Text of US HB 9874 (2024)

I 118TH CONGRESS 2D SESSION H. R. 9874 To prohibit the performance of gender-related medical treatment on minors, to amend title XVIII of the Social Security Act to prohibit payment and participation under the Medicare program with respect to such treatment, and for other purposes. IN THE HOUSE OF REPRESENTATIVES SEPTEMBER 27, 2024 Ms. MACE (for herself, Mr. GOSAR, Mrs. LESKO, Mr. WEBER of Texas, and Mr. BURCHETT) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on the Judiciary, and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provi- sions as fall within the jurisdiction of the committee concerned A BILL To prohibit the performance of gender-related medical treat- ment on minors, to amend title XVIII of the Social Security Act to prohibit payment and participation under the Medicare program with respect to such treatment, 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 ‘‘Childhood Genital Mu- 4 tilation Prevention Act’’. 5 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 2 •HR 9874 IH SEC. 2. PROHIBITING GENDER-RELATED MEDICAL TREAT- 1 MENT FOR MINORS. 2 (a) IN GENERAL.—Chapter 7 of title 18, United 3 States Code, is amended by inserting after section 116 the 4 following new section: 5 ‘‘§ 116A. Gender-related medical treatment furnished 6 to minors. 7 ‘‘(a) IN GENERAL.—Subject to subsection (c), who- 8 ever, in a circumstance described in subsection (b), know- 9 ingly performs or attempts to perform a gender-related 10 medical treatment on a minor, shall be fined under this 11 title, imprisoned not more than 10 years, or both. 12 ‘‘(b) CIRCUMSTANCES DESCRIBED.—For the pur- 13 poses of subsection (a), the circumstances described in this 14 subsection are that— 15 ‘‘(1) the offender or victim traveled in inter- 16 state or foreign commerce, or traveled using a 17 means, channel, facility, or instrumentality of inter- 18 state or foreign commerce, in furtherance of or in 19 connection with the conduct described in subsection 20 (a); 21 ‘‘(2) the offender used a means, channel, facil- 22 ity, or instrumentality of interstate or foreign com- 23 merce in furtherance of or in connection with the 24 conduct described in subsection (a); 25 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 3 •HR 9874 IH ‘‘(3) any payment of any kind was made, di- 1 rectly or indirectly, in furtherance of or in connec- 2 tion with the conduct described in subsection (a) 3 using any means, channel, facility, or instrumen- 4 tality of interstate or foreign commerce or in or af- 5 fecting interstate or foreign commerce; 6 ‘‘(4) the offender transmitted in interstate or 7 foreign commerce any communication relating to or 8 in furtherance of the conduct described in subsection 9 (a) using any means, channel, facility, or instrumen- 10 tality of interstate or foreign commerce or in or af- 11 fecting interstate or foreign commerce by any means 12 or in manner, including by computer, mail, wire, or 13 electromagnetic transmission; 14 ‘‘(5) any instrument, item, substance, or other 15 object that has traveled in interstate or foreign com- 16 merce was used to perform the conduct described in 17 subsection (a); 18 ‘‘(6) the conduct described in subsection (a) oc- 19 curred within the special maritime and territorial ju- 20 risdiction of the United States, or any territory or 21 possession of the United States; or 22 ‘‘(7) the conduct described in subsection (a) 23 otherwise occurred in or affected interstate or for- 24 eign commerce. 25 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 4 •HR 9874 IH ‘‘(c) EXCEPTIONS.— 1 ‘‘(1) IN GENERAL.—An individual who provides 2 gender-related medical treatment to a minor shall 3 not be considered to have violated the prohibition in 4 subsection (a) if such medical treatment is provided 5 to such minor for purposes of treating— 6 ‘‘(A) a disorder of sex development, diag- 7 nosed by a physician after such physician has 8 determined through genetic or biochemical test- 9 ing that such minor does not have normal sex 10 chromosome structure, sex steroid hormone pro- 11 duction, or sex steroid hormone action; 12 ‘‘(B) irresolvably ambiguous biological sex 13 characteristics of such minor, including the 14 presence of— 15 ‘‘(i) 46 XX chromosomes with 16 virilization; 17 ‘‘(ii) 46 XY chromosomes with 18 undervirilization; or 19 ‘‘(iii) both ovarian and testicular tis- 20 sue; or 21 ‘‘(C) an infection, injury, disease, or dis- 22 order caused or exacerbated by gender-related 23 medical treatment that was furnished to such 24 minor. 25 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 5 •HR 9874 IH ‘‘(2) EXCEPTION FOR MINORS.—A minor who 1 seeks gender-related medical treatment, or on whom 2 gender-related medical treatment was performed, 3 shall not be considered to have violated the prohibi- 4 tion in subsection (a). 5 ‘‘(d) DEFINITIONS.—In this section: 6 ‘‘(1) GENDER-RELATED MEDICAL TREAT- 7 MENT.—The term ‘gender-related medical treatment’ 8 means— 9 ‘‘(A) with respect to a female individual, 10 medical treatments provided for purposes of ad- 11 dressing the perception of such individual that 12 the gender or sex of such individual is not fe- 13 male, including— 14 ‘‘(i) surgical procedures, including— 15 ‘‘(I) vaginectomy; 16 ‘‘(II) hysterectomy; 17 ‘‘(III) oophorectomy; 18 ‘‘(IV) reconstruction of the ure- 19 thra; 20 ‘‘(V) metoidioplasty; 21 ‘‘(VI) phalloplasty; 22 ‘‘(VII) salpingo-oophorectomy; 23 ‘‘(VIII) scrotoplasty; 24 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 6 •HR 9874 IH ‘‘(IX) implantation of erection or 1 testicular protheses; 2 ‘‘(X) subcutaneous mastectomy; 3 ‘‘(XI) vocal cord surgery; 4 ‘‘(XII) pectoral implants; and 5 ‘‘(XIII) penile transplantation; 6 ‘‘(ii) exogenous doses of testosterone 7 or other androgens; and 8 ‘‘(iii) puberty blockers, including— 9 ‘‘(I) GnRH agonists; and 10 ‘‘(II) synthetic drugs that sup- 11 press the production of estrogen and 12 progesterone or delay or suppress pu- 13 bertal development in female individ- 14 uals; and 15 ‘‘(B) with respect to a male individual, 16 medical treatments provided for purposes of ad- 17 dressing the perception of such individual that 18 the gender or sex of such individual is not male, 19 including— 20 ‘‘(i) surgical procedures, including— 21 ‘‘(I) penectomy; 22 ‘‘(II) orchiectomy; 23 ‘‘(III) vaginoplasty; 24 ‘‘(IV) clitoroplasty; 25 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 7 •HR 9874 IH ‘‘(V) vulvoplasty; 1 ‘‘(VI) augmentation 2 mammoplasty; 3 ‘‘(VII) facial feminization sur- 4 gery; 5 ‘‘(VIII) vocal cord surgery; 6 ‘‘(IX) chondrolaryngoplasty; 7 ‘‘(X) gluteal augmentation; and 8 ‘‘(XI) uterine transplantation; 9 ‘‘(ii) exogenous doses of estrogen; and 10 ‘‘(iii) puberty blockers, including— 11 ‘‘(I) GnRH agonists; and 12 ‘‘(II) synthetic drugs that sup- 13 press the production of testosterone or 14 delay or suppress pubertal develop- 15 ment in male individuals. 16 ‘‘(2) FEMALE.—The term ‘female’— 17 ‘‘(A) means an individual who, under nor- 18 mal development— 19 ‘‘(i) has XX chromosomes; 20 ‘‘(ii) produces oocytes; and 21 ‘‘(iii) has a reproductive and endo- 22 crine system oriented around the produc- 23 tion of such oocytes; and 24 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 8 •HR 9874 IH ‘‘(B) includes an individual who would oth- 1 erwise fall within this definition but for a bio- 2 logical or genetic condition described in sub- 3 paragraph (A) or (B) of subsection (c)(1). 4 ‘‘(3) GENDER.—The term ‘gender’ means, with 5 respect to an individual, the psychological, behav- 6 ioral, social, and cultural aspects of being male or 7 female. 8 ‘‘(4) MALE.—The term ‘male’— 9 ‘‘(A) means an individual who, under nor- 10 mal development— 11 ‘‘(i) has XY chromosomes; 12 ‘‘(ii) produces sperm; and 13 ‘‘(iii) has a reproductive and endo- 14 crine system oriented around the produc- 15 tion of such sperm; and 16 ‘‘(B) includes an individual who would oth- 17 erwise fall within this definition but for a bio- 18 logical or genetic condition described in sub- 19 paragraph (A) or (B) of subsection (c)(1). 20 ‘‘(5) MINOR.—The term ‘minor’ means an indi- 21 vidual under 18 years of age. 22 ‘‘(6) SEX.—The term ‘sex’ means the biological 23 and genetic indication of whether an individual is 24 male or female, as determined by the organization of 25 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 9 •HR 9874 IH body parts and gametes for reproduction (including 1 sex chromosomes, naturally occurring sex chro- 2 mosomes, gonads, and nonambiguous internal and 3 external genitalia present at birth) without regard to 4 the psychological, behavioral, social, cultural, chosen, 5 or subjective experience of gender of such indi- 6 vidual.’’. 7 (b) CLERICAL AMENDMENT.—The table of sections 8 for such chapter is amended by inserting after the item 9 relating to section 116 the following new item: 10 ‘‘116A. Gender-related medical treatment for minors.’’. SEC. 3. PROHIBITING PAYMENT AND PARTICIPATION 11 UNDER MEDICARE WITH RESPECT TO GEN- 12 DER-RELATED MEDICAL TREATMENT FOR MI- 13 NORS. 14 (a) EXCLUDING FROM COVERAGE GENDER-RELATED 15 MEDICAL TREATMENT FOR MINORS.—Section 1862(a) of 16 the Social Security Act (42 U.S.C. 1395y(a)) is amend- 17 ed— 18 (1) in paragraph (24), by striking ‘‘or’’ at the 19 end; 20 (2) in paragraph (25), by striking the period at 21 the end and inserting ‘‘; or’’; and 22 (3) by inserting after paragraph (25) the fol- 23 lowing new paragraph: 24 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 10 •HR 9874 IH ‘‘(26) beginning on the date that is 90 days 1 after the date of the enactment of the Childhood 2 Genital Mutilation Prevention Act, which constitute 3 gender-related medical treatment for minors de- 4 scribed in section 116A of chapter 7 of title 18, 5 United States Code, and are not provided for the 6 purposes described in subsection (c)(1) of such sec- 7 tion.’’. 8 (b) EXCLUDING FROM PARTICIPATION PROVIDERS 9 FURNISHING GENDER-RELATED MEDICAL TREATMENT 10 FOR MINORS.—Section 1866 of the Social Security Act 11 (42 U.S.C. 1395cc) is amended by adding at the end the 12 following new subsection: 13 ‘‘(l) EXCLUSION OF PROVIDERS FURNISHING GEN- 14 DER-RELATED MEDICAL TREATMENT FOR MINORS.—Be- 15 ginning on the date that is 90 days after the date of the 16 enactment of the Childhood Genital Mutilation Prevention 17 Act, with respect to a provider of services or supplier that, 18 on or after the date that is 90 days after such date of 19 enactment, furnishes gender-related medical treatment for 20 minors, as described in section 116A of chapter 7 of title 21 18, United States Code to any individual (other than such 22 a treatment that is furnished for the purposes described 23 in subsection (c)(1) of such section), regardless of whether 24 VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB 11 •HR 9874 IH such individual is entitled to benefits under part A or en- 1 rolled under part B— 2 ‘‘(1) if such provider of services or supplier is 3 enrolled in the program under this title, the Sec- 4 retary shall terminate such enrollment; and 5 ‘‘(2) the Secretary may not enroll such provider 6 of services or supplier as a new provider of services 7 or supplier in the program under this title.’’. 8 SEC. 4. PROHIBITION ON FEDERAL FUNDING FOR GENDER- 9 RELATED MEDICAL TREATMENT FOR MI- 10 NORS. 11 No funds authorized or appropriated by Federal law, 12 and none of the funds in any trust fund to which funds 13 are authorized or appropriated by Federal law, shall be 14 obligated or expended for any gender-related medical 15 treatment furnished to a minor (as such terms are used 16 for purposes of section 116A of chapter 7 of title 18, 17 United States Code) or for any health benefits coverage 18 that includes coverage for gender-related medical treat- 19 ment furnished to a minor. 20 Æ VerDate Sep 11 2014 04:47 Oct 17, 2024 Jkt 059200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H9874.IH H9874 kjohnson on DSK7ZCZBW3PROD with $$_JOB