SEC. 2. GENERAL DEFINITIONS. 
Section 3 of the Child Abuse Prevention and Treat-
ment Act (42 U.S.C. 5101 note) is amended— 
(1) in the matter preceding paragraph (1), by 
striking ‘‘Act—’’ and inserting ‘‘Act:’’; 
(2) in paragraph (1)— 
(A) by striking ‘‘the term’’ and inserting 
‘‘CHILD.—The term’’; 
(B) in subparagraph (B), by inserting ‘‘or 
as provided in section 115’’ after ‘‘abuse’’; and 
(C) by striking the semicolon at the end 
and inserting a period; 
(3) in paragraph (2)— 
(A) by striking ‘‘the term’’ and inserting 
‘‘CHILD
ABUSE
AND
NEGLECT.—The term’’; 
and 
(B) by striking the semicolon at the end 
and inserting a period; 
(4) in paragraph (3)— 
(A) by striking ‘‘the term’’ and inserting 
‘‘CHILD WITH A DISABILITY.—The term’’; and 
(B) by striking the semicolon at the end 
and inserting a period; 
(5) in paragraph (4)— 
(A) by striking ‘‘the term’’ and inserting 
‘‘GOVERNOR.—The term’’; and 
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(B) by striking the semicolon at the end 
and inserting a period; 
(6) in paragraph (5)— 
(A) by striking ‘‘the terms’’ and inserting 
‘‘INDIAN; INDIAN
TRIBE; TRIBAL
ORGANIZA-
TION.—The terms’’; and 
(B) by striking the semicolon at the end 
and inserting a period; 
(7) in paragraph (6)— 
(A) by striking ‘‘the term’’ and inserting 
‘‘SECRETARY.—The term’’; and 
(B) by striking the semicolon at the end 
and inserting a period; 
(8) in paragraph (7)— 
(A) by striking ‘‘except as provided in sec-
tion 106(f), the term’’ and inserting ‘‘STATE.— 
Except as provided in section 106(f), the term’’; 
and 
(B) by striking ‘‘; and’’ and inserting a pe-
riod; 
(9) in paragraph (8), by striking ‘‘the term’’ 
and 
inserting 
‘‘UNACCOMPANIED
HOMELESS 
YOUTH.—The term’’; 
(10) by adding at the end the following: 
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‘‘(9) BIOLOGICAL
SEX.—The term ‘biological 
sex’ means the genetic classification of an individual 
as male or female, as reflected in the organization 
of the body of such individual for a reproductive role 
or capacity, such as through sex chromosomes, natu-
rally occurring sex hormones, and internal and ex-
ternal genitalia present at birth, without regard to 
the subjective sense of identity of the individual. 
‘‘(10) GENDER-TRANSITION INTERVENTION.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), the term ‘gender-transition 
intervention’ means— 
‘‘(i) the changing of an individual’s 
social presentation (including pronouns, 
first name, hairstyle, or clothing) to con-
form to the subjective sense of identity of 
the individual, which is incongruent with 
the biological sex of the individual; 
‘‘(ii) the prescription or administra-
tion of GnRH agonists or other puberty- 
blocking drugs to stop or delay normal pu-
berty in order to prevent bodily changes 
that do not conform to the subjective sense 
of identity of the individual, which is in-
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congruent with the biological sex of the in-
dividual; 
‘‘(iii) the prescription or administra-
tion of medications for the purpose of 
changing the body of an individual so that 
the individual’s body conforms to the sub-
jective sense of identity of the individual, 
which is incongruent with the biological sex 
of the individual, including prescribing or 
administering— 
‘‘(I) 
testosterone 
or 
other 
androgens to biological females at 
doses that are supraphysiologic to the 
female sex; or 
‘‘(II) estrogen to biological males 
at doses that are supraphysiologic to 
the male sex; 
‘‘(iv) performing a surgery that steri-
lizes an individual (including castration, 
vasectomy, hysterectomy, oophorectomy, 
metoidioplasty, penectomy, phalloplasty, 
and vaginoplasty) for the purpose of 
changing the body of the individual so that 
the individual’s body conforms to the sub-
jective sense of identity of the individual, 
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which is incongruent with the biological sex 
of the individual; or 
‘‘(v) performing a mastectomy on an 
individual for the purpose of changing the 
body of the individual so that the individ-
ual’s body conforms to the subjective sense 
of identity of the individual, which is in-
congruent with the biological sex of the in-
dividual. 
‘‘(B) EXCEPTION.—The term ‘gender-tran-
sition intervention’ does not include— 
‘‘(i) an intervention described in sub-
paragraph (A) that is performed on— 
‘‘(I) an individual with biological 
sex characteristics that are inherently 
ambiguous, such as those born with 
46 XX chromosomes with virilization, 
XY 
chromosomes 
with 
undervirilization, or having both ovar-
ian and testicular tissue; or 
‘‘(II) an individual with respect 
to whom a physician has determined 
through genetic or biochemical testing 
that the individual does not have nor-
mal sex chromosome structure, sex 
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steroid hormone production, or sex 
steroid hormone action, for a biologi-
cal male or biological female; 
‘‘(ii) the treatment of any infection, 
injury, disease, or disorder that has been 
caused or exacerbated by the performance 
of an intervention described in subpara-
graph (A); or 
‘‘(iii) any procedure undertaken be-
cause the individual suffers from a physical 
disorder, physical injury, or physical illness 
that would, as certified by a physician, 
place the individual in imminent danger of 
death or impairment of major bodily func-
tion unless the procedure is performed.’’; 
and 
(11) by reordering paragraphs (1) through (8) 
(as amended by paragraphs (2) through (9) of this 
section), and the paragraphs added by paragraph 
(10) of this section in alphabetical order, and re-
numbering such paragraphs as so reordered. 
SEC. 3. FUNDING PROHIBITION. 
(a) IN GENERAL.—Title I of the Child Abuse Preven-
tion and Treatment Act (42 U.S.C. 5101 et seq.) is 
amended by adding at the end the following: 
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‘‘SEC. 115. INELIGIBILITY FOR FUNDING. 
‘‘(a) IN GENERAL.—A State shall be ineligible to re-
ceive funds under this title if the laws of the State permit 
the child protective services system of the State— 
‘‘(1) to remove a child from the custody of the 
parent or legal guardian of the child due to the par-
ent’s or legal guardian’s reluctance or refusal to con-
sent to a gender-transition intervention for such 
child; or 
‘‘(2) to use such reluctance or refusal as evi-
dence of abuse or neglect by such parent or legal 
guardian. 
‘‘(b) CHILD DEFINED.—In this section, the term 
‘child’ means a person who has not attained the age of 
18.’’. 
(b) CONFORMING AMENDMENT.—The table of con-
tents for the Child Abuse Prevention and Treatment Act 
(42 U.S.C. 5101 et seq.) is amended by inserting after 
the item relating to section 114 the following: 
‘‘Sec. 115. Ineligibility for funding.’’. 
Æ 
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