,,ii #aahth ,,congress #ast ,session ,s4 #dce ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #ae1 #bjbc,mr4 ,rubio 7for himself1 ,mrs4 ,blackburn1 ,mr4 ,budd1 ,mr4 ,tuberville1 and ,mr4 ,braun7 introduced the following bill2 which was read twice and referred to the ,committee on ,armed ,services ,a ,,bill ,to provide requirements related to the eligibility of individuals who identify as transgender from serving in the ,armed ,forces4 #a4 ,short title ,this ,act may be cited as the ,ensuring ,military ,readiness ,act of #bjbc4 #b4 ,limitations on military service by individuals who identify as transgender ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,defense shall prescribe regulations regarding service of individuals who identify as transgender as follows3 7#a7 ,persons who identify as transgender with a history of diagnosis of gender dysphoria are disqualified from military service except under the following limited circumstances3 7,a7 ,individuals may serve in the ,armed ,forces if they have been stable for #cf consecutive months in their biological sex prior to accession4 7,b7 ,members of the ,armed ,forces diagnosed with gender dysphoria after entering into service may be retained if they do not undergo gender transition procedures and remain deployable within applicable retention standards for their biological sex4 7,c7 ,members of the ,armed ,forces serving as of the date of the enactment of this ,act who have been diagnosed with gender dysphoria may continue to serve only in their biological sex1 irrespective of any changes previously made to their gender marker in the ,defense ,enrollment ,eligibility ,reporting ,system 7,,deers71 and receive medically necessary treatment for gender dysphoria4 ,such treatment may not include gender transition procedures4 7#b7 ,persons who identify as transgender who seek or have undergone gender transition are disqualified from military service4 7#c7 ,persons who identify as transgender without a history or diagnosis of gender dysphoria1 who are otherwise qualified for service and meet all physical and mental requirements1 may serve in the ,armed ,forces in their biological sex4 #c4 ,revised regulations regarding gender markings ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,defense shall prescribe regulations updating the ,defense ,enrollment ,eligibility ,reporting ,system 7,,deers7 to require the gender markers for members of the ,armed ,forces to match their biological sex1 irrespective of any previous changes allowed4 #d4 ,definitions ,in this ,act3 7#a7 ,cross-sex hormones ,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 normally occur naturally in healthy biological females1 or estrogen given to biological males at doses that are profoundly larger or more potent than would normally occur naturally in healthy biological males4 7#b7 ,gender ,the term gender means the psychological1 behavioral1 social1 and cultural aspects of being male or female4 7#c7 ,gender dysphoria ,the term gender dysphoria means a marked incongruence between one's experienced or expressed gender and biological sex4 7#d7 ,gender transition ,the term gender transition means the process by 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 sex1 and may involve social1 legal1 or physical changes4 7#e7 ,gender transition procedures ,the term gender transition procedures-- 7,a7 means-- 7i7 any medical or surgical intervention1 including physician's services1 inpatient and outpatient hospital services1 or prescribed drugs related to gender transition1 that seeks to alter or remove physical or anatomical characteristics or features that are typical for the individual's biological sex or to instill or create physiological or anatomical characteristics that resemble a sex different from the individual's birth sex1 including medical services that provide puberty-blocking drugs1 cross-sex hormones1 or other mechanisms to promote the development of feminizing or masculinizing features 7in the opposite sex72 and 7ii7 genital or non-genital gender transition surgery performed for the purpose of assisting an individual with a gender transition2 and 7,b7 does not include-- 7i7 services to those born with a medically verifiable disorder of sex development1 including a person with external biological sex characteristics that are irresolvably ambiguous1 such as those born with #df ,,xx chromosomes with virilization1 #df ,,xy chromosomes with undervirilization1 or having both ovarian and testicular tissue2 7ii7 services provided when a physician has otherwise diagnosed a disorder of sexual development1 in which the physician has determined through genetic or biochemical testing that the person does not have normal sex chromosome structure1 sex steroid hormone production1 or sex steroid hormone action for a biological male or biological female2 or 7iii7 the treatment of any infection1 injury1 disease1 or disorder that has been caused by or exacerbated by the performance of gender transition procedures1 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 permissible4 7#f7 ,gender transition surgery ,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 the individual's biological sex in order to instill or create physiological or anatomical characteristics that resemble a sex different from the individual's birth sex1 including genital or non-genital gender reassignment surgery performed for the purpose of assisting an individual with a gender transition4 7#g7 ,genital gender transition surgery ,the term genital gender transition surgery includes surgical procedures such as penectomy1 orchiectomy1 vaginoplasty1 clitoroplasty1 or vulvoplasty for biologically male patients or hysterectomy1 ovariectomy1 reconstruction of the fixed part of the urethra with or without a metoidioplasty or a phalloplasty1 vaginectomy1 scrotoplasty1 or implantation of erection or testicular prostheses for biologically female patients1 when performed for the purpose of assisting an individual with a gender transition4 7#h7 ,non-genital gender transition surgery ,the term non-genital gender transition surgery-- 7,a7 includes1 when performed for the purpose of assisting an individual with a gender transition-- 7i7 surgical procedures such as augmentation mammoplasty1 facial feminization surgery1 liposuction1 lipofilling1 voice surgery1 thyroid cartilage reduction1 gluteal augmentation 7implants or lipofilling71 hair reconstruction1 or various aesthetic procedures for biologically male patients2 or 7ii7 subcutaneous mastectomy1 voice surgery1 liposuction1 lipofilling1 pectoral implants or various aesthetic procedures for biologically female patients2 and 7,b7 does not include any procedure undertaken because the individual suffers from a physical disorder1 physical injury1 or physical illness that would1 as certified by a physician1 place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed1 unless the procedure is for the purpose of a gender transition4 7#i7 ,puberty-blocking drugs ,the term puberty-blocking drugs means1 when used to delay or suppress pubertal development in children for the purpose of assisting an individual with a gender transition-- 7,a7 ,gonadotropin-releasing hormone 7,gn,r,h7 analogues or other synthetic drugs used in biological males to stop luteinizing hormone secretion and therefore testosterone secretion2 and 7,b7 synthetic drugs used in biological females that stop the production of estrogen and progesterone4 7#aj7 ,sex2 birth sex2 biological sex ,the terms sex1 birth sex1 and biological sex refer to the biological indication of male and female in the context of reproductive potential or capacity1 such as sex chromosomes1 naturally occurring sex hormones1 gonads1 and non-ambiguous internal and external genitalia present at birth1 without regard to an individual's psychological1 chosen1 or subjective experience of gender4