including physiology compromised by infection, lack of blood flow, or physical injury.
IX. "Malformation" means a structural defect in the body due to abnormal embryonic or fetal development.
X. "Metoidioplasty" means a surgery to transform the clitoris into a penis.
XI. "Minor" means a person who has not reached the age of majority.
XII. "Phalloplasty" means the surgical construction of a penis from other parts of the body.
XIII. "Physician" means a person who is licensed to practice medicine in this state under RSA 329.
XIV. "Reconstructive surgery" means surgery to restore normal form and function of tissue after it has been compromised by malformation, infection, trauma, cancer or other physical pathologies.
XV. "Vaginoplasty" means the surgical creation of a vagina from other parts of the body and includes but is not limited to:
(a) Penile inversion vaginoplasty, which is a first-line "gold standard" approach for those with sufficient penile tissue.
(b) Peritoneal vaginoplasty, which is an emerging surgical approach using the membrane that lines the abdominopelvic cavity and surrounds the abdominal organs, for people with insufficient penile tissue including those with a history of puberty blocking medications.
(c) Rectosigmoid vaginoplasty, which uses a section of the sigmoid colon to create the vaginal lining, providing an option for those without sufficient penile tissue or as a revision for failed vaginoplasty.