II 

117TH CONGRESS 

2D SESSION S. 4457 

To protect children from medical malpractice in the form of gender transition 

procedures. 

IN THE SENATE OF THE UNITED STATES 

JUNE 22, 2022 

Mr. COTTON (for himself, Mr. DAINES, Mr. RUBIO, Mr. HAWLEY, and Mr. 

LANKFORD) introduced the following bill; which was read twice and referred to the Committee on the Judiciary 

A BILL 

To protect children from medical malpractice in the form 

of gender transition procedures. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Protecting Minors 

5 from Medical Malpractice Act of 2022’’. 

6 SEC. 2. PRIVATE RIGHT OF ACTION FOR A GENDER-TRANSI7 TION PROCEDURE PERFORMED ON A MINOR. 

8 (a) IN GENERAL.—A medical practitioner, in any cir9 cumstance described in subsection (c), who performs a 

10 gender-transition procedure on an individual who is less 


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1 than 18 years of age shall, as described in subsection (b), 

2 be liable to the individual if injured (including any phys3 ical, psychological, emotional, or physiological harms) by 

4 such procedure, related treatment, or the aftereffects of 

5 the procedure or treatment. 

6 (b) PRIVATE RIGHT OF ACTION.—An individual cov7 ered by subsection (a) who receives a gender-transition 

8 procedure from a medical practitioner (or a representative, 

9 including a legal guardian, on behalf of such individual) 

10 may, not later than the day that is 30 years after the date 

11 on which the individual turns 18 years of age, bring a civil 

12 action against such medical practitioner in a court of com13 petent jurisdiction for— 

14 (1) declaratory or injunctive relief; 

15 (2) compensatory damages; 

16 (3) punitive damages; and 

17 (4) attorney’s fees and costs. 

18 (c) CIRCUMSTANCES.—For the purposes of sub19 section (a), the circumstances described in this subsection 

20 are that— 

21 (1) the medical practitioner or the individual re22 ceiving the gender-transition procedure traveled in 

23 interstate or foreign commerce, or traveled using a 

24 means, channel, facility, or instrumentality of inter25 state or foreign commerce, in furtherance of or in 


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1 connection with the conduct described in subsection 

2 (a); 

3 (2) the medical practitioner used a means, 

4 channel, facility, or instrumentality of interstate or 

5 foreign commerce in furtherance of or in connection 

6 with the conduct described in subsection (a); 

7 (3) any payment of any kind was made, directly 

8 or indirectly, in furtherance of or in connection with 

9 the conduct described in subsection (a) using any 

10 means, channel, facility, or instrumentality of inter11 state or foreign commerce or in or affecting inter12 state or foreign commerce; 

13 (4) the medical practitioner transmitted in 

14 interstate or foreign commerce any communication 

15 relating to or in furtherance of the conduct de16 scribed in subsection (a) using any means, channel, 

17 facility, or instrumentality of interstate or foreign 

18 commerce or in or affecting interstate or foreign 

19 commerce by any means or in any manner, including 

20 by computer, mail, wire, or electromagnetic trans21 mission; 

22 (5) any instrument, item, substance, or other 

23 object that has traveled in interstate or foreign com24 merce was used to perform the conduct described in 

25 subsection (a); 


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1 (6) the conduct described in subsection (a) oc2 curred within the special maritime and territorial ju3 risdiction of the United States, or any territory or 

4 possession of the United States; or 

5 (7) the conduct described in subsection (a) oth6 erwise occurred in or affected interstate or foreign 

7 commerce. 

8 SEC. 3. PRESERVING FREEDOM OF CONSCIENCE AND MED9 ICAL JUDGEMENT FOR MEDICAL PROVIDERS. 

10 Notwithstanding any other provision of law, no provi11 sion of Federal law shall require, or be construed to re12 quire, a medical practitioner to perform a gender-transi13 tion procedure. 

14 SEC. 4. PROHIBITION ON FUNDING FOR CERTAIN STATES. 

15 Notwithstanding any other provision of law, any 

16 State that requires medical practitioners to perform any 

17 gender-transition procedure on an individual in the State 

18 shall be ineligible to receive any Federal funding from the 

19 Department of Health and Human Services. 

20 SEC. 5. DEFINITIONS. 

21 In this Act: 

22 (1) BIOLOGICAL SEX.—The term ‘‘biological 

23 sex’’ means the genetic classification of an individual 

24 as male or female, as reflected in the organization 

25 of the body of such individual for a reproductive role 


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1 or capacity, such as through sex chromosomes, natu2 rally occurring sex hormones, and internal and ex3 ternal genitalia present at birth, without regard to 

4 the subjective sense of identity of the individual. 

5 (2) GENDER-TRANSITION PROCEDURE.— 

6 (A) IN GENERAL.—Except as provided in 

7 subparagraph (B), the term ‘‘gender-transition 

8 procedure’’ means— 

9 (i) the prescription or administration 

10 of puberty-blocking drugs for the purpose 

11 of changing the body of an individual so 

12 that it conforms to the subjective sense of 

13 identity of the individual, in the case such 

14 identity is at odds with the individual’s bi15 ological sex; 

16 (ii) the prescription or administration 

17 of cross-sex hormones for the purpose of 

18 changing the body of an individual so that 

19 it conforms to the subjective sense of iden20 tity of the individual, in the case such 

21 identity is at odds with the individual’s bi22 ological sex; or 

23 (iii) a surgery to change the body of 

24 an individual so that it conforms to the 

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1 vidual, in the case such identity is at odds 

2 with the individual’s biological sex. 

3 (B) EXCEPTION.—The term ‘‘gender-tran4 sition procedure’’ does not include— 

5 (i) an intervention described in sub6 paragraph (A) that is performed on— 

7 (I) an individual with biological 

8 sex characteristics that are inherently 

9 ambiguous, such as those born with 

10 46 XX chromosomes with virilization, 

11 46 XY chromosomes with 

12 undervirilization, or having both ovar13 ian and testicular tissue; or 

14 (II) an individual with respect to 

15 whom a physician has determined 

16 through genetic or biochemical testing 

17 that the individual does not have nor18 mal sex chromosome structure, sex 

19 steroid hormone production, or sex 

20 steroid hormone action, for a biologi21 cal male or biological female; 

22 (ii) the treatment of any infection, in23 jury, disease, or disorder that has been 

24 caused or exacerbated by the performance 

25 of an intervention described in subparaVerDate Sep 11 2014 23:44 Jun 25, 2022 Jkt 029200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4457.IS S4457

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1 graph (A) without regard to whether the 

2 intervention was performed in accordance 

3 with State or Federal law or whether the 

4 intervention is covered by the private right 

5 of action under section 2; or 

6 (iii) any procedure undertaken be7 cause the individual suffers from a physical 

8 disorder, physical injury, or physical illness 

9 that would, as certified by a physician, 

10 place the individual in imminent danger of 

11 death or impairment of major bodily func12 tion unless the procedure is performed. 

13 (3) MEDICAL PRACTITIONER.—The term ‘‘med14 ical practitioner’’ means a person who is licensed, 

15 certified, or otherwise authorized by the laws of a 

16 State to administer health care in the ordinary 

17 course of the practice of the person’s profession. 

18 SEC. 6. EFFECTIVE DATE. 

19 This Act shall take effect on the date of enactment 

20 of this Act. 

Æ 


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