I 

118TH CONGRESS 

2D SESSION H. R. 9874 

To prohibit the performance of gender-related medical treatment on minors, 

to amend title XVIII of the Social Security Act to prohibit payment 

and participation under the Medicare program with respect to such 

treatment, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 27, 2024 

Ms. MACE (for herself, Mr. GOSAR, Mrs. LESKO, Mr. WEBER of Texas, and 

Mr. BURCHETT) introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committees 

on the Judiciary, and Ways and Means, for a period to be subsequently 

determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To prohibit the performance of gender-related medical treatment on minors, to amend title XVIII of the Social 

Security Act to prohibit payment and participation under 

the Medicare program with respect to such treatment, 

and for other purposes. 

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 ‘‘Childhood Genital Mu5 tilation Prevention Act’’. 


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1 SEC. 2. PROHIBITING GENDER-RELATED MEDICAL TREAT2 MENT FOR MINORS. 

3 (a) IN GENERAL.—Chapter 7 of title 18, United 

4 States Code, is amended by inserting after section 116 the 

5 following new section: 

6 ‘‘§ 116A. Gender-related medical treatment furnished 

7 to minors. 

8 ‘‘(a) IN GENERAL.—Subject to subsection (c), who9 ever, in a circumstance described in subsection (b), know10 ingly performs or attempts to perform a gender-related 

11 medical treatment on a minor, shall be fined under this 

12 title, imprisoned not more than 10 years, or both. 

13 ‘‘(b) CIRCUMSTANCES DESCRIBED.—For the pur14 poses of subsection (a), the circumstances described in this 

15 subsection are that— 

16 ‘‘(1) the offender or victim traveled in inter17 state or foreign commerce, or traveled using a 

18 means, channel, facility, or instrumentality of inter19 state or foreign commerce, in furtherance of or in 

20 connection with the conduct described in subsection 

21 (a); 

22 ‘‘(2) the offender used a means, channel, facil23 ity, or instrumentality of interstate or foreign com24 merce in furtherance of or in connection with the 

25 conduct described in subsection (a); 


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1 ‘‘(3) any payment of any kind was made, di2 rectly or indirectly, in furtherance of or in connec3 tion with the conduct described in subsection (a) 

4 using any means, channel, facility, or instrumen5 tality of interstate or foreign commerce or in or af6 fecting interstate or foreign commerce; 

7 ‘‘(4) the offender transmitted in interstate or 

8 foreign commerce any communication relating to or 

9 in furtherance of the conduct described in subsection 

10 (a) using any means, channel, facility, or instrumen11 tality of interstate or foreign commerce or in or af12 fecting interstate or foreign commerce by any means 

13 or in manner, including by computer, mail, wire, or 

14 electromagnetic transmission; 

15 ‘‘(5) any instrument, item, substance, or other 

16 object that has traveled in interstate or foreign com17 merce was used to perform the conduct described in 

18 subsection (a); 

19 ‘‘(6) the conduct described in subsection (a) oc20 curred within the special maritime and territorial ju21 risdiction of the United States, or any territory or 

22 possession of the United States; or 

23 ‘‘(7) the conduct described in subsection (a) 

24 otherwise occurred in or affected interstate or for25 eign commerce. 


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1 ‘‘(c) EXCEPTIONS.— 

2 ‘‘(1) IN GENERAL.—An individual who provides 

3 gender-related medical treatment to a minor shall 

4 not be considered to have violated the prohibition in 

5 subsection (a) if such medical treatment is provided 

6 to such minor for purposes of treating— 

7 ‘‘(A) a disorder of sex development, diag8 nosed by a physician after such physician has 

9 determined through genetic or biochemical test10 ing that such minor does not have normal sex 

11 chromosome structure, sex steroid hormone pro12 duction, or sex steroid hormone action; 

13 ‘‘(B) irresolvably ambiguous biological sex 

14 characteristics of such minor, including the 

15 presence of— 

16 ‘‘(i) 46 XX chromosomes with 

17 virilization; 

18 ‘‘(ii) 46 XY chromosomes with 

19 undervirilization; or 

20 ‘‘(iii) both ovarian and testicular tis21 sue; or 

22 ‘‘(C) an infection, injury, disease, or dis23 order caused or exacerbated by gender-related 

24 medical treatment that was furnished to such 

25 minor. 


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1 ‘‘(2) EXCEPTION FOR MINORS.—A minor who 

2 seeks gender-related medical treatment, or on whom 

3 gender-related medical treatment was performed, 

4 shall not be considered to have violated the prohibi5 tion in subsection (a). 

6 ‘‘(d) DEFINITIONS.—In this section: 

7 ‘‘(1) GENDER-RELATED MEDICAL TREAT8 MENT.—The term ‘gender-related medical treatment’ 

9 means— 

10 ‘‘(A) with respect to a female individual, 

11 medical treatments provided for purposes of ad12 dressing the perception of such individual that 

13 the gender or sex of such individual is not fe14 male, including— 

15 ‘‘(i) surgical procedures, including— 

16 ‘‘(I) vaginectomy; 

17 ‘‘(II) hysterectomy; 

18 ‘‘(III) oophorectomy; 

19 ‘‘(IV) reconstruction of the ure20 thra; 

21 ‘‘(V) metoidioplasty; 

22 ‘‘(VI) phalloplasty; 

23 ‘‘(VII) salpingo-oophorectomy; 

24 ‘‘(VIII) scrotoplasty; 


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1 ‘‘(IX) implantation of erection or 

2 testicular protheses; 

3 ‘‘(X) subcutaneous mastectomy; 

4 ‘‘(XI) vocal cord surgery; 

5 ‘‘(XII) pectoral implants; and 

6 ‘‘(XIII) penile transplantation; 

7 ‘‘(ii) exogenous doses of testosterone 

8 or other androgens; and 

9 ‘‘(iii) puberty blockers, including— 

10 ‘‘(I) GnRH agonists; and 

11 ‘‘(II) synthetic drugs that sup12 press the production of estrogen and 

13 progesterone or delay or suppress pu14 bertal development in female individ15 uals; and 

16 ‘‘(B) with respect to a male individual, 

17 medical treatments provided for purposes of ad18 dressing the perception of such individual that 

19 the gender or sex of such individual is not male, 

20 including— 

21 ‘‘(i) surgical procedures, including— 

22 ‘‘(I) penectomy; 

23 ‘‘(II) orchiectomy; 

24 ‘‘(III) vaginoplasty; 

25 ‘‘(IV) clitoroplasty; 


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1 ‘‘(V) vulvoplasty; 

2 ‘‘(VI) augmentation 

3 mammoplasty; 

4 ‘‘(VII) facial feminization sur5 gery; 

6 ‘‘(VIII) vocal cord surgery; 

7 ‘‘(IX) chondrolaryngoplasty; 

8 ‘‘(X) gluteal augmentation; and 

9 ‘‘(XI) uterine transplantation; 

10 ‘‘(ii) exogenous doses of estrogen; and 

11 ‘‘(iii) puberty blockers, including— 

12 ‘‘(I) GnRH agonists; and 

13 ‘‘(II) synthetic drugs that sup14 press the production of testosterone or 

15 delay or suppress pubertal develop16 ment in male individuals. 

17 ‘‘(2) FEMALE.—The term ‘female’— 

18 ‘‘(A) means an individual who, under nor19 mal development— 

20 ‘‘(i) has XX chromosomes; 

21 ‘‘(ii) produces oocytes; and 

22 ‘‘(iii) has a reproductive and endo23 crine system oriented around the produc24 tion of such oocytes; and 


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1 ‘‘(B) includes an individual who would oth2 erwise fall within this definition but for a bio3 logical or genetic condition described in sub4 paragraph (A) or (B) of subsection (c)(1). 

5 ‘‘(3) GENDER.—The term ‘gender’ means, with 

6 respect to an individual, the psychological, behav7 ioral, social, and cultural aspects of being male or 

8 female. 

9 ‘‘(4) MALE.—The term ‘male’— 

10 ‘‘(A) means an individual who, under nor11 mal development— 

12 ‘‘(i) has XY chromosomes; 

13 ‘‘(ii) produces sperm; and 

14 ‘‘(iii) has a reproductive and endo15 crine system oriented around the produc16 tion of such sperm; and 

17 ‘‘(B) includes an individual who would oth18 erwise fall within this definition but for a bio19 logical or genetic condition described in sub20 paragraph (A) or (B) of subsection (c)(1). 

21 ‘‘(5) MINOR.—The term ‘minor’ means an indi22 vidual under 18 years of age. 

23 ‘‘(6) SEX.—The term ‘sex’ means the biological 

24 and genetic indication of whether an individual is 

25 male or female, as determined by the organization of 


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1 body parts and gametes for reproduction (including 

2 sex chromosomes, naturally occurring sex chro3 mosomes, gonads, and nonambiguous internal and 

4 external genitalia present at birth) without regard to 

5 the psychological, behavioral, social, cultural, chosen, 

6 or subjective experience of gender of such indi7 vidual.’’. 

8 (b) CLERICAL AMENDMENT.—The table of sections 

9 for such chapter is amended by inserting after the item 

10 relating to section 116 the following new item: 

‘‘116A. Gender-related medical treatment for minors.’’. 

11 SEC. 3. PROHIBITING PAYMENT AND PARTICIPATION 

12 UNDER MEDICARE WITH RESPECT TO GEN13 DER-RELATED MEDICAL TREATMENT FOR MI14 NORS. 

15 (a) EXCLUDING FROM COVERAGE GENDER-RELATED

16 MEDICAL TREATMENT FOR MINORS.—Section 1862(a) of 

17 the Social Security Act (42 U.S.C. 1395y(a)) is amend18 ed— 

19 (1) in paragraph (24), by striking ‘‘or’’ at the 

20 end; 

21 (2) in paragraph (25), by striking the period at 

22 the end and inserting ‘‘; or’’; and 

23 (3) by inserting after paragraph (25) the fol24 lowing new paragraph: 


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1 ‘‘(26) beginning on the date that is 90 days 

2 after the date of the enactment of the Childhood 

3 Genital Mutilation Prevention Act, which constitute 

4 gender-related medical treatment for minors de5 scribed in section 116A of chapter 7 of title 18, 

6 United States Code, and are not provided for the 

7 purposes described in subsection (c)(1) of such sec8 tion.’’. 

9 (b) EXCLUDING FROM PARTICIPATION PROVIDERS

10 FURNISHING GENDER-RELATED MEDICAL TREATMENT

11 FOR MINORS.—Section 1866 of the Social Security Act 

12 (42 U.S.C. 1395cc) is amended by adding at the end the 

13 following new subsection: 

14 ‘‘(l) EXCLUSION OF PROVIDERS FURNISHING GEN15 DER-RELATED MEDICAL TREATMENT FOR MINORS.—Be16 ginning on the date that is 90 days after the date of the 

17 enactment of the Childhood Genital Mutilation Prevention 

18 Act, with respect to a provider of services or supplier that, 

19 on or after the date that is 90 days after such date of 

20 enactment, furnishes gender-related medical treatment for 

21 minors, as described in section 116A of chapter 7 of title 

22 18, United States Code to any individual (other than such 

23 a treatment that is furnished for the purposes described 

24 in subsection (c)(1) of such section), regardless of whether 


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1 such individual is entitled to benefits under part A or en2 rolled under part B— 

3 ‘‘(1) if such provider of services or supplier is 

4 enrolled in the program under this title, the Sec5 retary shall terminate such enrollment; and 

6 ‘‘(2) the Secretary may not enroll such provider 

7 of services or supplier as a new provider of services 

8 or supplier in the program under this title.’’. 

9 SEC. 4. PROHIBITION ON FEDERAL FUNDING FOR GENDER10 RELATED MEDICAL TREATMENT FOR MI11 NORS. 

12 No funds authorized or appropriated by Federal law, 

13 and none of the funds in any trust fund to which funds 

14 are authorized or appropriated by Federal law, shall be 

15 obligated or expended for any gender-related medical 

16 treatment furnished to a minor (as such terms are used 

17 for purposes of section 116A of chapter 7 of title 18, 

18 United States Code) or for any health benefits coverage 

19 that includes coverage for gender-related medical treat20 ment furnished to a minor. 

Æ 


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