(1)

by adding at the end the following:

2260B. Gender transition procedures on minors

(a) In general

Any physical or mental health care professional who, under the circumstances described in subsection (d), knowingly performs or otherwise aids and abets the performance of a gender transition procedure on a minor shall be fined under this title, imprisoned not more than 5 years, or both.

(b) Prohibition on prosecution of person on whom procedures are performed

No person on whom the gender transition procedure under subsection (a) is performed may be arrested or prosecuted for an offense under this section.

(c) Civil action

A person on whom a gender transition procedure is performed under this section may bring a civil action for appropriate relief against each person who performed the gender transition procedure.

(d) Circumstances described

For purposes of subsection (a), the circumstances described in this subsection are that—

(1)

the defendant or minor traveled in interstate or foreign commerce, or traveled using a means, channel, facility, or instrumentality of interstate or foreign commerce, in furtherance of or in connection with the conduct described in subsection (a);

(2)

the defendant used a means, channel, facility, or instrumentality of interstate or foreign commerce in furtherance of or in connection with the conduct described in subsection (a);

(3)

any payment of any kind was made, directly or indirectly, in furtherance of or in connection with the conduct described in subsection (a) using any means, channel, facility, or instrumentality of interstate or foreign commerce or in or affecting interstate or foreign commerce;

(4)

the defendant transmitted in interstate or foreign commerce any communication relating to or in furtherance of the conduct described in subsection (a) using any means, channel, facility, or instrumentality of interstate or foreign commerce or in or affecting interstate or foreign commerce by any means or in manner, including by computer, mail, wire, or electromagnetic transmission;

(5)

any instrument, item, substance, or other object that has traveled in interstate or foreign commerce was used to perform the conduct described in subsection (a);

(6)

the conduct described in subsection (a) occurred within the special maritime and territorial jurisdiction of the United States, or any territory or possession of the United States; or

(7)

the conduct described in subsection (a) otherwise occurred in or affected interstate or foreign commerce.

(e) Definitions

In this section:

(1) Female

The term female, when used to refer to a natural person, means an individual who naturally has, had, will have, or would have, but for a congenital anomaly, historical accident, or intentional or unintentional disruption, the reproductive system that at some point produces, transports, and utilizes eggs for fertilization.

(2) Gender transition

The term gender transition means the process in which an individual goes from identifying with or presenting as his or her sex to identifying with or presenting a self-proclaimed identity that does not correspond with or is different from his or her sex, and may be accompanied with social, legal, or physical changes.

(3) Gender transition procedure

(A) In general

The term gender transition procedure means any hormonal or surgical intervention for the purpose of gender transition, including—

(i)

gonadotropin-releasing hormone (GnRH) agonists or other puberty-blocking or suppressing drugs to stop or delay normal puberty;

(ii)

testosterone, estrogen, progesterone, or other androgens to an individual at doses that are supraphysiologic to what would normally be produced endogenously in a healthy individual of the same age and sex;

(iii)

castration;

(iv)

orchiectomy;

(v)

scrotoplasty;

(vi)

implantation of erection or testicular prostheses;

(vii)

vasectomy;

(viii)

hysterectomy;

(ix)

oophorectomy;

(x)

ovariectomy;

(xi)

reconstruction of the fixed part of the urethra with or without a metoidioplasty or a phalloplasty;

(xii)

metoidioplasty;

(xiii)

penectomy;

(xiv)

phalloplasty;

(xv)

vaginoplasty;

(xvi)

clitoroplasty;

(xvii)

vaginectomy;

(xviii)

vulvoplasty;

(xix)

reduction thyrochondroplasty;

(xx)

chondrolaryngoplasty;

(xxi)

mastectomy;

(xxii)

tubal ligation;

(xxiii)

sterilization;

(xxiv)

any plastic, cosmetic, or aesthetic surgery that feminizes or masculinizes the facial or other physiological features of an individual;

(xxv)

any placement of chest implants to create feminine breasts;

(xxvi)

any placement of fat or artificial implants in the gluteal region;

(xxvii)

augmentation mammoplasty;

(xxviii)

liposuction;

(xxix)

lipofilling;

(xxx)

voice surgery;

(xxxi)

hair reconstruction;

(xxxii)

pectoral implants; and

(xxxiii)

the removal of any otherwise healthy or non-diseased body part or tissue.

(B) Exclusions

The term gender transition procedure does not include the following when furnished to an individual by a health care provider with the consent of such individual or, if applicable, such individual’s parents or legal guardian:

(i)

Services to individuals born with a medically verifiable disorder of sex development, including an individual with external sex characteristics that are irresolvably ambiguous, such as an individual born with 46 XX chromosomes with virilization, an individual born with 46 XY chromosomes with undervirilization, or an individual born having both ovarian and testicular tissue.

(ii)

Services provided when a physician has otherwise diagnosed a disorder of sexual development in which the physician has determined through genetic or biochemical testing that the individual does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action for a healthy individual of the same sex and age.

(iii)

The treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of gender transition procedures, whether or not the gender transition procedure was performed in accordance with State and Federal law or whether or not funding for the gender transition procedure is permissible under this section.

(iv)

Any procedure undertaken because the individual suffers from a physical disorder, physical injury, or physical illness (but not mental, behavioral, or emotional distress or a mental, behavioral, or emotional disorder) that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function, unless the procedure is performed.

(v)

Puberty suppression or blocking prescription drugs for the purpose of normalizing puberty for a minor experiencing precocious puberty.

(vi)

Male circumcision.

(4) Male

The term male, when used to refer to a natural person, means an individual who naturally has, had, will have, or would have, but for a congenital anomaly, historical accident, or intentional or unintentional disruption, the reproductive system that at some point produces, transports, and utilizes sperm for fertilization.

(5) Minor

The term minor means an individual under the age of 18.

(6) Sex

The term sex, when referring to an individual’s sex, means to refer to either male or female, as biologically determined.; and

(2)

by amending the table of sections for such chapter by adding at the end the following: