,,ii  #aaith ,,congress  #ast ,session  
,s4 #aggd  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,may #ae1 #bjbe
 ,mr4 ,risch 7for himself1 ,ms4 ,lummis1
 ,mr4 ,ricketts1 and ,mr4 ,cramer7      
introduced the following bill2 which was
 read twice and referred to the         
,committee on ,homeland ,security and   
,governmental ,affairs  ,a ,,bill  ,to  
amend title #e1 ,united ,states ,code1  
to provide that certain treatments may  
not be covered under the health         
insurance program carried out under     
chapter #hi of that title1 and for other
 purposes4  #a4  ,short title  ,this    
,act may be cited as the ,protecting    
,minors in ,federal ,health ,plans ,act4
  #b4  ,prohibitions on ,,fehb coverage 
for certain treatment  7a7  ,in general 
,section #hijb of title #e1 ,united     
,states ,code1 is amended by adding at  
the end the following3  7q7  7#a7 ,in   
this subsection1 the term               
gender-affirming care or service--  7,a7
 means a medical intervention designed  

to treat gender dysphoria2  7,b7        
includes hormone therapy1 the use of    
puberty blockers1 and any surgical      
procedure aimed at gender transition2   
and  7,c7 notwithstanding subparagraphs 
7,a7 and 7,b71 does not include--  7i7 a
 service provided to an individual with 
a medically verifiable disorder of      
sexual development1 including an        
individual with an irresolvable and     
ambiguous external sex characteristic1  
including an individual born with--     
7,i7 #df ,,xy chromosomes and           
under-virilization2  7,,ii7 #df ,,xx    
chromosomes and virilization2 or        
7,,iii7 both ovarian and testicular     
tissue2  7ii7 a service provided to     
treat a disorder diagnosed by a         
physician in which the physician has    
determined through genetic or           
biochemical testing that the applicable 
individual has abnormal 7or otherwise   
inconsistent with typical male or female
 characteristics7--  7,i7 sex chromosome
 structure2  7,,ii7 sex steroid hormone 

production2 or  7,,iii7 sex steroid     
hormone action2  7iii7 the treatment of 
any infection1 injury1 disease1 or      
disorder that has been caused or        
worsened by a medical intervention      
described in subparagraph 7,a71 without 
regard to whether that intervention--   
7,i7 was performed in compliance with   
,state or ,federal law2 or  7,,ii7 was  
covered under a contract under this     
chapter1 as of the date on which the    
intervention was performed2  7iv7 any   
procedure that-- 7,i7 is performed to   
address a physical disorder1 injury1 or 
illness that1 as certified by a         
physician1 poses an imminent risk of    
death or impairment of major bodily     
function2 and  7,,ii7 is not performed  
for the purpose of gender transition or 
to alleviate psychological1 physical1 or
 mental distress relating to gender2    
7v7 a prescription for puberty          
suppression or blocking that is used to 
normalize puberty in an individual      
younger than #ah years of age who has   

been diagnosed with precocious puberty2 
7vi7 any hormone therapy procedure that 
is used to stimulate puberty in an      
individual younger than #ah years of age
 who has been diagnosed with delayed    
puberty1 if the hormones administered   
through that procedure are--  7,i7      
consistent with the biological sex of   
the individual2 and  7,,ii7 used to     
stimulate a normal puberty consistent   
with the biological sex of the          
individual2 or  7vii7 male circumcision4
  7#b7 ,subject to paragraph 7#c71 and  
notwithstanding any other provision of  
law or regulation1 a contract under this
 chapter may not include coverage for   
any gender-affirming care or service for
 any individual younger than #ah years  
of age4  7#c7 ,in the case of an        
individual who1 as of the effective date
 of this subsection1 is younger than #ah
 years of age and who1 as of that       
effective date1 is undergoing hormone   
therapy that1 as of the day before that 
effective date1 is covered by a contract

 under this chapter1 that hormone       
therapy may continue to be covered under
 such a contract after that effective   
date if the hormone therapy is provided 
pursuant to a reduction schedule that-- 
7,a7 is supervised by a physician2 and  
7,b7 requires that therapy to conclude  
not later than #a year after that       
effective date4  4  7b7  ,applicability 
,the amendment made by subsection 7a7   
shall apply with respect to any contract
 entered into1 or renewed for a contract
 year1 on or after the date of enactment
 of this ,act4