HR2387-119

What This Bill Does

The No Harm Act prohibits the use of federal funds for gender-transition medical and surgical treatments for minors (defined as individuals under 18). It blocks federal spending on providing, sponsoring, promoting, or supporting such treatments, and also bars funding for regulatory actions that promote them. It amends federal criminal law (18 U.S.C. 116) to classify providing gender-transition treatments to minors as falling under the female genital mutilation statute. It cuts off all federal funding to medical institutions and schools that provide or support these treatments for minors without parental consent. The bill establishes extensive private rights of action allowing patients, parents, and taxpayers to sue in federal court, with a 30-year statute of limitations running from the minor's age of majority.

Who Benefits and How

• Parents seeking to prevent gender-transition treatments: Gain explicit statutory rights to decline treatments and mandatory informed consent requirements (72-hour waiting period, written parental consent, full disclosure of side effects).
• Healthcare providers who refuse to perform gender-transition treatments: Receive broad legal protections against retaliation, discrimination, or loss of federal funding for declining to participate in, refer for, or pay for such treatments. This extends to physicians, hospitals, pharmacies, insurers, training programs, and health care sharing ministries.
• Plaintiffs' attorneys: Multiple new federal causes of action with treble damages, attorney's fees, and a 30-year statute of limitations create significant litigation opportunities.
• Minors (as framed by the bill): The bill frames its restrictions as protecting minors from irreversible medical treatments.

Who Bears the Burden and How

• Medical institutions providing gender-affirming care to minors: Face total loss of all federal funding (not just funding for the specific treatments) if they provide sex-trait altering treatments to any minor. This includes hospitals, clinics, medical schools, FQHCs, and rural health centers.
• Transgender minors and their families: Lose access to federally-funded gender-affirming medical care entirely. Even with parental consent, accessing treatment becomes far more restricted and carries new liability risks for providers.
• States with gender-affirming care policies: Risk losing Medicaid (Title XIX) and TANF (Title IV-A) funding if they have policies providing such treatment without both parents' consent or separating minors from parents based on refusal to consent.
• Healthcare providers who currently offer these treatments: Face new federal malpractice liability with treble damages and a 30-year exposure window, plus potential criminal liability under the expanded FGM statute.
• Schools: Risk losing all federal funding if any school personnel provide, assist, or support the provision of sex-trait altering treatment without parental notification and written approval.

Key Provisions

• Prohibits all federal funds for paying, sponsoring, promoting, assisting, or supporting sex-trait altering treatments for minors (Sec. 2)
• Prohibits federal funds for regulatory or subregulatory actions promoting such treatments to minors (Sec. 3)
• Amends 18 U.S.C. 116 (female genital mutilation statute) to include gender-transition treatments for minors (Sec. 4)
• Cuts off all federal funding to medical institutions that provide such treatments to minors (Sec. 5)
• Establishes parental right to decline; conditions Medicaid/TANF funding on state compliance with parental consent requirements (Sec. 6)
• Requires 72-hour informed consent process with written parental authorization (Sec. 7)
• Creates federal medical malpractice cause of action with treble damages and 30-year statute of limitations (Sec. 8)
• Protects healthcare providers who refuse to perform or participate in such treatments from retaliation or discrimination (Sec. 9)
• Cuts off federal funding to schools where personnel provide or support such treatments without parental consent (Sec. 10)
• Defines "sex-trait altering treatment" broadly to include puberty blockers, hormone therapy, and surgical procedures, with exceptions for disorders of sex development and emergency care (Sec. 11)