,,ii #aaith ,,congress #ast ,session ,s4 #bijg ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #ah 7legislative day1 ,september #af71 #bjbe,mrs4 ,blackburn 7for herself1 ,mr4 ,schmitt1 ,mr4 ,sheehy1 and ,mr4 ,scott of ,florida7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to prohibit health care professionals1 hospitals1 or clinics from participating in the chemical or surgical mutilation of a child and to provide a private right of action for children and the parents of children whose healthy body parts have been damaged by medical professionals practicing chemical and surgical mutilation4 #a4 ,short title ,this ,act may be cited as the ,chloe ,cole ,act4 #b4 ,definitions ,in this ,act3 7#a7 ,chemical or surgical mutilation 7,a7 ,in general ,the term chemical or surgical mutilation means engaging in any one or more of the following for the purpose of intentionally halting the natural development of the individual's body so that it no longer corresponds to the individual's sex or intentionally changing the individual's body1 including the individual's external appearance or biological functions1 to no longer correspond to the individual's sex3 7i7 ,the use of puberty blockers1 including gonadotropin releasing hormone agonists and other interventions1 to delay the onset or progression of normally timed puberty in an individual4 7ii7 ,the use of sex hormones1 such as androgen blockers1 estrogen1 progesterone1 or testosterone4 7iii7 ,surgical procedures that attempt to transform an individual's physical appearance or that attempt to alter or remove an individual's sexual organs4 7,b7 ,exclusions ,such term does not include any of the following3 7i7 ,appropriate and medically necessary procedures to treat a verifiable disorder of sexual development1 including an individual born with #df ,,xx chromosomes with virilization1 with #df ,,xy chromosomes with undervirilization1 or having both ovarian and testicular tissue4 7ii7 ,the treatment of any infection1 injury1 disease1 or disorder that has been caused or exacerbated by the performance of an intervention described in subparagraph 7,a7 without regard to whether the intervention was performed in accordance with ,state or ,federal law or whether the intervention is covered by the private right of action under section #d4 7iii7 ,any intervention undertaken because the individual suffers from any diagnosed and verifiable condition of the body's organ systems1 including the following3 7,i7 ,traumatic bodily injuries 7such as fractures1 organ rupture1 or penetrating trauma74 7,,ii7 ,congenital structural anomalies of major organs or systems1 including the cardiovascular1 respiratory1 renal1 hepatic1 neurological1 or musculoskeletal systems4 7,,iii7 ,acute illnesses with a high probability of rapid mortality4 7iv7 ,detransition treatment4 7#b7 ,child ,the term child means an individual under #ah years of age4 7#c7 ,detransition treatment ,the term detransition treatment means any treatment1 including a mental health treatment1 medical intervention1 or surgery1 that does either or both of the following3 7,a7 ,stops or reverses the effects of a prior chemical or surgical mutilation4 7,b7 ,helps an individual cope with the effects of a prior chemical or surgical mutilation4 7#d7 ,health care professional ,the term health care professional means a person1 including a physician1 who is licensed1 certified1 or otherwise authorized by the laws of a ,state to administer health care in the ordinary course of the practice of his or her profession or performing such acts which require such licensure4 7#e7 ,mental health professional ,the term mental health professional means a person who is licensed to diagnose and treat mental health conditions in a ,state4 7#f7 ,participate ,the term participate1 with respect to acts constituting chemical or surgical mutilation as defined in paragraph 7#a71 means directly engaging in the planning1 authorization1 prescription1 administration1 or performance of any such act1 including any of the following3 7,a7 ,prescribing puberty blockers1 sex hormones1 or related medications with the intent to alter an individual's physical appearance or reproductive function to align with an identity differing from his or her sex4 7,b7 ,administering medications or treatments described in subparagraph 7,a7 with such intent1 whether by injection1 oral delivery1 or other means4 7,c7 ,performing surgical procedures that attempt to transform an individual's physical appearance to confirm a patient's physical appearance to be of the alternate sex1 or that alter or remove sexual organs as part of chemical or surgical mutilation4 7,d7 ,authorizing or directing such chemical or surgical mutilation procedures as a supervising health care professional or institutional representative4 7,e7 ,knowingly planning or coordinating the provision of treatments or procedures described above in subparagraph 7,a71 7,c71 or 7,d7 with the intent to facilitate chemical or surgical mutilation4 7#g7 ,sex ,the term sex means a person's immutable biological classification1 determined at the moment of conception1 as either male or female1 as follows3 7,a7 ,the term female is a person who naturally has1 had1 will have1 or would have but for a congenital anomaly or intentional or unintentional disruption1 the reproductive system that produces1 transports1 and utilizes the large gamete 7ova7 for fertilization4 7,b7 ,the term male is a person who naturally has1 had1 will have1 or would have but for a congenital anomaly or intentional or unintentional disruption1 the reproductive system that produces1 transports1 and utilizes the small gamete 7sperm7 for fertilization4 #c4 ,prohibition on chemical or surgical mutilation 7a7 ,in general ,no health care professional1 hospital1 or clinic shall1 in a circumstance described in subsection 7b71 participate in the chemical or surgical mutilation of a child1 and a health care professional1 hospital1 or clinic may commence participation in a treatment that qualifies as an exception specified in clauses 7i7 through 7iv7 of section #b7a77;,b7 only after determining that clear and convincing evidence supports a determination that the treatment so qualifies4 7b7 ,circumstances described ,the circumstances described in this subsection are that-- 7#a7 the defendant or child traveled in interstate or foreign commerce1 or traveled using a means1 channel1 facility1 or instrumentality of interstate or foreign commerce1 in furtherance of or in connection with the participation in the chemical or surgical mutilation2 7#b7 the defendant used a means1 channel1 facility1 or instrumentality of interstate or foreign commerce in furtherance of or in connection with the participation in the chemical or surgical mutilation2 7#c7 any payment of any kind was made1 directly or indirectly1 in furtherance of or in connection with the participation in the chemical or surgical mutilation using any means1 channel1 facility1 or instrumentality of interstate or foreign commerce or in or affecting interstate or foreign commerce2 7#d7 the defendant transmitted in interstate or foreign commerce any communication relating to or in furtherance of the participation in the chemical or surgical mutilation using any means1 channel1 facility1 or instrumentality of interstate or foreign commerce or in or affecting interstate or foreign commerce by any means or in any manner1 including by computer1 mail1 wire1 or electromagnetic transmission2 7#e7 any instrument1 item1 substance1 or other object that has traveled in interstate or foreign commerce was used to perform the chemical or surgical mutilation2 7#f7 the chemical or surgical mutilation occurred within the ,district of ,columbia1 the special maritime and territorial jurisdiction of the ,united ,states1 or any territory or possession of the ,united ,states2 or 7#g7 the chemical or surgical mutilation otherwise occurred in or affected interstate or foreign commerce4 #d4 ,private right of action 7a7 ,in general ,an individual subjected as a child to chemical or surgical mutilation prohibited by section #c1 or the parents or legal guardians of such individual1 may bring a civil action in an appropriate district court of the ,united ,states for damages against any health care professional1 hospital1 or clinic1 who participates in the chemical or surgical mutilation of that child4 ,such a cause of action shall be available regardless of whether the alleged chemical or surgical mutilation occurred before1 on1 or after the date of enactment of this ,act4 7b7 ,damages ,damages available pursuant to such an action may include-- 7#a7 compensatory damages1 including all economic damages associated with undoing1 correcting1 or ameliorating the effects or results of any chemical or surgical mutilation procedures2 7#b7 non-economic damages for emotional distress and pain and suffering2 and 7#c7 punitive damages1 if the claimant proves by clear and convincing evidence that the defendant against whom punitive damages are sought acted maliciously1 intentionally1 fraudulently1 or recklessly4 7c7 ,strict liability ,any health care professional1 hospital1 or clinic whose participation in the chemical or surgical mutilation of a child after the date of enactment of this ,act is proven by clear and convincing evidence shall be strictly liable for damages for any such act of mutilation4 ,if a treatment qualifies under an exception specified in clauses 7i7 through 7iv7 of section #b7a77;,b71 and that is raised as an affirmative defense to a violation of this ,act1 the health care professional1 hospital1 or clinic shall bear the burden of proving by clear and convincing evidence that such exception applies4 #e4 ,rules of construction ,in this ,act3 7#a7 ,no private right of action is established based on counseling1 referrals to mental health professionals1 or discussions of treatment options1 including counseling1 referrals1 or options available upon reaching adulthood1 or in circumstances not described in section #c7;b71 provided by health care professionals1 or mental health professionals1 provided that such actions do not constitute participation in chemical or surgical mutilation1 as defined in section #b4 7#b7 ,no liability for a health care professional under these provisions may be waived4 7#c7 ,any ambiguities shall be resolved against any party found to have engaged in participation1 as defined in section #b7f71 in the chemical or surgical mutilation of a child4 7#d7 ,in any cases in which chemical or surgical mutilation of a child is shown to have occurred before the date of enactment of this ,act1 there is limited deference to prevailing standards of care to the extent that such standards contradict the intent of this ,act and it is shown that the health care professional knew or should have known that such standards of care were in serious1 scientific1 and medical dispute at the time of the chemical or surgical mutilation4 7#e7 ,nothing in this ,act shall be construed to prohibit a health care professional or mental health professional from providing information about all available treatment options1 discussing risks and benefits1 or expressing professional medical opinions1 so long as such actions do not constitute participation in chemical or surgical mutilation4 #f4 ,statute of limitations ,an action under section #d may be brought within #be years from the date of the eighteenth birthday of an individual subjected to chemical or surgical mutilation as a child or within #d years from the time the cost of a detransition treatment is incurred1 whichever date is later4 #g4 ,severability ,if any provision of this ,act1 or the application of such a provision to any person or circumstance1 is held to be unconstitutional1 the remainder of this ,act1 and the application of the provision held to be unconstitutional to any other person or circumstance1 shall not be affected4