Text of US HB 2387 (2025)

I 119TH CONGRESS 1ST SESSION H. R. 2387 To prohibit Federal funds from being used for sex-trait altering treatments for minors, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MARCH 26, 2025 Mr. ONDER (for himself, Mr. HARRIS of Maryland, Mrs. MILLER of Illinois, and Mrs. BIGGS of South Carolina) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on the Judiciary, Education and Workforce, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the juris- diction of the committee concerned A BILL To prohibit Federal funds from being used for sex-trait altering treatments for minors, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘No Harm Act’’. 4 SEC. 2. PROHIBITION ON USE OF FEDERAL FUNDS FOR 5 CERTAIN TREATMENTS. 6 (a) IN GENERAL.—Notwithstanding any other provi- 7 sion of law, no Federal funds may be made available for 8 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 2 •HR 2387 IH purposes of paying for, sponsoring, promoting, assisting, 1 or supporting the furnishing of a sex-trait altering treat- 2 ment to a minor. 3 (b) CIVIL ACTION.—Any person, including a tax- 4 payer, may bring a civil action for violation of subsection 5 (a) for legal damages and equitable relief against the 6 United States, or the appropriate Department or Agency 7 disbursing federal funds in violation of subsection (a), in 8 an appropriate district court of the United States. 9 SEC. 3. PROHIBITION ON USE OF FEDERAL FUNDS FOR 10 CERTAIN ACTIONS. 11 (a) IN GENERAL.—Notwithstanding any other provi- 12 sion of law, no Federal funds may be made available for 13 purposes of taking any regulatory or subregulatory action 14 to promote sex-trait altering treatments to minors. 15 (b) CIVIL ACTION.—Any person, including a tax- 16 payer, may bring a civil action for violation of subsection 17 (a) for legal damages and equitable relief against the 18 United States, or the appropriate Department or Agency 19 disbursing federal funds in violation of subsection (a), in 20 an appropriate district court of the United States. 21 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 3 •HR 2387 IH SEC. 4. FEMALE GENITAL MUTILATION TO INCLUDE PROVI- 1 SION OF SEX-TRAIT ALTERING TREATMENT 2 TO MINORS. 3 Section 116 of title 18, United States Code, is 4 amended by adding at the end the following: ‘‘For the pur- 5 pose of subsection (b)(1), the phrase ‘‘necessary to the 6 health of the person’’ shall not include change of gender 7 or sex, or affirmation of gender or sex.’’. 8 SEC. 5. PROHIBITION ON FUNDING CERTAIN INSTITU- 9 TIONS. 10 Notwithstanding any other provision of law, no Fed- 11 eral funds may be made available to a medical institution 12 (including a hospital, medical school, clinic, public health 13 organization, federally qualified health center, rural health 14 center, or medical practice) if such institution provides 15 sex-trait altering treatments to minors. 16 SEC. 6. RIGHT TO DECLINE TREATMENTS. 17 (a) IN GENERAL.—The parent of a minor shall have 18 the right to decline any sex-trait altering treatment for 19 such minor. Likewise, no specified Federal funds shall be 20 made available to a State that has in place a policy to 21 provide sex-trait altering treatment for a minor without 22 the consent of both parents. 23 (b) STATE REQUIREMENT.— 24 (1) IN GENERAL.—No specified Federal funds 25 may be made available to a State that has in place 26 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 4 •HR 2387 IH a policy to separate a minor from such minor’s par- 1 ent based solely on such parent’s refusal to consent 2 to a sex-trait altering treatment for such minor. 3 (2) SPECIFIED FEDERAL FUNDS DEFINED.— 4 For purposes of this section, the term ‘‘specified 5 Federal funds’’ means Federal funds made available 6 under title XIX of the Social Security Act (42 7 U.S.C. 1396 et seq.) or under part A of title IV of 8 such Act (42 U.S.C. 601 et seq.). 9 (c) CIVIL ACTION.— 10 (1) IN GENERAL.—A minor or a parent of a 11 minor who is harmed by a violation of this section 12 may bring a civil action against the United States 13 and against any State with a policy in place in viola- 14 tion of this section in an appropriate district court 15 of the United States to obtain appropriate relief. 16 (2) STATUTE OF LIMITATIONS.—An action 17 under this subsection may be brought at any time 18 prior to 30 years after the date on which the minor 19 attains the age of majority. 20 SEC. 7. REQUIREMENT TO RECEIVE INFORMED CONSENT. 21 (a) IN GENERAL.—No health care provider may fur- 22 nish any sex-trait altering treatment to a minor unless, 23 at least 72 hours prior to furnishing such treatment, such 24 provider— 25 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 5 •HR 2387 IH (1) holds a consultation appointment with the 1 parents of such minor to discuss such treatment; 2 (2) provides to the parents of such minor a 3 complete, printed list of potential side effects of such 4 treatment, including any permanent risks relating to 5 fertility and sexual function; and 6 (3) received the written, informed consent of 7 the parents of such minor for such treatment. 8 (b) CIVIL ACTION.— 9 (1) IN GENERAL.—A minor or a parent of a 10 minor who is harmed by a violation of this section 11 may bring a civil action against the health care pro- 12 vider in an appropriate district court of the United 13 States to obtain appropriate relief. 14 (2) STATUTE OF LIMITATIONS.—An action 15 under this subsection may be brought at any time 16 prior to 30 years after the date on which the minor 17 attains the age of majority. 18 SEC. 8. MEDICAL MALPRACTICE LIABILITY. 19 (a) IN GENERAL.—An individual may bring a civil 20 action in an appropriate district court of the United States 21 to obtain appropriate relief for any physical, psychological, 22 or physiological harm caused by a sex-trait altering treat- 23 ment performed on the individual when the individual was 24 a minor against a medical practitioner, hospital, clinic, 25 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 6 •HR 2387 IH surgery center or other provider that performed or pre- 1 scribed such treatment. If said civil action is successful, 2 the individual will be awarded attorney’s fees and litiga- 3 tion costs, and treble damages. 4 (b) STATUTE OF LIMITATIONS.—An action under 5 this subsection may be brought at any time prior to 30 6 years after the date on which the minor attains the age 7 of majority. 8 SEC. 9. RIGHT OF CONSCIENCE FOR HEALTH CARE PRO- 9 VIDERS. 10 (a) IN GENERAL.—A health care provider may not 11 be penalized, retaliated against, or otherwise discriminated 12 against on the basis that the provider does not or declines 13 to— 14 (1) perform, refer for, pay for, or otherwise 15 participate in sex-trait altering treatment; 16 (2) provide or sponsor sex-trait altering treat- 17 ment coverage; or 18 (3) facilitate or make arrangements for sex- 19 trait altering treatment. 20 (b) STATE REQUIREMENT.— 21 (1) IN GENERAL.—No specified Federal funds 22 (as defined in paragraph (2)) may be made available 23 to a State that requires a health care provider to 24 provide sex-trait altering treatments. 25 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 7 •HR 2387 IH (2) SPECIFIED FEDERAL FUNDS DEFINED.— 1 For purposes of this subsection, the term ‘‘specified 2 Federal funds’’ means any Federal funds made 3 available under a program administered by the De- 4 partment of Health and Human Services. 5 (c) CIVIL ACTION.—A health care provider who is 6 harmed by a violation of subsection (a) may, in a civil ac- 7 tion, obtain all appropriate relief, including injunctive re- 8 lief, declaratory relief, and compensatory damages to pre- 9 vent the occurrence, continuance, or repetition of such vio- 10 lation and to compensate for losses resulting from the vio- 11 lation. 12 (d) DEFINITION.— The term ‘‘health care provider’’ 13 includes— 14 (1) an individual physician, health care assist- 15 ant, nurse, pharmacist, health researcher, or other 16 health care personnel; 17 (2) a hospital, laboratory, pharmacy, health sys- 18 tem, or other health care or medical research facility 19 or organization (including a party to a proposed 20 merger or other collaborative arrangement relating 21 to health services, and an entity resulting there- 22 from); 23 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 8 •HR 2387 IH (3) a provider-sponsored organization, an ac- 1 countable care organization, or a health maintenance 2 organization; 3 (4) a social services provider that provides or 4 authorizes referrals for health care services; 5 (5) a program of training or education in the 6 health professions or medical research, a participant 7 in such a program, or any individual applying or 8 otherwise aspiring to participate in such a program; 9 (6) an issuer of health insurance coverage or of 10 a health plan; 11 (7) a health care sharing ministry; 12 (8) a health insurance plan, including group, in- 13 dividual, or student health plans, or a sponsor or ad- 14 ministrator thereof; and 15 (9) any other health care organization, pro- 16 gram, facility, or plan. 17 SEC. 10. PROHIBITION ON FEDERAL FUNDS FOR PRO- 18 VIDING SEX-TRAIT ALTERING TREATMENT TO 19 STUDENTS WITHOUT PARENTAL CONSENT. 20 (a) IN GENERAL.—Notwithstanding any other provi- 21 sion of law, no Federal funds may be provided to an ele- 22 mentary school or secondary school that allows school per- 23 sonnel to provide, assist in providing, or otherwise support 24 the provision of sex-trait altering treatment to a student 25 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 9 •HR 2387 IH without notifying the parents of the student and receiving 1 written approval from such parents. 2 (b) DEFINITIONS.—In this section: 3 (1) ESEA TERMS.—The terms ‘‘elementary 4 school’’, ‘‘paraprofessional’’, ‘‘parent’’, ‘‘school lead- 5 er’’, ‘‘secondary school’’, and ‘‘specialized instruc- 6 tional support personnel’’ have the meanings given 7 the terms in section 8101 of the Elementary and 8 Secondary Education Act of 1965 (20 U.S.C. 7801). 9 (2) SCHOOL PERSONNEL.—The term ‘‘school 10 personnel’’ includes— 11 (A) teachers; 12 (B) paraprofessionals; 13 (C) school leaders; 14 (D) specialized instructional support per- 15 sonnel; 16 (E) volunteers performing services for a 17 school; and 18 (F) other support staff who are employed 19 by a school or who perform services for a school 20 on a contractual basis. 21 SEC. 11. DEFINITIONS. 22 In this Act: 23 (1) SEX-TRAIT ALTERING TREATMENT.—The 24 term ‘‘sex-trait altering treatment’’ means any med- 25 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 10 •HR 2387 IH ical or surgical service, including physician’s serv- 1 ices, practitioner’s services, inpatient and outpatient 2 hospital services, or prescribed drugs related to gen- 3 der transition, other than an excepted service, that 4 seeks to: 5 (A) Alter or remove physical or anatomical 6 characteristics or features that are typical for 7 the individual’s sex; or 8 (B) Instill or create physiological or ana- 9 tomical characteristics that resemble a sex dif- 10 ferent from the individual’s sex, including med- 11 ical services that provide puberty blocking 12 drugs, gender transition hormone therapy, or 13 genital gender reassignment surgery or nongen- 14 ital gender reassignment surgery knowingly per- 15 formed for the purpose of assisting an indi- 16 vidual with a gender transition. 17 (2) SEX.—The term ‘‘sex’’ means the biological 18 indication of being male or female, including sex 19 chromosomes, and naturally occurring sex hormones, 20 gonads, and nonambiguous internal and external 21 genitalia present at birth. 22 (3) GENDER TRANSITION HORMONE THER- 23 APY.—The term ‘‘gender transition hormone ther- 24 apy’’ means testosterone, estrogen, or progesterone 25 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 11 •HR 2387 IH given to an individual in an amount greater than 1 would normally be produced endogenously in a 2 healthy individual of that individual’s age and sex. 3 (4) GENDER.—The term ‘‘gender’’ means the 4 psychological, behavioral, social, and cultural aspects 5 of being male or female. 6 (5) GENDER REASSIGNMENT SURGERY.—The 7 term ‘‘gender reassignment surgery’’ means any 8 medical or surgical service that seeks to surgically 9 alter or remove healthy physical or anatomical char- 10 acteristics or features that are typical for the indi- 11 vidual’s sex, in order to instill or create physiological 12 or anatomical characteristics that resemble a sex dif- 13 ferent from the individual’s sex, including genital 14 gender reassignment surgery or nongenital gender 15 reassignment surgery knowingly performed for the 16 purpose of assisting an individual with a gender 17 transition. 18 (6) GENDER TRANSITION.—The term ‘‘gender 19 transition’’ means the process in which an individual 20 shifts from identifying with and living as a gender 21 that corresponds to his or her sex to identifying with 22 and living as a gender different from his or her sex, 23 and may involve social, legal, or physical changes. 24 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 12 •HR 2387 IH (7) GENITAL GENDER REASSIGNMENT SUR- 1 GERY.—The term ‘‘genital gender reassignment sur- 2 gery’’ means a medical procedure knowingly per- 3 formed for the purpose of assisting an individual 4 with a gender transition, including the following: 5 (A) Surgical procedures, including a 6 penectomy, orchiectomy, vaginoplasty, 7 clitoroplasty, or vulvoplasty for a male sex pa- 8 tient or hysterectomy or ovariectomy for a fe- 9 male sex patient. 10 (B) Reconstruction of the fixed part of the 11 urethra with or without a metoidioplasty. 12 (C) Phalloplasty, vaginectomy, 13 scrotoplasty, or implantation of erection or tes- 14 ticular prostheses for a female sex patient. 15 (8) NONGENITAL GENDER REASSIGNMENT SUR- 16 GERY.—The term ‘‘nongenital gender reassignment 17 surgery’’ means medical procedures knowingly per- 18 formed for the purpose of assisting an individual 19 with a gender transition, including the following: 20 (A) Surgical procedures for a male sex pa- 21 tient, including augmentation mammoplasty, fa- 22 cial feminization surgery, liposuction, lipofilling, 23 voice surgery, thyroid cartilage reduction, glu- 24 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 13 •HR 2387 IH teal augmentation, hair reconstruction, or asso- 1 ciated aesthetic procedures. 2 (B) Surgical procedures for a female sex 3 patient, including subcutaneous mastectomy, 4 voice surgery, liposuction, lipofilling, pectoral 5 implants, or associated aesthetic procedures. 6 (9) PUBERTY BLOCKING DRUGS.—The term 7 ‘‘puberty blocking drugs’’ means the following when 8 used for the purpose of assisting an individual with 9 a gender transition. 10 (A) Gonadotropin releasing hormone ana- 11 logues or other synthetic drugs used to stop 12 luteinizing hormone and follicle stimulating hor- 13 mone secretion; or 14 (B) Synthetic antiandrogen drugs used to 15 block the androgen receptor. 16 (10) EXCEPTED SERVICE.—The term ‘‘excepted 17 service’’ means any of the following: 18 (A) Medical or surgical services furnished 19 to an individual born with a medically verifiable 20 disorder of sex development, including an indi- 21 vidual with: 22 (i) External sex characteristics that 23 are irresolvably ambiguous; 24 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 14 •HR 2387 IH (ii) Forty-six XX chromosomes with 1 virilization; 2 (iii) Forty-six XY chromosomes with 3 undervirilization; or 4 (iv) Both ovarian and testicular tis- 5 sue. 6 (B) Medical or surgical services provided 7 when a physician or practitioner has diagnosed 8 a disorder or condition of sexual development 9 that the physician or practitioner has deter- 10 mined through genetic or biochemical testing 11 that the individual does not have normal sex 12 chromosome structure, sex steroid hormone pro- 13 duction, or sex steroid hormone action. 14 (C) The treatment of any infection, injury, 15 disease, or disorder that has been caused by or 16 exacerbated by the performance of sex-trait al- 17 tering treatments. 18 (D) Any medical or surgical service under- 19 taken because the individual suffers from a 20 physical disorder, physical injury, or physical 21 illness that would, as certified by a physician or 22 practitioner, place the individual in imminent 23 danger of death or impairment of major bodily 24 VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00014 Fmt 6652 Sfmt 6201 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS 15 •HR 2387 IH function unless the medical or surgical service 1 is performed. 2 (E) Mental health or social services, other 3 than sex-trait altering treatments. 4 (F) Services for a disorder or condition of 5 sexual development that is unrelated to a diag- 6 nosis of gender dysphoria or gender identity 7 disorder. 8 (11) MINOR.—The term ‘‘minor’’ means an in- 9 dividual under 18 years of age. 10 Æ VerDate Sep 11 2014 17:13 Apr 05, 2025 Jkt 059200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6301 E:\BILLS\H2387.IH H2387 ssavage on LAPJG3WLY3PROD with BILLS