,,ii  #aai? ,,congress  #a/ ,session    
,s4 #aggd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #ae1 #bjbe ,mr4   
,ris* 7= himself1 ,ms4 ,lummis1 ,mr4    
,ricketts1 & ,mr4 ,cram]7 introduc$ !   
foll[+ bill2 :i* 0 read twice & ref]r$  
to ! ,committee on ,homel& ,security &  
,gov]nm5tal ,affairs  ,a ,,bill  ,to    
am5d title #e1 ,unit$ ,/ates ,code1 to  
provide t c]ta9 treatm5ts may n be cov]$
 "u ! heal? insurance program c>ri$ out 
"u *apt] #hi ( t title1 & = o!r         
purposes4  #a4  ,%ort title  ,?is ,act  
may be cit$ z ! ,protect+ ,m9ors 9      
,f$]al ,heal? ,plans ,act4  #b4         
,prohibitions on ,,fehb cov]age = c]ta9 
treatm5t  7a7  ,9 g5]al  ,section #hijb 
( title #e1 ,unit$ ,/ates ,code1 is     
am5d$ by add+ at ! end ! foll[+3  7q7   
7#a7 ,9 ?is subsection1 ! t]m           
g5d]-affirm+ c>e or s]vice--  7,a7 means
 a m$ical int]v5tion design$ to treat   
g5d] dysphoria2  7,b7 includes hormone  
!rapy1 ! use ( pub]ty block]s1 & any    
surgical proc$ure aim$ at g5d]          

transition2 &  7,c7 not)/&+ subp>agraphs
 7,a7 & 7,b71 does n include--  7i7 a   
s]vice provid$ to an individual ) a     
m$ically v]ifiable disord] ( sexual     
developm5t1 includ+ an individual ) an  
irresolvable & ambigu\s ext]nal sex     
*>act]i/ic1 includ+ an individual born  
)--  7,i7 #df ,,xy *romosomes &         
"u-virilization2  7,,ii7 #df ,,xx       
*romosomes & virilization2 or  7,,iii7  
bo? ov>ian & te/icul> tissue2  7ii7 a   
s]vice provid$ to treat a disord]       
diagnos$ by a physician 9 :i* !         
physician has det]m9$ ?r\gh g5etic or   
bio*emical te/+ t ! applicable          
individual has abnormal 7or o!rwise     
inconsi/5t ) typical male or female     
*>act]i/ics7--  7,i7 sex *romosome      
/ructure2  7,,ii7 sex /]oid hormone     
production2 or  7,,iii7 sex /]oid       
hormone action2  7iii7 ! treatm5t ( any 
infection1 injury1 disease1 or disord] t
 has be5 caus$ or wors5$ by a m$ical    
int]v5tion describ$ 9 subp>agraph 7,a71 
)\t reg>d to :e!r t int]v5tion--  7,i7 0

 p]=m$ 9 compliance ) ,/ate or ,f$]al   
law2 or  7,,ii7 0 cov]$ "u a contract "u
 ?is *apt]1 z ( ! date on :i* !         
int]v5tion 0 p]=m$2  7iv7 any proc$ure  
t-- 7,i7 is p]=m$ to address a physical 
disord]1 injury1 or illness t1 z c]tifi$
 by a physician1 poses an imm95t risk ( 
dea? or impairm5t ( major bodily        
function2 &  7,,ii7 is n p]=m$ = !      
purpose ( g5d] transition or to         
alleviate psy*ological1 physical1 or    
m5tal di/ress relat+ to g5d]2  7v7 a    
prescription = pub]ty suppression or    
block+ t is us$ to normalize pub]ty 9 an
 individual y\ng] ?an #ah ye>s ( age :o 
has be5 diagnos$ ) precoci\s pub]ty2    
7vi7 any hormone !rapy proc$ure t is us$
 to /imulate pub]ty 9 an individual     
y\ng] ?an #ah ye>s ( age :o has be5     
diagnos$ ) delay$ pub]ty1 if ! hormones 
adm9i/]$ ?r\gh t proc$ure are--  7,i7   
consi/5t ) ! biological sex ( !         
individual2 &  7,,ii7 us$ to /imulate a 
normal pub]ty consi/5t ) ! biological   
sex ( ! individual2 or  7vii7 male      

circumcision4  7#b7 ,subject to p>agraph
 7#c71 & not)/&+ any o!r provision ( law
 or regulation1 a contract "u ?is *apt] 
may n include cov]age = any g5d]-affirm+
 c>e or s]vice = any individual y\ng]   
?an #ah ye>s ( age4  7#c7 ,9 ! case ( an
 individual :o1 z ( ! effective date (  
?is subsection1 is y\ng] ?an #ah ye>s ( 
age & :o1 z ( t effective date1 is      
und]go+ hormone !rapy t1 z ( ! day be=e 
t effective date1 is cov]$ by a contract
 "u ?is *apt]1 t hormone !rapy may      
cont9ue to be cov]$ "u su* a contract   
aft] t effective date if ! hormone !rapy
 is provid$ pursuant to a r$uction      
s*$ule t--  7,a7 is sup]vis$ by a       
physician2 &  7,b7 requires t !rapy to  
conclude n lat] ?an #a ye> aft] t       
effective date4  4  7b7  ,applicability 
,! am5dm5t made by subsection 7a7 %all  
apply ) respect to any contract ent]$   
into1 or r5ew$ = a contract ye>1 on or  
aft] ! date ( enactm5t ( ?is ,act4