I 

118TH CONGRESS 

1ST SESSION H. R. 5636 

To amend chapter 110 of title 18, United States Code, to prohibit gender 

affirming care on minors. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 21, 2023 

Ms. GREENE of Georgia introduced the following bill; which was referred to 

the Committee on the Judiciary 

A BILL 

To amend chapter 110 of title 18, United States Code, 

to prohibit gender affirming care on minors. 

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 ‘‘Protect Children’s In5 nocence Act’’. 

6 SEC. 2. GENDER AFFIRMING CARE ON MINORS PROHIB7 ITED. 

8 Chapter 110 of title 18, United States Code, is 

9 amended— 

10 (1) by adding at the end the following: 


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1 ‘‘§ 2260B. Gender affirming care for minors 

2 ‘‘(a) IN GENERAL.—Whoever, in any circumstance 

3 described in subsection (e), knowingly performs any gen4 der affirming care on a minor is guilty of a class C felony. 

5 ‘‘(b) PROHIBITION ON PROSECUTION OF PERSON ON

6 WHOM INTERVENTION IS PERFORMED.—No person on 

7 whom the gender affirming care under subsection (a) is 

8 performed may be arrested or prosecuted for an offense 

9 under this section. 

10 ‘‘(c) CIVIL ACTION.—A person on whom gender af11 firming care is performed under this section may bring 

12 a civil action for appropriate relief, including compen13 satory and punitive damages, against each person who 

14 performed the gender affirming care. 

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

16 ‘‘(1) GENDER AFFIRMING CARE.— 

17 ‘‘(A) IN GENERAL.—For purposes of this 

18 chapter, except as provided in subparagraph 

19 (B), the term ‘gender affirming care’ means, 

20 with respect to an individual, any of the fol21 lowing: 

22 ‘‘(i) Performing any surgery for the 

23 purpose of changing the body of such indi24 vidual to correspond to a sex that differs 

25 from their biological sex, including— 

26 ‘‘(I) castration; 


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1 ‘‘(II) orchiectomy; 

2 ‘‘(III) scrotoplasty; 

3 ‘‘(IV) vasectomy; 

4 ‘‘(V) hysterectomy; 

5 ‘‘(VI) oophorectomy; 

6 ‘‘(VII) ovariectomy; 

7 ‘‘(VIII) metoidioplasty; 

8 ‘‘(IX) penectomy; 

9 ‘‘(X) phalloplasty; 

10 ‘‘(XI) vaginoplasty; 

11 ‘‘(XII) vaginectomy; 

12 ‘‘(XIII) vulvoplasty; 

13 ‘‘(XIV) reduction 

14 thyrochondroplasty; 

15 ‘‘(XV) chondrolaryngoplasty; and 

16 ‘‘(XVI) mastectomy. 

17 ‘‘(ii) Any plastic surgery that femi18 nizes or masculinizes the facial features for 

19 the purposes described in clause (i). 

20 ‘‘(iii) Any placement of chest implants 

21 to create feminine breasts for the purposes 

22 described in clause (i). 

23 ‘‘(iv) Any placement of fat or artificial 

24 implants in the gluteal region for the pur25 poses described in clause (i). 


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1 ‘‘(v) Administering, supplying, pre2 scribing, dispensing, distributing, or other3 wise conveying to an individual medications 

4 for the purposes described in clause (i), in5 cluding— 

6 ‘‘(I) gonadotropin-releasing hor7 mone (GnRH) analogues or other pu8 berty-blocking drugs to stop or delay 

9 normal puberty; 

10 ‘‘(II) testosterone or other 

11 androgens to biological females at 

12 doses that are supraphysiologic to the 

13 female sex; and 

14 ‘‘(III) estrogen to biological 

15 males at doses that are 

16 supraphysiologic to the male sex. 

17 ‘‘(B) EXCEPTION.—Subparagraph (A) 

18 shall not apply to the following individuals: 

19 ‘‘(i) An individual with both ovarian 

20 and testicular tissue. 

21 ‘‘(ii) An individual with respect to 

22 whom a physician has determined through 

23 genetic or biochemical testing that the in24 dividual does not have normal sex chroVerDate Sep 11 2014 00:28 Sep 26, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5636.IH H5636

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1 mosome structure, sex steroid hormone 

2 production, or sex steroid hormone action. 

3 ‘‘(iii) An individual experiencing infec4 tion, disease, injury, or disorder caused or 

5 exacerbated by previous gender transition 

6 procedures. 

7 ‘‘(iv) An individual suffering from a 

8 physical disorder, physical injury, or phys9 ical illness that would, as certified by a 

10 physician, place the individual in imminent 

11 danger of death or impairment of a major 

12 bodily function unless the procedure is per13 formed. 

14 ‘‘(2) BIOLOGICAL SEX.—The term ‘biological 

15 sex’ means the indication of male or female sex by 

16 reproductive potential or capacity, sex chromosomes, 

17 naturally occurring sex hormones, gonads, or inter18 nal or external genitalia present at birth. 

19 ‘‘(3) MINOR.—The term ‘minor’ means any per20 son under the age of eighteen years. 

21 ‘‘(e) CIRCUMSTANCES DESCRIBED.—For purposes of 

22 subsection (a), the circumstances described in this sub23 section are that— 

24 ‘‘(1) the defendant or victim traveled in inter25 state or foreign commerce, or traveled using a 


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1 means, channel, facility, or instrumentality of inter2 state or foreign commerce, in furtherance of or in 

3 connection with the conduct described in subsection 

4 (a); 

5 ‘‘(2) the defendant used a means, channel, fa6 cility, or instrumentality of interstate or foreign 

7 commerce in furtherance of or in connection with 

8 the conduct described in subsection (a); 

9 ‘‘(3) any payment of any kind was made, di10 rectly or indirectly, in furtherance of or in connec11 tion with the conduct described in subsection (a) 

12 using any means, channel, facility, or instrumen13 tality of interstate or foreign commerce or in or af14 fecting interstate or foreign commerce; 

15 ‘‘(4) the defendant transmitted in interstate or 

16 foreign commerce any communication relating to or 

17 in furtherance of the conduct described in subsection 

18 (a) using any means, channel, facility, or instrumen19 tality of interstate or foreign commerce or in or af20 fecting interstate or foreign commerce by any means 

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

22 electromagnetic transmission; 

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

24 object that has traveled in interstate or foreign comVerDate Sep 11 2014 00:28 Sep 26, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H5636.IH H5636

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1 merce was used to perform the conduct described in 

2 subsection (a); 

3 ‘‘(6) the conduct described in subsection (a) oc4 curred within the special maritime and territorial ju5 risdiction of the United States, or any territory or 

6 possession of the United States; or 

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

8 otherwise occurred in or affected interstate or for9 eign commerce. 

10 ‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec11 tion shall be construed as prohibiting provision of the med12 ical services described in subsection (d)(1)(A) to address 

13 legitimate health issues, such as any male or female repro14 ductive cancers, apart from changing the body to cor15 respond to a sex that differs from one’s biological sex.’’; 

16 and 

17 (2) by amending the table of sections for such 

18 chapter by adding at the end the following: 

‘‘2260B. Gender affirming care on minors.’’. 

Æ 


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