Sec. 101. Prohibiting taxpayer-funded gender transition procedures
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/bill/118/hr/3329/ih/section-101A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Title 1, United States Code, is amended by adding at the end the following new chapter: 301. Prohibition on funding for gender transition procedures. 302. Prohibition on funding for health benefits plans that cover gender transition procedures. 303. Limitation on Federal facilities and employees. 304. Construction relating to separate coverage. 305. Construction relating to the use of non-Federal funds for health coverage. 306. Construction relating to complications arising from gender transition procedures. 307.
Definitions. No funds authorized or appropriated by Federal law, and none of the funds in any trust fund to which funds are authorized or appropriated by Federal law, shall be expended for any gender transition procedures. No funds authorized or appropriated by Federal law, and none of the funds in any trust fund to which funds are authorized or appropriated by Federal law, shall be expended for health benefits coverage that includes coverage of gender transition procedures. No health care service furnished— by or in a health care facility owned or operated by the Federal Government; or by any physician or other individual employed by the Federal Government to provide health care services within the scope of the physician’s or individual’s employment, may include gender transition procedures.
Nothing in this chapter shall be construed as prohibiting any individual, entity, State, or locality from purchasing separate coverage for gender transition procedures or health benefits coverage that include gender transition procedures so long as such coverage is paid for entirely with funds not authorized or appropriated by Federal law, and such coverage shall not be purchased using matching funds required for a federally subsidized program, including a State or locality’s contribution of Medicaid matching funds.
Nothing in this chapter shall be construed as restricting the ability of any non-Federal health benefits coverage provider from offering coverage for gender transition procedures, or the ability of a State or locality to contract separately with such a provider for such coverage, so long as only funds not authorized or appropriated by Federal law are used, and such coverage shall not be purchased using matching funds required for a federally subsidized program, including a State or locality’s contribution of Medicaid matching funds.
Nothing in this chapter shall be construed to apply to the treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of a gender transition procedure. For purposes of this chapter: The term biological sex means the biological indication of male or female in the context of reproductive potential or capacity, such as sex chromosomes, naturally occurring sex hormones, gonads, and non-ambiguous internal and external genitalia present at birth, without regard to an individual’s psychological, chosen, or subjective experience of gender.
The term cross-sex hormones means— testosterone or other androgens given to biological females at doses that are profoundly larger or more potent than would naturally occur in healthy biological females; or estrogen given to biological males at doses that are profoundly larger or more potent than would naturally occur in healthy biological males. The term gender means the psychological, behavioral, social, and cultural aspects of being male or female. The term gender transition means the process in which a person goes from identifying with and living as a gender that corresponds to his or her biological sex to identifying with and living as a gender different from his or her biological sex, and may involve social, legal, or physical changes.
The term gender transition procedure means any medical or surgical service, including physician’s services, inpatient and outpatient hospital services, or prescribed drugs related to gender transition, that seek to alter or remove physical or anatomical characteristics or features that are typical for an individual’s biological sex, or to instill or create physiological or anatomical characteristics that resemble a sex different from an individual’s birth sex, including, without limitation, medical services that provide puberty-blocking drugs, cross-sex hormones, or other mechanisms to promote the development of feminizing or masculinizing features (in the opposite sex), or genital gender transition surgery or nongenital gender transition surgery performed for the purpose of assisting an individual with a gender transition.
The term gender transition procedure does not include— services to those born with a medically-verifiable disorder of sex development, including a person with external biological sex characteristics that are irresolvably ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue; or services provided when a physician has otherwise diagnosed a disorder of sexual development, in which such physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a biological male or biological female; or the treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of a gender transition procedure, whether or not such procedure was performed in accordance with State or Federal law, or whether funding for such procedure was permissible under this chapter.
The term gender transition surgery means any medical or surgical service that seeks to surgically alter or remove healthy physical or anatomical characteristics or features that are typical for an individual’s biological sex in order to instill or create physiological or anatomical characteristics that resemble a sex different from an individual’s birth sex, including, without limitation, genital gender reassignment surgery or non-genital gender reassignment surgery performed for the purpose of assisting an individual with a gender transition.
Gender transition surgery does not include any procedure undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed. The term genital gender transition surgery includes surgical procedures such as penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for biologically male patients, or hysterectomy/ovariectomy, reconstruction of the fixed part of the urethra with or without a metoidioplasty or a phalloplasty, vaginectomy, scrotoplasty, or implantation of erection or testicular prostheses for biologically female patients when performed for the purpose of assisting an individual with a gender transition.
The term non-genital gender transition surgery means surgical procedures including augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation (implants or lipofilling), hair reconstruction, or other aesthetic procedures for biologically male patients or subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants, or other aesthetic procedures for biologically female patients, when performed for the purpose of assisting an individual with a gender transition.
The term puberty-blocking drugs means— Gonadotropin-releasing hormone
(GnRH)analogues or other synthetic drugs used in biological males to stop luteinizing hormone secretion and therefore testosterone secretion; synthetic drugs used in biological females that stop the production of estrogen; and progesterone when used to delay or suppress pubertal development in children for the purpose of assisting an individual with a gender transition. .