HR2387-119

1. Short title This Act may be cited as the No Harm Act.

2. Prohibition on use of Federal funds for certain treatments Notwithstanding any other provision of law, no Federal funds may be made available for purposes of paying for, sponsoring, promoting, assisting, or supporting the furnishing of a sex-trait altering treatment to a minor. Any person, including a taxpayer, may bring a civil action for violation of subsection (a) for legal damages and equitable relief against the United States, or the appropriate Department or Agency disbursing federal funds in violation of subsection (a), in an appropriate district court of the United States.

3. Prohibition on use of Federal funds for certain actions Notwithstanding any other provision of law, no Federal funds may be made available for purposes of taking any regulatory or subregulatory action to promote sex-trait altering treatments to minors. Any person, including a taxpayer, may bring a civil action for violation of subsection (a) for legal damages and equitable relief against the United States, or the appropriate Department or Agency disbursing federal funds in violation of subsection (a), in an appropriate district court of the United States.

4. Female genital mutilation to include provision of sex-trait altering treatment to minors Section 116 of title 18, United States Code, is amended by adding at the end the following: For the purpose of subsection (b)(1), the phrase “necessary to the health of the person” shall not include change of gender or sex, or affirmation of gender or sex..

5. Prohibition on funding certain institutions Notwithstanding any other provision of law, no Federal funds may be made available to a medical institution (including a hospital, medical school, clinic, public health organization, federally qualified health center, rural health center, or medical practice) if such institution provides sex-trait altering treatments to minors.

6. Right to decline treatments The parent of a minor shall have the right to decline any sex-trait altering treatment for such minor. Likewise, no specified Federal funds shall be made available to a State that has in place a policy to provide sex-trait altering treatment for a minor without the consent of both parents. No specified Federal funds may be made available to a State that has in place a policy to separate a minor from such minor’s parent based solely on such parent’s refusal to consent to a sex-trait altering treatment for such minor. For purposes of this section, the term specified Federal funds means Federal funds made available under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) or under part A of title IV of such Act (42 U.S.C. 601 et seq.). A minor or a parent of a minor who is harmed by a violation of this section may bring a civil action against the United States and against any State with a policy in place in violation of this section in an appropriate district court of the United States to obtain appropriate relief. An action under this subsection may be brought at any time prior to 30 years after the date on which the minor attains the age of majority.

7. Requirement to receive informed consent No health care provider may furnish any sex-trait altering treatment to a minor unless, at least 72 hours prior to furnishing such treatment, such provider— holds a consultation appointment with the parents of such minor to discuss such treatment; provides to the parents of such minor a complete, printed list of potential side effects of such treatment, including any permanent risks relating to fertility and sexual function; and received the written, informed consent of the parents of such minor for such treatment. A minor or a parent of a minor who is harmed by a violation of this section may bring a civil action against the health care provider in an appropriate district court of the United States to obtain appropriate relief. An action under this subsection may be brought at any time prior to 30 years after the date on which the minor attains the age of majority.

8. Medical malpractice liability An individual may bring a civil action in an appropriate district court of the United States to obtain appropriate relief for any physical, psychological, or physiological harm caused by a sex-trait altering treatment performed on the individual when the individual was a minor against a medical practitioner, hospital, clinic, surgery center or other provider that performed or prescribed such treatment. If said civil action is successful, the individual will be awarded attorney’s fees and litigation costs, and treble damages. An action under this subsection may be brought at any time prior to 30 years after the date on which the minor attains the age of majority.

9. Right of conscience for health care providers A health care provider may not be penalized, retaliated against, or otherwise discriminated against on the basis that the provider does not or declines to— perform, refer for, pay for, or otherwise participate in sex-trait altering treatment; provide or sponsor sex-trait altering treatment coverage; or facilitate or make arrangements for sex-trait altering treatment. No specified Federal funds (as defined in paragraph (2)) may be made available to a State that requires a health care provider to provide sex-trait altering treatments. For purposes of this subsection, the term specified Federal funds means any Federal funds made available under a program administered by the Department of Health and Human Services. A health care provider who is harmed by a violation of subsection (a) may, in a civil action, obtain all appropriate relief, including injunctive relief, declaratory relief, and compensatory damages to prevent the occurrence, continuance, or repetition of such violation and to compensate for losses resulting from the violation. The term health care provider includes— an individual physician, health care assistant, nurse, pharmacist, health researcher, or other health care personnel; a hospital, laboratory, pharmacy, health system, or other health care or medical research facility or organization (including a party to a proposed merger or other collaborative arrangement relating to health services, and an entity resulting therefrom); a provider-sponsored organization, an accountable care organization, or a health maintenance organization; a social services provider that provides or authorizes referrals for health care services; a program of training or education in the health professions or medical research, a participant in such a program, or any individual applying or otherwise aspiring to participate in such a program; an issuer of health insurance coverage or of a health plan; a health care sharing ministry; a health insurance plan, including group, individual, or student health plans, or a sponsor or administrator thereof; and any other health care organization, program, facility, or plan.

10. Prohibition on Federal funds for providing sex-trait altering treatment to students without parental consent Notwithstanding any other provision of law, no Federal funds may be provided to an elementary school or secondary school that allows school personnel to provide, assist in providing, or otherwise support the provision of sex-trait altering treatment to a student without notifying the parents of the student and receiving written approval from such parents. In this section: The terms elementary school, paraprofessional, parent, school leader, secondary school, and specialized instructional support personnel have the meanings given the terms in section 8101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801). The term school personnel includes— teachers; paraprofessionals; school leaders; specialized instructional support personnel; volunteers performing services for a school; and other support staff who are employed by a school or who perform services for a school on a contractual basis.

11. Definitions In this Act: The term sex-trait altering treatment means any medical or surgical service, including physician’s services, practitioner’s services, inpatient and outpatient hospital services, or prescribed drugs related to gender transition, other than an excepted service, that seeks to: Alter or remove physical or anatomical characteristics or features that are typical for the individual’s sex; or Instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s sex, including medical services that provide puberty blocking drugs, gender transition hormone therapy, or genital gender reassignment surgery or nongenital gender reassignment surgery knowingly performed for the purpose of assisting an individual with a gender transition. The term sex means the biological indication of being male or female, including sex chromosomes, and naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth. The term gender transition hormone therapy means testosterone, estrogen, or progesterone given to an individual in an amount greater than would normally be produced endogenously in a healthy individual of that individual’s age and sex. The term gender means the psychological, behavioral, social, and cultural aspects of being male or female. The term gender reassignment surgery means any medical or surgical service that seeks to surgically alter or remove healthy physical or anatomical characteristics or features that are typical for the individual’s sex, in order to instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s sex, including genital gender reassignment surgery or nongenital gender reassignment surgery knowingly performed for the purpose of assisting an individual with a gender transition. The term gender transition means the process in which an individual shifts from identifying with and living as a gender that corresponds to his or her sex to identifying with and living as a gender different from his or her sex, and may involve social, legal, or physical changes. The term genital gender reassignment surgery means a medical procedure knowingly performed for the purpose of assisting an individual with a gender transition, including the following: Surgical procedures, including a penectomy, orchiectomy, vaginoplasty, clitoroplasty, or vulvoplasty for a male sex patient or hysterectomy or ovariectomy for a female sex patient. Reconstruction of the fixed part of the urethra with or without a metoidioplasty. Phalloplasty, vaginectomy, scrotoplasty, or implantation of erection or testicular prostheses for a female sex patient. The term nongenital gender reassignment surgery means medical procedures knowingly performed for the purpose of assisting an individual with a gender transition, including the following: Surgical procedures for a male sex patient, including augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation, hair reconstruction, or associated aesthetic procedures. Surgical procedures for a female sex patient, including subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants, or associated aesthetic procedures. The term puberty blocking drugs means the following when used for the purpose of assisting an individual with a gender transition. Gonadotropin releasing hormone analogues or other synthetic drugs used to stop luteinizing hormone and follicle stimulating hormone secretion; or Synthetic antiandrogen drugs used to block the androgen receptor. The term excepted service means any of the following: Medical or surgical services furnished to an individual born with a medically verifiable disorder of sex development, including an individual with: External sex characteristics that are irresolvably ambiguous; Forty-six XX chromosomes with virilization; Forty-six XY chromosomes with undervirilization; or Both ovarian and testicular tissue. Medical or surgical services provided when a physician or practitioner has diagnosed a disorder or condition of sexual development that the physician or practitioner has determined through genetic or biochemical testing that the individual does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action. The treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of sex-trait altering treatments. Any medical or surgical service undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician or practitioner, place the individual in imminent danger of death or impairment of major bodily function unless the medical or surgical service is performed. Mental health or social services, other than sex-trait altering treatments. Services for a disorder or condition of sexual development that is unrelated to a diagnosis of gender dysphoria or gender identity disorder. The term minor means an individual under 18 years of age.