To amend chapter 110 of title 18, United States Code, to prohibit gender-affirming care on minors, and for other purposes.
Analysis under review: This bill has generated analysis that may be too generic or incomplete. Clause-level evidence remains available below.
Summary
What This Bill Does
This bill creates a comprehensive federal prohibition on gender-affirming care for individuals under 18. It makes it a federal crime (punishable by up to 12 years in prison) for healthcare providers to perform such procedures on minors, prohibits all federal funding for gender-affirming care regardless of age, and restricts health insurance tax credits for plans that cover such care.
Who Benefits and How
Social conservative advocacy groups achieve their policy goal of restricting access to gender transition services. Private healthcare insurers may see reduced claims if fewer providers offer these services. Religious healthcare organizations gain clearer legal standing to refuse these services.
Who Bears the Burden and How
Healthcare providers (physicians, surgeons, endocrinologists) who currently provide gender-affirming care to minors face criminal prosecution and up to 12 years imprisonment. Transgender minors and their families lose access to federally-funded care and face reduced insurance options. Medical schools and teaching hospitals lose federal education funding if they teach these procedures. Foreign-born healthcare providers who have performed these procedures face deportation or inadmissibility.
Key Provisions
- Creates federal felony (12 years max) for performing gender-affirming care on minors
- Bans all federal funding (Medicare, Medicaid, CHIP) for gender-affirming care at any age
- Disqualifies health plans covering gender-affirming care from ACA premium tax credits
- Bars higher education institutions from federal funding if they teach gender-affirming care
- Makes performing such care grounds for immigration inadmissibility and deportation
Evidence Chain:
This summary is generated from the full bill text using AI analysis. Expand "Detailed Analysis" below for identified beneficiaries/burden bearers.
At a Glance
What This Bill Does
Prohibits gender-affirming care for minors by creating federal criminal penalties, banning federal funding, restricting tax credits, and imposing immigration consequences
Key Policy Areas
Healthcare, Criminal Justice, Immigration, Education, Taxation
Primary Purpose
Prohibits gender-affirming care for minors by creating federal criminal penalties, banning federal funding, restricting tax credits, and imposing immigration consequences
Policy Domains
Title I - Criminal Prohibition
Identified Gains
Contextual inference, no direct clause citation- Social conservative advocacy organizations
- Religious healthcare organizations
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Physicians and surgeons providing gender-affirming care
- Transgender minors
- Families of transgender minors
- Hospitals and clinics
Contextual inference, no direct clause citation
Title II - Federal Funding Prohibition
Identified Gains
Contextual inference, no direct clause citation- Federal budget (reduced healthcare expenditures)
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Medicare beneficiaries seeking gender-affirming care
- Medicaid beneficiaries
- Veterans using VA healthcare
- Federal employees
Contextual inference, no direct clause citation
Title IV - Education and Immigration
Identified Gains
Contextual inference, no direct clause citation- Educational institutions not offering such instruction
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Medical schools teaching gender-affirming procedures
- Foreign-born physicians who have provided such care
- Teaching hospitals
- Accreditation agencies
Contextual inference, no direct clause citation
Title III - ACA Tax Credit Restrictions
Identified Gains
Contextual inference, no direct clause citation- Health insurers not covering gender-affirming care (competitive advantage)
Contextual inference, no direct clause citation
Identified Costs
Contextual inference, no direct clause citation- Health insurers covering gender-affirming care
- ACA marketplace consumers seeking coverage
- Small employers using 45R tax credit
Contextual inference, no direct clause citation
Sponsors
Legislative Progress
IntroducedMr. Vance introduced the following bill; which was read twice …
Stakeholder Effects
cui bono?How this legislation distributes effects. Mention counts reflect frequency, not effect magnitude.
Endocrinologists treating gender dysphoria in minors, Federal employees providing healthcare, Healthcare providers billing Medicare for gender-affirming services
Positive-direction: Healthcare providers treating complications
Negative-direction: Endocrinologists treating gender dysphoria in minors, Federal employees providing healthcare, Healthcare providers billing Medicare for gender-affirming services, Healthcare providers billing federal programs for gender-affirming care, Healthcare providers performing gender-affirming care, Physicians and surgeons providing gender-affirming care to minors
Hospitals and clinics offering gender transition services, Indian Health Service facilities, Military healthcare facilities
ACA marketplace consumers with subsidized plans, Individuals seeking privately-funded coverage, Minors receiving gender-affirming care
Positive-direction: Minors receiving gender-affirming care, Patients experiencing complications from prior procedures
Negative-direction: ACA marketplace consumers with subsidized plans, Individuals seeking privately-funded coverage
Health insurers offering plans with gender-affirming care coverage, Health insurers selling ACA marketplace plans, Non-federal health insurers
Positive-direction: Non-federal health insurers, Private health insurers offering gender-affirming care coverage
Negative-direction: Health insurers offering plans with gender-affirming care coverage, Health insurers selling ACA marketplace plans
Faculty members teaching gender medicine, Medical schools and teaching hospitals, Nursing programs and allied health schools
Federal employees with FEHB coverage, OPM managing multi-state plans, State governments contracting for health coverage
Accreditation agencies for medical education
Pharmaceutical companies producing puberty blockers and hormone therapies
Bill Structure & Actor Mappings
Who is "The Secretary" in each section?
- "the_director"
- → Director of Office of Personnel Management
Key Definitions
Terms defined in this bill
The indication of male or female sex by reproductive potential or capacity, sex chromosomes, naturally occurring sex hormones, gonads, or internal or external genitalia present at birth
Surgeries, hormone treatments, and puberty blockers performed to change the body to correspond to a sex different from biological sex, with exceptions for intersex conditions and medical emergencies
Any individual under the age of 18 years
We use a combination of our own taxonomy and classification in addition to large language models to assess meaning and potential beneficiaries. High confidence means strong textual evidence. Always verify with the original bill text.
Learn more about our methodology