,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #dih  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,janu>y #af1 #bjbe,mr4
 ,cr5%aw 7= himself & ,ms4 ,gre5e (     
,georgia7 introduc$ ! foll[+ bill2 :i* 0
 ref]r$ to ! ,committee on ,en]gy &     
,comm]ce  ,a ,,bill  ,to am5d title     
,,xix ( ! ,social ,security ,act to     
prohibit ,f$]al ,m$icaid fund+ = g5d]   
transition proc$ures = m9ors4  #a4 ,%ort
 title ,?is ,act may be cit$ z ! ,d ,no 
,h>m 9 ,m$icaid ,act4  #b4 ,prohibit+   
f$]al m$icaid fund+ = g5d] transition = 
m9ors  7a7 ,9 g5]al ,section #aijc7;i7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acif;b7i77 is am5d$-- 7#a7 9 p>agraph 
7#bf71 by /rik+ 2 or & ins]t+ a         
semicolon2  7#b7 9 p>agraph 7#bg71 by   
/rik+ ! p]iod at ! end & ins]t+ 2 or2 & 
7#c7 by ins]t+ aft] p>agraph 7#bg7 !    
foll[+ new p>agraph3 7#bh7 ) respect to 
any am\nt exp5d$ = specifi$ g5d]        
proc$ures "u section #aije7kk7 to an    
individual "u #ah ye>s ( age enroll$ 9 a
 ,/ate plan 7or waiv] ( su* plan71      

includ+ any am\nts exp5d$ = !           
adm9i/ration ( a ,/ate program t        
furni%es specifi$ proc$ures & drugs to  
individuals "u #ah ye>s ( age44  7#d7 9 
! flu% left matt] at ! end1 by /rik+ &  
7#ah71 & ins]t+ 7#ah71 & 7#bh74  7b7    
,prohibit+ f$]al m$icaid fund+ = g5d]   
transitions = m9ors ,section #aije ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7 is am5d$ by add+ at ! end !    
foll[+ new subsection3  7,,kk7          
,prohibit+ f$]al m$icaid fund+ = g5d]   
transitions = m9ors  7,a7 ,= purposes ( 
section #aijc7;i77#bh71 except z provid$
 9 subp>agraph 7,b71 ! t]m specifi$ g5d]
 transition proc$ures means1 ) respect  
to an individual1 any ( ! foll[+ :5     
p]=m$ = ! purpose ( int5tionally *ang+ !
 body ( su* individual 7includ+ by      
disrupt+ ! body's developm5t1 inhibit+  
its natural functions1 or modify+ its   
appe>ance7 to no long] correspond to !  
individual's sex3 7i7 ,p]=m+ any surg]y1
 includ+-- 7,i7 ca/ration2  7,,ii7      
/]ilization2  7,,iii7 or*iectomy2       

7,,iv7 scrotopla/y2  7,v7 vasectomy2    
7,,vi7 tubal ligation2  7,,vii7         
hy/]ectomy2  7,,viii7 oophorectomy2     
7,,ix7 ov>iectomy2  7,x7 metoidiopla/y2 
7,,xi7 clitoropla/y2  7,,xii7           
recon/ruction ( ! fix$ "p ( ! ure?ra )  
or )\t a metoidiopla/y or a phallopla/y2
  7,,xiii7 p5ectomy2  7,,xiv7           
phallopla/y2  7,,xv7 vag9opla/y2        
7,,xvi7 vag9ectomy2  7,,xvii7           
vulvopla/y2  7,,xviii7 r$uction         
?yro*ondropla/y2  7,,xix7               
*ondrol>yngopla/y2  7,,xx7 ma/ectomy2 & 
7,,xxi7 any pla/ic1 cosmetic1 or        
ae/hetic surg]y t fem9izes or           
mascul9izes ! facial or o!r             
physiological features ( an individual4 
7ii7 ,any placem5t ( *e/ implants to    
create fem99e brea/s or any placem5t (  
erection or te/icul> prose!ses4  7iii7  
,any placem5t ( fat or artificial       
implants 9 ! gluteal region4  7iv7      
,adm9i/]+1 supply+1 prescrib+1 disp5s+1 
di/ribut+1 or o!rwise convey+ to an     
individual m$ications1 includ+-- 7,i7   

gonadotrop9-releas+ hormone 7,gn,r,h7   
analogues or o!r pub]ty-block+ drugs to 
/op or delay normal pub]ty2 &  7,,ii7   
te/o/]one1 e/rog51 proge/]one or o!r    
&rog5s to an individual at doses t are  
supraphysiologic1 great] or m pot5t ?an 
w\ld normally be produc$ endog5\sly 9 a 
heal?y individual ( ! same age & sex4   
7,b7 ,exception ,subp>agraph 7,a7 %all n
 apply to ! foll[+ :5 furni%$ to an     
individual by a heal? c>e provid] ) !   
cons5t ( su* individual's p>5t or legal 
gu>dian3 7i7 ,pub]ty suppression or     
block+ prescription drugs = ! purpose ( 
normaliz+ pub]ty = an individual        
exp]i5c+ precoci\s pub]ty4  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 *romosome )               
und]virilization2 &  7cc7 bo? ov>ian &  
te/icul> tissue2  7,,ii7 sex *romosome  
/ructure1 sex/]oid hormone production1  

or sex hormone action1 if det]m9$ to be 
abnormal = a heal?y individual ( ! same 
sex & age by a physician ?r\gh g5etic or
 bio*emical te/+2  7,,iii7 infection1   
disease1 injury1 or disord] caus$ or    
exac]bat$ by a previ\s proc$ure describ$
 9 subp>agraph 7,a71 or 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$1 n includ+ proc$ures p]=m$ = !    
alleviation ( m5tal di/ress2 or  7,,iv7 
proc$ures to re/ore or recon/ruct ! body
 ( ! individual 9 ord] to correspond to 
! individual's sex aft] "o or m previ\s 
proc$ures describ$ 9 subp>agraph 7,a71  
:i* may include ! removal ( a pseudo    
phallus or brea/ augm5tation4  7,c7 ,sex
 ,= purposes ( subp>agraph7,a71 ! t]m   
sex means ei!r male or female1 z        
biologically det]m9$ & def9$ by clause  
7i7 & clause 7ii74 7i7 ,female ,! t]m   
female means an individual :o naturally 

has1 _h1 w h1 or w\ld h1 b = a          
developm5tal or g5etic anomaly or       
hi/orical accid5t1 ! reproductive sy/em 
t at "s po9t produces1 transports1 &    
utilizes eggs = f]tilization4  7ii7     
,male ,! t]m male means an individual :o
 naturally has1 _h1 w h1 or w\ld h1 b = 
a developm5tal or g5etic anomaly or     
hi/orical accid5t1 ! reproductive sy/em 
t at "s po9t produces1 transports1 &    
utilizes sp]m = f]tilization4  4