I 
119TH CONGRESS 
1ST SESSION H. R. 2202 
To prohibit taxpayer-funded gender transition procedures, and for other 
purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 18, 2025 
Mr. LAMALFA introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
the Judiciary, and Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To prohibit taxpayer-funded gender transition procedures, 
and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘End Taxpayer Funding of Gender Experimentation Act 
of 2025’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
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TITLE I—PROHIBITING FEDERALLY FUNDED GENDER 
TRANSITION PROCEDURES 
Sec. 101. Prohibiting taxpayer-funded gender transition procedures. 
Sec. 102. Amendment to table of chapters. 
TITLE II—APPLICATION UNDER THE AFFORDABLE CARE ACT 
Sec. 201. Clarifying application of prohibition to premium credits and cost- 
sharing reductions under ACA. 
TITLE I—PROHIBITING FEDER-
ALLY FUNDED GENDER TRAN-
SITION PROCEDURES 
SEC. 101. PROHIBITING TAXPAYER-FUNDED GENDER TRAN-
SITION PROCEDURES. 
Title 1, United States Code, is amended by adding 
at the end the following new chapter: 
‘‘CHAPTER 
4—PROHIBITING 
TAXPAYER- 
FUNDED GENDER TRANSITION PROCE-
DURES 
‘‘Sec. 
‘‘301. Prohibition on funding for gender transition procedures. 
‘‘302. Prohibition on funding for health benefits plans that cover gender transi-
tion procedures. 
‘‘303. Limitation on Federal facilities and employees. 
‘‘304. Construction relating to separate coverage. 
‘‘305. Construction relating to the use of non-Federal funds for health coverage. 
‘‘306. Construction relating to complications arising from gender transition pro-
cedures. 
‘‘307. Definitions. 
‘‘§ 301. Prohibition on funding for gender transition 
procedures 
‘‘No funds authorized or appropriated by Federal 
law, and none of the funds in any trust fund to which 
funds are authorized or appropriated by Federal law, shall 
be expended for any gender transition procedures. 
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‘‘§ 302. Prohibition on funding for health benefits 
plans that cover gender transition proce-
dures 
‘‘No funds authorized or appropriated by Federal 
law, and none of the funds in any trust fund to which 
funds are authorized or appropriated by Federal law, shall 
be expended for health benefits coverage that includes cov-
erage of gender transition procedures. 
‘‘§ 303. Limitation on Federal facilities and employees 
‘‘No health care service furnished— 
‘‘(1) by or in a health care facility owned or op-
erated by the Federal Government; or 
‘‘(2) by any physician or other individual em-
ployed by the Federal Government to provide health 
care services within the scope of the physician’s or 
individual’s employment, 
may include gender transition procedures. 
‘‘§ 304. Construction relating to separate coverage 
‘‘Nothing in this chapter shall be construed as pro-
hibiting any individual, entity, or State or locality from 
purchasing separate coverage for gender transition proce-
dures or health benefits coverage that includes gender 
transition procedures so long as such coverage is paid for 
entirely using only funds not authorized or appropriated 
by Federal law and such coverage shall not be purchased 
using matching funds required for a federally subsidized 
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program, including a State’s or locality’s contribution of 
Medicaid matching funds. 
‘‘§ 305. Construction relating to the use of non-Fed-
eral funds for health coverage 
‘‘Nothing in this chapter shall be construed as re-
stricting the ability of any non-Federal health benefits cov-
erage provider from offering coverage for gender transi-
tion procedures, or the ability of a State or locality to con-
tract separately with such a provider for such coverage, 
so long as only funds not authorized or appropriated by 
Federal law are used and such coverage shall not be pur-
chased using matching funds required for a federally sub-
sidized program, including a State’s or locality’s contribu-
tion of Medicaid matching funds. 
‘‘§ 306. Construction relating to complications arising 
from gender transition procedures 
‘‘Nothing in this chapter shall be construed to apply 
to the treatment of any infection, injury, disease, or dis-
order that has been caused by or exacerbated by the per-
formance of a gender transition procedure. 
‘‘§ 307. Definitions 
‘‘For purposes of this chapter: 
‘‘(1) FEMALE.—The term ‘female’, when used 
to refer to a natural person, means an individual 
who naturally has, had, will have, or would have, but 
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for a congenital anomaly, historical accident, or in-
tentional or unintentional disruption, the reproduc-
tive system that at some point produces, transports, 
and utilizes eggs for fertilization. 
‘‘(2) GENDER TRANSITION.—The term ‘gender 
transition’ means the process in which an individual 
goes from identifying with or presenting as his or 
her sex to identifying with or presenting a self-pro-
claimed identity that does not correspond with or is 
different from his or her sex, and may be accom-
panied with social, legal, or physical changes. 
‘‘(3) GENDER TRANSITION PROCEDURE.— 
‘‘(A) IN
GENERAL.—The term ‘gender 
transition procedure’ means any hormonal or 
surgical intervention for the purpose of gender 
transition, including— 
‘‘(i) gonadotropin-releasing hormone 
(GnRH) agonists or any other puberty- 
blocking or suppressing drugs to stop or 
delay normal puberty; 
‘‘(ii) testosterone, estrogen, progester-
one, or other androgens to an individual at 
doses that are supraphysiologic to what 
would normally be produced endogenously 
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in a healthy individual of the same age and 
sex; 
‘‘(iii) castration; 
‘‘(iv) orchiectomy; 
‘‘(v) scrotoplasty; 
‘‘(vi) implantation of erection or tes-
ticular prostheses; 
‘‘(vii) vasectomy; 
‘‘(viii) hysterectomy; 
‘‘(ix) oophorectomy; 
‘‘(x) ovariectomy; 
‘‘(xi) reconstruction of the fixed part 
of 
the 
urethra 
with 
or 
without 
a 
metoidioplasty or a phalloplasty; 
‘‘(xii) metoidioplasty; 
‘‘(xiii) penectomy; 
‘‘(xiv) phalloplasty; 
‘‘(xv) vaginoplasty; 
‘‘(xvi) clitoroplasty 
‘‘(xvii) vaginectomy; 
‘‘(xviii) vulvoplasty; 
‘‘(xix) reduction thyrochondroplasty; 
‘‘(xx) chondrolaryngoplasty; 
‘‘(xxi) mastectomy; 
‘‘(xxii) tubal ligation; 
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‘‘(xxiii) sterilization; 
‘‘(xxiv) any plastic, cosmetic, or aes-
thetic 
surgery 
that 
feminizes 
or 
masculinizes the facial or other physio-
logical features of an individual; 
‘‘(xxv) any placement of chest im-
plants to create feminine breasts; 
‘‘(xxvi) any placement of fat or artifi-
cial implants in the gluteal region; 
‘‘(xxvii) augmentation mammoplasty; 
‘‘(xxviii) liposuction; 
‘‘(xxix) lipofilling; 
‘‘(xxx) voice surgery; 
‘‘(xxxi) hair reconstruction; 
‘‘(xxxii) pectoral implants; and 
‘‘(xxxiii) the removal of any otherwise 
healthy or non-diseased body part or tis-
sue. 
‘‘(B) EXCLUSIONS.—The term ‘gender 
transition procedure’ does not include the fol-
lowing when furnished to an individual by a 
health care provider with the consent of such 
individual or, if applicable, such individual’s 
parents or legal guardian: 
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‘‘(i) Services to individuals born with 
a medically verifiable disorder of sex devel-
opment, including an individual with exter-
nal sex characteristics that are irresolvably 
ambiguous, such as an individual born with 
46 XX chromosomes with virilization, an 
individual born with 46 XY chromosomes 
with undervirilization, or an individual 
born having both ovarian and testicular 
tissue. 
‘‘(ii) Services provided when a physi-
cian has otherwise diagnosed a disorder of 
sexual development in which the physician 
has determined through genetic or bio-
chemical testing that the individual does 
not have normal sex chromosome struc-
ture, sex steroid hormone production, or 
sex steroid hormone action for a healthy 
individual of the same sex and age. 
‘‘(iii) The treatment of any infection, 
injury, disease, or disorder that has been 
caused by or exacerbated by the perform-
ance of gender transition procedures, 
whether or not the gender transition proce-
dure was performed in accordance with 
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