,i #aaith ,,congress #ast ,session ,h4 ,r4 #bchg ,,in ,,the ,,house ,,of ,,representatives ,march #bf1 #bjbe,mr4 ,onder 7for himself1 ,mr4 ,harris of ,maryland1 ,mrs4 ,miller of ,illinois1 and ,mrs4 ,biggs of ,south ,carolina7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on the ,judiciary1 ,education and ,workforce1 and ,ways and ,means1 for a period to be subsequently determined by the ,speaker1 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 minors1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,no ,harm ,act4 #b4 ,prohibition on use of ,federal funds for certain treatments 7a7 ,in general ,notwithstanding any other provision of law1 no ,federal funds may be made available for purposes of paying for1 sponsoring1 promoting1 assisting1 or supporting the furnishing of a sex-trait altering treatment to a minor4 7b7 ,civil action ,any person1 including a taxpayer1 may bring a civil action for violation of subsection 7a7 for legal damages and equitable relief against the ,united ,states1 or the appropriate ,department or ,agency disbursing federal funds in violation of subsection 7a71 in an appropriate district court of the ,united ,states4 #c4 ,prohibition on use of ,federal funds for certain actions 7a7 ,in general ,notwithstanding any other provision of law1 no ,federal funds may be made available for purposes of taking any regulatory or subregulatory action to promote sex-trait altering treatments to minors4 7b7 ,civil action ,any person1 including a taxpayer1 may bring a civil action for violation of subsection 7a7 for legal damages and equitable relief against the ,united ,states1 or the appropriate ,department or ,agency disbursing federal funds in violation of subsection 7a71 in an appropriate district court of the ,united ,states4 #d4 ,female genital mutilation to include provision of sex-trait altering treatment to minors ,section #aaf of title #ah1 ,united ,states ,code1 is amended by adding at the end the following3 ,for the purpose of subsection 7b77#a71 the phrase 8necessary to the health of the person0 shall not include change of gender or sex1 or affirmation of gender or sex44 #e4 ,prohibition on funding certain institutions ,notwithstanding any other provision of law1 no ,federal funds may be made available to a medical institution 7including a hospital1 medical school1 clinic1 public health organization1 federally qualified health center1 rural health center1 or medical practice7 if such institution provides sex-trait altering treatments to minors4 #f4 ,right to decline treatments 7a7 ,in general ,the parent of a minor shall have the right to decline any sex-trait altering treatment for such minor4 ,likewise1 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 parents4 7b7 ,state requirement 7#a7 ,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 minor4 7#b7 ,specified ,federal funds defined ,for purposes of this section1 the term specified ,federal funds means ,federal funds made available under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 or under part ,a of title ,,iv of such ,act 7#db ,u4,s4,c4 #fja et seq474 7c7 ,civil action 7#a7 ,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 relief4 7#b7 ,statute of limitations ,an action under this subsection may be brought at any time prior to #cj years after the date on which the minor attains the age of majority4 #g4 ,requirement to receive informed consent 7a7 ,in general ,no health care provider may furnish any sex-trait altering treatment to a minor unless1 at least #gb hours prior to furnishing such treatment1 such provider-- 7#a7 holds a consultation appointment with the parents of such minor to discuss such treatment2 7#b7 provides to the parents of such minor a complete1 printed list of potential side effects of such treatment1 including any permanent risks relating to fertility and sexual function2 and 7#c7 received the written1 informed consent of the parents of such minor for such treatment4 7b7 ,civil action 7#a7 ,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 relief4 7#b7 ,statute of limitations ,an action under this subsection may be brought at any time prior to #cj years after the date on which the minor attains the age of majority4 #h4 ,medical malpractice liability 7a7 ,in general ,an individual may bring a civil action in an appropriate district court of the ,united ,states to obtain appropriate relief for any physical1 psychological1 or physiological harm caused by a sex-trait altering treatment performed on the individual when the individual was a minor against a medical practitioner1 hospital1 clinic1 surgery center or other provider that performed or prescribed such treatment4 ,if said civil action is successful1 the individual will be awarded attorney's fees and litigation costs1 and treble damages4 7b7 ,statute of limitations ,an action under this subsection may be brought at any time prior to #cj years after the date on which the minor attains the age of majority4 #i4 ,right of conscience for health care providers 7a7 ,in general ,a health care provider may not be penalized1 retaliated against1 or otherwise discriminated against on the basis that the provider does not or declines to-- 7#a7 perform1 refer for1 pay for1 or otherwise participate in sex-trait altering treatment2 7#b7 provide or sponsor sex-trait altering treatment coverage2 or 7#c7 facilitate or make arrangements for sex-trait altering treatment4 7b7 ,state requirement 7#a7 ,in general ,no specified ,federal funds 7as defined in paragraph 7#b77 may be made available to a ,state that requires a health care provider to provide sex-trait altering treatments4 7#b7 ,specified ,federal funds defined ,for purposes of this subsection1 the term specified ,federal funds means any ,federal funds made available under a program administered by the ,department of ,health and ,human ,services4 7c7 ,civil action ,a health care provider who is harmed by a violation of subsection 7a7 may1 in a civil action1 obtain all appropriate relief1 including injunctive relief1 declaratory relief1 and compensatory damages to prevent the occurrence1 continuance1 or repetition of such violation and to compensate for losses resulting from the violation4 7d7 ,definition ,the term health care provider includes-- 7#a7 an individual physician1 health care assistant1 nurse1 pharmacist1 health researcher1 or other health care personnel2 7#b7 a hospital1 laboratory1 pharmacy1 health system1 or other health care or medical research facility or organization 7including a party to a proposed merger or other collaborative arrangement relating to health services1 and an entity resulting therefrom72 7#c7 a provider-sponsored organization1 an accountable care organization1 or a health maintenance organization2 7#d7 a social services provider that provides or authorizes referrals for health care services2 7#e7 a program of training or education in the health professions or medical research1 a participant in such a program1 or any individual applying or otherwise aspiring to participate in such a program2 7#f7 an issuer of health insurance coverage or of a health plan2 7#g7 a health care sharing ministry2 7#h7 a health insurance plan1 including group1 individual1 or student health plans1 or a sponsor or administrator thereof2 and 7#i7 any other health care organization1 program1 facility1 or plan4 #aj4 ,prohibition on ,federal funds for providing sex-trait altering treatment to students without parental consent 7a7 ,in general ,notwithstanding any other provision of law1 no ,federal funds may be provided to an elementary school or secondary school that allows school personnel to provide1 assist in providing1 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 parents4 7b7 ,definitions ,in this section3 7#a7 ,,esea terms ,the terms elementary school1 paraprofessional1 parent1 school leader1 secondary school1 and specialized instructional support personnel have the meanings given the terms in section #haja of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #ghja74 7#b7 ,school personnel ,the term school personnel includes-- 7,a7 teachers2 7,b7 paraprofessionals2 7,c7 school leaders2 7,d7 specialized instructional support personnel2 7,e7 volunteers performing services for a school2 and 7,f7 other support staff who are employed by a school or who perform services for a school on a contractual basis4 #aa4 ,definitions ,in this ,act3 7#a7 ,sex-trait altering treatment ,the term sex-trait altering treatment means any medical or surgical service1 including physician's services1 practitioner's services1 inpatient and outpatient hospital services1 or prescribed drugs related to gender transition1 other than an excepted service1 that seeks to3 7,a7 ,alter or remove physical or anatomical characteristics or features that are typical for the individual's sex2 or 7,b7 ,instill or create physiological or anatomical characteristics that resemble a sex different from the individual's sex1 including medical services that provide puberty blocking drugs1 gender transition hormone therapy1 or genital gender reassignment surgery or nongenital gender reassignment surgery knowingly performed for the purpose of assisting an individual with a gender transition4 7#b7 ,sex ,the term sex means the biological indication of being male or female1 including sex chromosomes1 and naturally occurring sex hormones1 gonads1 and nonambiguous internal and external genitalia present at birth4 7#c7 ,gender transition hormone therapy ,the term gender transition hormone therapy means testosterone1 estrogen1 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 sex4 7#d7 ,gender ,the term gender means the psychological1 behavioral1 social1 and cultural aspects of being male or female4 7#e7 ,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 sex1 in order to instill or create physiological or anatomical characteristics that resemble a sex different from the individual's sex1 including genital gender reassignment surgery or nongenital gender reassignment surgery knowingly performed for the purpose of assisting an individual with a gender transition4 7#f7 ,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 sex1 and may involve social1 legal1 or physical changes4 7#g7 ,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 transition1 including the following3 7,a7 ,surgical procedures1 including a penectomy1 orchiectomy1 vaginoplasty1 clitoroplasty1 or vulvoplasty for a male sex patient or hysterectomy or ovariectomy for a female sex patient4 7,b7 ,reconstruction of the fixed part of the urethra with or without a metoidioplasty4 7,c7 ,phalloplasty1 vaginectomy1 scrotoplasty1 or implantation of erection or testicular prostheses for a female sex patient4 7#h7 ,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 transition1 including the following3 7,a7 ,surgical procedures for a male sex patient1 including augmentation mammoplasty1 facial feminization surgery1 liposuction1 lipofilling1 voice surgery1 thyroid cartilage reduction1 gluteal augmentation1 hair reconstruction1 or associated aesthetic procedures4 7,b7 ,surgical procedures for a female sex patient1 including subcutaneous mastectomy1 voice surgery1 liposuction1 lipofilling1 pectoral implants1 or associated aesthetic procedures4 7#i7 ,puberty blocking drugs ,the term puberty blocking drugs means the following when used for the purpose of assisting an individual with a gender transition4 7,a7 ,gonadotropin releasing hormone analogues or other synthetic drugs used to stop luteinizing hormone and follicle stimulating hormone secretion2 or 7,b7 ,synthetic antiandrogen drugs used to block the androgen receptor4 7#aj7 ,excepted service ,the term excepted service means any of the following3 7,a7 ,medical or surgical services furnished to an individual born with a medically verifiable disorder of sex development1 including an individual with3 7i7 ,external sex characteristics that are irresolvably ambiguous2 7ii7 ,forty-six ,,xx chromosomes with virilization2 7iii7 ,forty-six ,,xy chromosomes with undervirilization2 or 7iv7 ,both ovarian and testicular tissue4 7,b7 ,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 structure1 sex steroid hormone production1 or sex steroid hormone action4 7,c7 ,the treatment of any infection1 injury1 disease1 or disorder that has been caused by or exacerbated by the performance of sex-trait altering treatments4 7,d7 ,any medical or surgical service undertaken because the individual suffers from a physical disorder1 physical injury1 or physical illness that would1 as certified by a physician or practitioner1 place the individual in imminent danger of death or impairment of major bodily function unless the medical or surgical service is performed4 7,e7 ,mental health or social services1 other than sex-trait altering treatments4 7,f7 ,services for a disorder or condition of sexual development that is unrelated to a diagnosis of gender dysphoria or gender identity disorder4 7#aa7 ,minor ,the term minor means an individual under #ah years of age4