,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #bajg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #ad1 #bjbe,mr4   
,cr5%aw 7= himself1 ,mrs4 ,mill] (      
,ill9ois1 ,mrs4 ,mill]-,meeks1 ,mr4     
,pflug]1 ,mr4 ,ellzey1 ,mr4 ,van ,drew1 
,mr4 ,gre5 ( ,t5nessee1 ,mr4 ,r\z]1     
,mrs4 ,h>%b>g]1 ,mr4 ,gro?man1 ,mr4     
,jackson ( ,texas1 & ,mr4 ,scott        
,frankl9 ( ,florida7 introduc$ ! foll[+ 
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce  ,a ,,bill  ,to am5d  
title ,,iii ( ! ,public ,heal? ,s]vice  
,act to reau?orize ! program ( paym5ts  
to *ildr5's hospitals t op]ate graduate 
m$ical education programs1 & = o!r      
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,*ildr5's ,hospital ,,gme  
,support ,reau?orization ,act ( #bjbe4  
#b4 ,program ( paym5ts to *ildr5's      
hospitals t op]ate graduate m$ical      
education programs ,section #cdj;,e ( ! 
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bef;e7 is am5d$-- 7#a7 9     
subsection 7a71 by /rik+ #bjbc & ins]t+ 

#bjcj2  7#b7 9 subsection 7b77#c77;,d71 
by ins]t+ & ! end ( fiscal ye> #bjcj1   
aft] fiscal ye> #bjbb12  7#c7 9         
subsection 7e71 by add+ at ! end !      
foll[+ new p>agraph3  7#d7 ,prohibition 
on paym5ts to hospitals furni%+ specifi$
 proc$ures & drugs to m9ors  7,a7 ,9    
g5]al ,not)/&+ any o!r provision ( ?is  
section1 no paym5t may be made "u ?is   
section to a *ildr5's hospital = a      
fiscal ye> 7beg9n+ ) fiscal ye> #bjbf7  
if1 at any po9t dur+ ! prec$+ fiscal    
ye>1 su* hospital furni%$ specifi$      
proc$ures & drugs 7z def9$ 9 subsection 
7g77 to an individual "u #ah ye>s ( age4
  7,b7 ,special rule = fiscal ye> #bjbf 
,9 apply+ subp>agraph 7,a7 ) respect to 
paym5ts describ$ 9 su* subp>agraph =    
fiscal ye> #bjbf-- 7i7 ! ref]5ce to = a 
fiscal ye> %all be treat$ z a ref]5ce to
 = any portion ( fiscal ye> #bjbf       
occurr+ aft] ,decemb] #ca1 #bjbe2 &     
7ii7 ! ref]5ce to ! prec$+ fiscal ye>   
%all be treat$ z a ref]5ce to ! p]iod   
beg9n+ on ,septemb] #a1 #bjbe1 & end+ on

 ,decemb] #ca1 #bjbe4  7,c7 ,rule (     
con/ruction ,no?+ 9 ?is p>agraph %all be
 con/ru$ z prohibit+ paym5ts = a fiscal 
ye> 7or1 9 ! case ( paym5ts = fiscal ye>
 #bjbf1 dur+ ! portion ( su* fiscal ye> 
describ$ 9 subp>agraph 7,b77i77 to a    
hospital t1 dur+ ! prec$+ fiscal ye>    
7or1 9 ! case ( paym5ts = fiscal ye>    
#bjbf1 dur+ ! p]iod describ$ 9          
subp>agraph 7,b77ii771 furni%$ m5tal or 
behavioral heal? s]vices to individuals 
"u #ah ye>s ( age = ! treatm5t ( g5d]   
dysphoria n consi/+ ( specifi$ proc$ures
 & drugs4  2  7#d7 9 subsection 7f7--   
7,a7 9 p>agraph 7#a77;,a7-- 7i7 9 clause
 7v71 by /rik+ & at ! end2  7ii7 9      
clause 7vi71 by /rik+ ! p]iod at ! end &
 ins]t+ 2 &2 &  7iii7 by add+ at ! end !
 foll[+3  7vii7 = ea* ( fiscal ye>s     
#bjbf ?r\gh #bjcj1 #abd1jjj1jjj4  2 &   
7,b7 9 p>agraph 7#b7-- 7i7 9 subp>agraph
 7,e71 by /rik+ & at ! end2  7ii7 9     
subp>agraph 7,f71 by /rik+ ! p]iod at ! 
end & ins]t+ 2 &2 &  7iii7 by add+ at ! 
end ! foll[+3  7,g7 = ea* ( fiscal ye>s 

#bjbf ?r\gh #bjcj1 #bfa1jjj1jjj  2 &    
7#e7 9 subsection 7g71 by add+ at ! end 
! foll[+ new p>agraph3  7#d7 ,specifi$  
proc$ures & drugs  7,a7 ,9 g5]al ,except
 z provid$ 9 subp>agraph 7,b71 ! t]m    
specifi$ proc$ures & drugs means1 )     
respect to an individual1 any ( !       
foll[+3 7i7 ,p]=m+ any surg]y = !       
purpose ( *ang+ ! body ( su* individual 
to no long] correspond to ! individual's
 sex1 includ+-- 7,i7 ca/ration2  7,,ii7 
or*iectomy2  7,,iii7 scrotopla/y2       
7,,iv7 vasectomy2  7,v7 hy/]ectomy2     
7,,vi7 oophorectomy2  7,,vii7           
ov>iectomy2  7,,viii7 metoidiopla/y2    
7,,ix7 p5ectomy2  7,x7 phallopla/y2     
7,,xi7 vag9opla/y2  7,,xii7 vag9ectomy2 
7,,xiii7 vulvopla/y2  7,,xiv7 r$uction  
?yro*ondropla/y2  7,,xv7                
*ondrol>yngopla/y1 or any pla/ic surg]y 
t fem9izes or mascul9izes ! facial      
features2  7,,xvi7 ma/ectomy1 or any    
placem5t ( *e/ implants to create fem99e
 brea/s2 &  7,,xvii7 ,any placem5t ( fat
 or artificial implants 9 ! gluteal     

region4  7ii7 ,adm9i/]+1 supply+1       
prescrib+1 disp5s+1 di/ribut+1 or       
o!rwise convey+ to an individual        
m$ications = ! purposes describ$ 9      
clause 7i71 includ+ gonadotroph9 releas+
 hormone 7,gn,r,h7 analogues or o!r     
pub]ty-block+ drugs to /op or delay     
normal pub]ty1 & e/rog51 te/o/]one1     
proge/]one1 or o!r &rog5s to an         
individual 9 an am\nt great] ?an w\ld   
normally be produc$ endog5\sly 9 a      
heal?y individual ( t individual's age &
 sex4  7,b7 ,exception ,subp>agraph 7,a7
 %all n apply to ! provision by a       
physician or heal? c>e provid]1 ) !     
cons5t ( ! *ild's p>5t or legal gu>dian1
 (-- 7i7 pub]ty suppression or block+   
prescription drugs = ! purpose (        
normaliz+ pub]ty = a m9or exp]i5c+      
precoci\s pub]ty2  7ii7 appropriate &   
m$ically necess>y proc$ures or treatm5ts
 to correct =-- 7,i7 a m$ically         
v]ifiable g5etic disord] ( sex          
developm5t1 includ+-- 7aa7 #df1,,xx     
*romosomes ) virilization2  7bb7        

#df1,,xy *romosomes ) und]virilization2 
&  7cc7 bo? ov>ian & te/icul> tissue2 or
  7,,ii7 sex *romosome /ructure1 sex    
/]oid hormone production1 or sex hormone
 action1 if det]m9$ to be abnormal by a 
physician ?r\gh g5etic or bio*emical    
te/+2  7iii7 infection1 disease1 injury1
 or disord] caus$ or exac]bat$ by       
previ\s m$ical proc$ures z def9$ 9      
subsection 7g77#d77;,a72 or  7iv7 a     
physical disord]1 physical injury1 or   
physical illness t w\ld1 z c]tifi$ by a 
physician1 place ! individual 9 imm95t  
dang] ( dea? or impairm5t ( a major     
bodily function unless ! proc$ure is    
p]=m$1 n includ+ if ! proc$ure or drug  
is = ! purpose describ$ 9 subsection    
7g77#d77;,a77i74  7,c7 ,sex ,= purposes 
( subp>agraph 7,a71 ! t]m sex means !   
indication ( male or female sex by      
reproductive pot5tial or capacity1 sex  
*romosomes1 naturally occurr+ sex       
hormones1 gonads1 or int]nal or ext]nal 
g5italia pres5t at bir?4  4