[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2387 Introduced in House (IH)]

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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 jurisdiction 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 Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``No Harm Act''.

SEC. 2. PROHIBITION ON USE OF FEDERAL FUNDS FOR CERTAIN TREATMENTS.

    (a) In General.--Notwithstanding any other provision of law, no 
Federal funds may be made available for purposes of paying for, 
sponsoring, promoting, assisting, or supporting the furnishing of a 
sex-trait altering treatment to a minor.
    (b) Civil Action.--Any person, including a taxpayer, may bring a 
civil action for violation of subsection (a) for legal damages and 
equitable relief against the United States, or the appropriate 
Department or Agency disbursing federal funds in violation of 
subsection (a), in an appropriate district court of the United States.

SEC. 3. PROHIBITION ON USE OF FEDERAL FUNDS FOR CERTAIN ACTIONS.

    (a) In General.--Notwithstanding any other provision of law, no 
Federal funds may be made available for purposes of taking any 
regulatory or subregulatory action to promote sex-trait altering 
treatments to minors.
    (b) Civil Action.--Any person, including a taxpayer, may bring a 
civil action for violation of subsection (a) for legal damages and 
equitable relief against the United States, or the appropriate 
Department or Agency disbursing federal funds in violation of 
subsection (a), in an appropriate district court of the United States.

SEC. 4. FEMALE GENITAL MUTILATION TO INCLUDE PROVISION OF SEX-TRAIT 
              ALTERING TREATMENT TO MINORS.

    Section 116 of title 18, United States Code, is amended by adding 
at the end the following: ``For the purpose of subsection (b)(1), the 
phrase ``necessary to the health of the person'' shall not include 
change of gender or sex, or affirmation of gender or sex.''.

SEC. 5. PROHIBITION ON FUNDING CERTAIN INSTITUTIONS.

    Notwithstanding any other provision of law, no Federal funds may be 
made available to a medical institution (including a hospital, medical 
school, clinic, public health organization, federally qualified health 
center, rural health center, or medical practice) if such institution 
provides sex-trait altering treatments to minors.

SEC. 6. RIGHT TO DECLINE TREATMENTS.

    (a) In General.--The parent of a minor shall have the right to 
decline any sex-trait altering treatment for such minor. Likewise, no 
specified Federal funds shall be made available to a State that has in 
place a policy to provide sex-trait altering treatment for a minor 
without the consent of both parents.
    (b) State Requirement.--
            (1) In general.--No specified Federal funds may be made 
        available to a State that has in place a policy to separate a 
        minor from such minor's parent based solely on such parent's 
        refusal to consent to a sex-trait altering treatment for such 
        minor.
            (2) Specified federal funds defined.--For purposes of this 
        section, the term ``specified Federal funds'' means Federal 
        funds made available under title XIX of the Social Security Act 
        (42 U.S.C. 1396 et seq.) or under part A of title IV of such 
        Act (42 U.S.C. 601 et seq.).
    (c) Civil Action.--
            (1) In general.--A minor or a parent of a minor who is 
        harmed by a violation of this section may bring a civil action 
        against the United States and against any State with a policy 
        in place in violation of this section in an appropriate 
        district court of the United States to obtain appropriate 
        relief.
            (2) Statute of limitations.--An action under this 
        subsection may be brought at any time prior to 30 years after 
        the date on which the minor attains the age of majority.

SEC. 7. REQUIREMENT TO RECEIVE INFORMED CONSENT.

    (a) In General.--No health care provider may furnish any sex-trait 
altering treatment to a minor unless, at least 72 hours prior to 
furnishing such treatment, such provider--
            (1) holds a consultation appointment with the parents of 
        such minor to discuss such treatment;
            (2) provides to the parents of such minor a complete, 
        printed list of potential side effects of such treatment, 
        including any permanent risks relating to fertility and sexual 
        function; and
            (3) received the written, informed consent of the parents 
        of such minor for such treatment.
    (b) Civil Action.--
            (1) In general.--A minor or a parent of a minor who is 
        harmed by a violation of this section may bring a civil action 
        against the health care provider in an appropriate district 
        court of the United States to obtain appropriate relief.
            (2) Statute of limitations.--An action under this 
        subsection may be brought at any time prior to 30 years after 
        the date on which the minor attains the age of majority.

SEC. 8. MEDICAL MALPRACTICE LIABILITY.

    (a) In General.--An individual may bring a civil action in an 
appropriate district court of the United States to obtain appropriate 
relief for any physical, psychological, or physiological harm caused by 
a sex-trait altering treatment performed on the individual when the 
individual was a minor against a medical practitioner, hospital, 
clinic, surgery center or other provider that performed or prescribed 
such treatment. If said civil action is successful, the individual will 
be awarded attorney's fees and litigation costs, and treble damages.
    (b) Statute of Limitations.--An action under this subsection may be 
brought at any time prior to 30 years after the date on which the minor 
attains the age of majority.

SEC. 9. RIGHT OF CONSCIENCE FOR HEALTH CARE PROVIDERS.

    (a) In General.--A health care provider may not be penalized, 
retaliated against, or otherwise discriminated against on the basis 
that the provider does not or declines to--
            (1) perform, refer for, pay for, or otherwise participate 
        in sex-trait altering treatment;
            (2) provide or sponsor sex-trait altering treatment 
        coverage; or
            (3) facilitate or make arrangements for sex-trait altering 
        treatment.
    (b) State Requirement.--
            (1) In general.--No specified Federal funds (as defined in 
        paragraph (2)) may be made available to a State that requires a 
        health care provider to provide sex-trait altering treatments.
            (2) Specified federal funds defined.--For purposes of this 
        subsection, the term ``specified Federal funds'' means any 
        Federal funds made available under a program administered by 
        the Department of Health and Human Services.
    (c) Civil Action.--A health care provider who is harmed by a 
violation of subsection (a) may, in a civil action, obtain all 
appropriate relief, including injunctive relief, declaratory relief, 
and compensatory damages to prevent the occurrence, continuance, or 
repetition of such violation and to compensate for losses resulting 
from the violation.
    (d) Definition.-- The term ``health care provider'' includes--
            (1) an individual physician, health care assistant, nurse, 
        pharmacist, health researcher, or other health care personnel;
            (2) a hospital, laboratory, pharmacy, health system, or 
        other health care or medical research facility or organization 
        (including a party to a proposed merger or other collaborative 
        arrangement relating to health services, and an entity 
        resulting therefrom);
            (3) a provider-sponsored organization, an accountable care 
        organization, or a health maintenance organization;
            (4) a social services provider that provides or authorizes 
        referrals for health care services;
            (5) a program of training or education in the health 
        professions or medical research, a participant in such a 
        program, or any individual applying or otherwise aspiring to 
        participate in such a program;
            (6) an issuer of health insurance coverage or of a health 
        plan;
            (7) a health care sharing ministry;
            (8) a health insurance plan, including group, individual, 
        or student health plans, or a sponsor or administrator thereof; 
        and
            (9) any other health care organization, program, facility, 
        or plan.

SEC. 10. PROHIBITION ON FEDERAL FUNDS FOR PROVIDING SEX-TRAIT ALTERING 
              TREATMENT TO STUDENTS WITHOUT PARENTAL CONSENT.

    (a) In General.--Notwithstanding any other provision of law, no 
Federal funds may be provided to an elementary school or secondary 
school that allows school personnel to provide, assist in providing, or 
otherwise support the provision of sex-trait altering treatment to a 
student without notifying the parents of the student and receiving 
written approval from such parents.
    (b) Definitions.--In this section:
            (1) ESEA terms.--The terms ``elementary school'', 
        ``paraprofessional'', ``parent'', ``school leader'', 
        ``secondary school'', and ``specialized instructional support 
        personnel'' have the meanings given the terms in section 8101 
        of the Elementary and Secondary Education Act of 1965 (20 
        U.S.C. 7801).
            (2) School personnel.--The term ``school personnel'' 
        includes--
                    (A) teachers;
                    (B) paraprofessionals;
                    (C) school leaders;
                    (D) specialized instructional support personnel;
                    (E) volunteers performing services for a school; 
                and
                    (F) other support staff who are employed by a 
                school or who perform services for a school on a 
                contractual basis.

SEC. 11. DEFINITIONS.

    In this Act:
            (1) Sex-trait altering treatment.--The term ``sex-trait 
        altering treatment'' means any medical or surgical service, 
        including physician's services, practitioner's services, 
        inpatient and outpatient hospital services, or prescribed drugs 
        related to gender transition, other than an excepted service, 
        that seeks to:
                    (A) Alter or remove physical or anatomical 
                characteristics or features that are typical for the 
                individual's sex; or
                    (B) Instill or create physiological or anatomical 
                characteristics that resemble a sex different from the 
                individual's sex, including medical services that 
                provide puberty blocking drugs, gender transition 
                hormone therapy, or genital gender reassignment surgery 
                or nongenital gender reassignment surgery knowingly 
                performed for the purpose of assisting an individual 
                with a gender transition.
            (2) Sex.--The term ``sex'' means the biological indication 
        of being male or female, including sex chromosomes, and 
        naturally occurring sex hormones, gonads, and nonambiguous 
        internal and external genitalia present at birth.
            (3) Gender transition hormone therapy.--The term ``gender 
        transition hormone therapy'' means testosterone, estrogen, or 
        progesterone given to an individual in an amount greater than 
        would normally be produced endogenously in a healthy individual 
        of that individual's age and sex.
            (4) Gender.--The term ``gender'' means the psychological, 
        behavioral, social, and cultural aspects of being male or 
        female.
            (5) Gender reassignment surgery.--The term ``gender 
        reassignment 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 the 
        individual's sex, in order to instill or create physiological 
        or anatomical characteristics that resemble a sex different 
        from the individual's sex, including genital gender 
        reassignment surgery or nongenital gender reassignment surgery 
        knowingly performed for the purpose of assisting an individual 
        with a gender transition.
            (6) Gender transition.--The term ``gender transition'' 
        means the process in which an individual shifts from 
        identifying with and living as a gender that corresponds to his 
        or her sex to identifying with and living as a gender different 
        from his or her sex, and may involve social, legal, or physical 
        changes.
            (7) Genital gender reassignment surgery.--The term 
        ``genital gender reassignment surgery'' means a medical 
        procedure knowingly performed for the purpose of assisting an 
        individual with a gender transition, including the following:
                    (A) Surgical procedures, including a penectomy, 
                orchiectomy, vaginoplasty, clitoroplasty, or 
                vulvoplasty for a male sex patient or hysterectomy or 
                ovariectomy for a female sex patient.
                    (B) Reconstruction of the fixed part of the urethra 
                with or without a metoidioplasty.
                    (C) Phalloplasty, vaginectomy, scrotoplasty, or 
                implantation of erection or testicular prostheses for a 
                female sex patient.
            (8) Nongenital gender reassignment surgery.--The term 
        ``nongenital gender reassignment surgery'' means medical 
        procedures knowingly performed for the purpose of assisting an 
        individual with a gender transition, including the following:
                    (A) Surgical procedures for a male sex patient, 
                including augmentation mammoplasty, facial feminization 
                surgery, liposuction, lipofilling, voice surgery, 
                thyroid cartilage reduction, gluteal augmentation, hair 
                reconstruction, or associated aesthetic procedures.
                    (B) Surgical procedures for a female sex patient, 
                including subcutaneous mastectomy, voice surgery, 
                liposuction, lipofilling, pectoral implants, or 
                associated aesthetic procedures.
            (9) Puberty blocking drugs.--The term ``puberty blocking 
        drugs'' means the following when used for the purpose of 
        assisting an individual with a gender transition.
                    (A) Gonadotropin releasing hormone analogues or 
                other synthetic drugs used to stop luteinizing hormone 
                and follicle stimulating hormone secretion; or
                    (B) Synthetic antiandrogen drugs used to block the 
                androgen receptor.
            (10) Excepted service.--The term ``excepted service'' means 
        any of the following:
                    (A) Medical or surgical services furnished to an 
                individual born with a medically verifiable disorder of 
                sex development, including an individual with:
                            (i) External sex characteristics that are 
                        irresolvably ambiguous;
                            (ii) Forty-six XX chromosomes with 
                        virilization;
                            (iii) Forty-six XY chromosomes with 
                        undervirilization; or
                            (iv) Both ovarian and testicular tissue.
                    (B) Medical or surgical services provided when a 
                physician or practitioner has diagnosed a disorder or 
                condition of sexual development that the physician or 
                practitioner 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.
                    (C) The treatment of any infection, injury, 
                disease, or disorder that has been caused by or 
                exacerbated by the performance of sex-trait altering 
                treatments.
                    (D) Any medical or surgical service undertaken 
                because the individual suffers from a physical 
                disorder, physical injury, or physical illness that 
                would, as certified by a physician or practitioner, 
                place the individual in imminent danger of death or 
                impairment of major bodily function unless the medical 
                or surgical service is performed.
                    (E) Mental health or social services, other than 
                sex-trait altering treatments.
                    (F) Services for a disorder or condition of sexual 
                development that is unrelated to a diagnosis of gender 
                dysphoria or gender identity disorder.
            (11) Minor.--The term ``minor'' means an individual under 
        18 years of age.
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