#aaith ,,congress #ast ,session ,h4 ,r4 #dih ,,an ,,act ,to amend title ,,xix of the ,social ,security ,act to prohibit ,federal ,medicaid funding for gender transition procedures for minors4 #a4 ,short title ,this ,act may be cited as the ,do ,no ,harm in ,medicaid ,act4 #b4 ,prohibiting federal medicaid funding for gender transition for minors 7a7 ,in general ,section #aijc7;i7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7i77 is amended-- 7#a7 in paragraph 7#bf71 by striking 2 or and inserting a semicolon2 7#b7 in paragraph 7#bg71 by striking the period at the end and inserting 2 or2 and 7#c7 by inserting after paragraph 7#bg7 the following new paragraph3 7#bh7 with respect to any amount expended for specified gender procedures under section #aije7kk7 to an individual under #ah years of age enrolled in a ,state plan 7or waiver of such plan71 including any amounts expended for the administration of a ,state program that furnishes specified procedures and drugs to individuals under #ah years of age44 7#d7 in the flush left matter at the end1 by striking and 7#ah71 and inserting 7#ah71 and 7#bh74 7b7 ,prohibiting federal medicaid funding for gender transitions for minors ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended by adding at the end the following new subsection3 7,,kk7 ,prohibiting federal medicaid funding for gender transitions for minors 7,a7 ,for purposes of section #aijc7;i77#bh71 except as provided in subparagraph 7,b71 the term specified gender transition procedures means1 with respect to an individual1 any of the following when performed for the purpose of intentionally changing the body of such individual 7including by disrupting the body's development1 inhibiting its natural functions1 or modifying its appearance7 to no longer correspond to the individual's sex3 7i7 ,performing any surgery1 including-- 7,i7 castration2 7,,ii7 sterilization2 7,,iii7 orchiectomy2 7,,iv7 scrotoplasty2 7,v7 vasectomy2 7,,vi7 tubal ligation2 7,,vii7 hysterectomy2 7,,viii7 oophorectomy2 7,,ix7 ovariectomy2 7,x7 metoidioplasty2 7,,xi7 clitoroplasty2 7,,xii7 reconstruction of the fixed part of the urethra with or without a metoidioplasty or a phalloplasty2 7,,xiii7 penectomy2 7,,xiv7 phalloplasty2 7,,xv7 vaginoplasty2 7,,xvi7 vaginectomy2 7,,xvii7 vulvoplasty2 7,,xviii7 reduction thyrochondroplasty2 7,,xix7 chondrolaryngoplasty2 7,,xx7 mastectomy2 and 7,,xxi7 any plastic1 cosmetic1 or aesthetic surgery that feminizes or masculinizes the facial or other physiological features of an individual4 7ii7 ,any placement of chest implants to create feminine breasts or any placement of erection or testicular prosetheses4 7iii7 ,any placement of fat or artificial implants in the gluteal region4 7iv7 ,administering1 supplying1 prescribing1 dispensing1 distributing1 or otherwise conveying to an individual medications1 including-- 7,i7 gonadotropin-releasing hormone 7,gn,r,h7 analogues or other puberty-blocking drugs to stop or delay normal puberty2 and 7,,ii7 testosterone1 estrogen1 progesterone or other androgens to an individual at doses that are supraphysiologic1 greater or more potent than would normally be produced endogenously in a healthy individual of the same age and sex4 7,b7 ,exception ,subparagraph 7,a7 shall not apply to the following when furnished to an individual by a health care provider with the consent of such individual's parent or legal guardian3 7i7 ,puberty suppression or blocking prescription drugs for the purpose of normalizing puberty for an individual experiencing precocious puberty4 7ii7 ,appropriate and medically necessary procedures or treatments to correct for-- 7,i7 a medically verifiable genetic disorder of sex development1 including-- 7aa7 #df1,,xx chromosomes with virilization2 7bb7 #df1,,xy chromosome with undervirilization2 and 7cc7 both ovarian and testicular tissue2 7,,ii7 sex chromosome structure1 sexsteroid hormone production1 or sex hormone action1 if determined to be abnormal for a healthy individual of the same sex and age by a physician through genetic or biochemical testing2 7,,iii7 infection1 disease1 injury1 or disorder caused or exacerbated by a previous procedure described in subparagraph 7,a71 or 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 a major bodily function unless the procedure is performed1 not including procedures performed for the alleviation of mental distress2 or 7,,iv7 procedures to restore or reconstruct the body of the individual in order to correspond to the individual's sex after one or more previous procedures described in subparagraph 7,a71 which may include the removal of a pseudo phallus or breast augmentation4 7,c7 ,sex ,for purposes of subparagraph7,a71 the term sex means either male or female1 as biologically determined and defined by clause 7i7 and clause 7ii74 7i7 ,female ,the term female means an individual who naturally has1 had1 will have1 or would have1 but for a developmental or genetic anomaly or historical accident1 the reproductive system that at some point produces1 transports1 and utilizes eggs for fertilization4 7ii7 ,male ,the term male means an individual who naturally has1 had1 will have1 or would have1 but for a developmental or genetic anomaly or historical accident1 the reproductive system that at some point produces1 transports1 and utilizes sperm for fertilization4 4 ,passed the ,house of ,representatives ,december #ah1 #bjbe4;,clerk4