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 provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To prohibit the performance of gender-related medical treat-
ment 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Childhood Genital Mu-
tilation Prevention Act’’. 
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SEC. 2. PROHIBITING GENDER-RELATED MEDICAL TREAT-
MENT FOR MINORS. 
(a) IN GENERAL.—Chapter 7 of title 18, United 
States Code, is amended by inserting after section 116 the 
following new section: 
‘‘§ 116A. Gender-related medical treatment furnished 
to minors. 
‘‘(a) IN GENERAL.—Subject to subsection (c), who-
ever, in a circumstance described in subsection (b), know-
ingly performs or attempts to perform a gender-related 
medical treatment on a minor, shall be fined under this 
title, imprisoned not more than 10 years, or both. 
‘‘(b) CIRCUMSTANCES DESCRIBED.—For the pur-
poses of subsection (a), the circumstances described in this 
subsection are that— 
‘‘(1) the offender or victim traveled in inter-
state or foreign commerce, or traveled using a 
means, channel, facility, or instrumentality of inter-
state or foreign commerce, in furtherance of or in 
connection with the conduct described in subsection 
(a); 
‘‘(2) the offender used a means, channel, facil-
ity, or instrumentality of interstate or foreign com-
merce in furtherance of or in connection with the 
conduct described in subsection (a); 
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‘‘(3) any payment of any kind was made, di-
rectly or indirectly, in furtherance of or in connec-
tion with the conduct described in subsection (a) 
using any means, channel, facility, or instrumen-
tality of interstate or foreign commerce or in or af-
fecting interstate or foreign commerce; 
‘‘(4) the offender transmitted in interstate or 
foreign commerce any communication relating to or 
in furtherance of the conduct described in subsection 
(a) using any means, channel, facility, or instrumen-
tality of interstate or foreign commerce or in or af-
fecting interstate or foreign commerce by any means 
or in manner, including by computer, mail, wire, or 
electromagnetic transmission; 
‘‘(5) any instrument, item, substance, or other 
object that has traveled in interstate or foreign com-
merce was used to perform the conduct described in 
subsection (a); 
‘‘(6) the conduct described in subsection (a) oc-
curred within the special maritime and territorial ju-
risdiction of the United States, or any territory or 
possession of the United States; or 
‘‘(7) the conduct described in subsection (a) 
otherwise occurred in or affected interstate or for-
eign commerce. 
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‘‘(c) EXCEPTIONS.— 
‘‘(1) IN GENERAL.—An individual who provides 
gender-related medical treatment to a minor shall 
not be considered to have violated the prohibition in 
subsection (a) if such medical treatment is provided 
to such minor for purposes of treating— 
‘‘(A) a disorder of sex development, diag-
nosed by a physician after such physician has 
determined through genetic or biochemical test-
ing that such minor does not have normal sex 
chromosome structure, sex steroid hormone pro-
duction, or sex steroid hormone action; 
‘‘(B) irresolvably ambiguous biological sex 
characteristics of such minor, including the 
presence of— 
‘‘(i) 
XX 
chromosomes 
with 
virilization; 
‘‘(ii) 
XY 
chromosomes 
with 
undervirilization; or 
‘‘(iii) both ovarian and testicular tis-
sue; or 
‘‘(C) an infection, injury, disease, or dis-
order caused or exacerbated by gender-related 
medical treatment that was furnished to such 
minor. 
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‘‘(2) EXCEPTION FOR MINORS.—A minor who 
seeks gender-related medical treatment, or on whom 
gender-related medical treatment was performed, 
shall not be considered to have violated the prohibi-
tion in subsection (a). 
‘‘(d) DEFINITIONS.—In this section: 
‘‘(1) 
GENDER-RELATED
MEDICAL
TREAT-
MENT.—The term ‘gender-related medical treatment’ 
means— 
‘‘(A) with respect to a female individual, 
medical treatments provided for purposes of ad-
dressing the perception of such individual that 
the gender or sex of such individual is not fe-
male, including— 
‘‘(i) surgical procedures, including— 
‘‘(I) vaginectomy; 
‘‘(II) hysterectomy; 
‘‘(III) oophorectomy; 
‘‘(IV) reconstruction of the ure-
thra; 
‘‘(V) metoidioplasty; 
‘‘(VI) phalloplasty; 
‘‘(VII) salpingo-oophorectomy; 
‘‘(VIII) scrotoplasty; 
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‘‘(IX) implantation of erection or 
testicular protheses; 
‘‘(X) subcutaneous mastectomy; 
‘‘(XI) vocal cord surgery; 
‘‘(XII) pectoral implants; and 
‘‘(XIII) penile transplantation; 
‘‘(ii) exogenous doses of testosterone 
or other androgens; and 
‘‘(iii) puberty blockers, including— 
‘‘(I) GnRH agonists; and 
‘‘(II) synthetic drugs that sup-
press the production of estrogen and 
progesterone or delay or suppress pu-
bertal development in female individ-
uals; and 
‘‘(B) with respect to a male individual, 
medical treatments provided for purposes of ad-
dressing the perception of such individual that 
the gender or sex of such individual is not male, 
including— 
‘‘(i) surgical procedures, including— 
‘‘(I) penectomy; 
‘‘(II) orchiectomy; 
‘‘(III) vaginoplasty; 
‘‘(IV) clitoroplasty; 
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‘‘(V) vulvoplasty; 
‘‘(VI) 
augmentation 
mammoplasty; 
‘‘(VII) facial feminization sur-
gery; 
‘‘(VIII) vocal cord surgery; 
‘‘(IX) chondrolaryngoplasty; 
‘‘(X) gluteal augmentation; and 
‘‘(XI) uterine transplantation; 
‘‘(ii) exogenous doses of estrogen; and 
‘‘(iii) puberty blockers, including— 
‘‘(I) GnRH agonists; and 
‘‘(II) synthetic drugs that sup-
press the production of testosterone or 
delay or suppress pubertal develop-
ment in male individuals. 
‘‘(2) FEMALE.—The term ‘female’— 
‘‘(A) means an individual who, under nor-
mal development— 
‘‘(i) has XX chromosomes; 
‘‘(ii) produces oocytes; and 
‘‘(iii) has a reproductive and endo-
crine system oriented around the produc-
tion of such oocytes; and 
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‘‘(B) includes an individual who would oth-
erwise fall within this definition but for a bio-
logical or genetic condition described in sub-
paragraph (A) or (B) of subsection (c)(1). 
‘‘(3) GENDER.—The term ‘gender’ means, with 
respect to an individual, the psychological, behav-
ioral, social, and cultural aspects of being male or 
female. 
‘‘(4) MALE.—The term ‘male’— 
‘‘(A) means an individual who, under nor-
mal development— 
‘‘(i) has XY chromosomes; 
‘‘(ii) produces sperm; and 
‘‘(iii) has a reproductive and endo-
crine system oriented around the produc-
tion of such sperm; and 
‘‘(B) includes an individual who would oth-
erwise fall within this definition but for a bio-
logical or genetic condition described in sub-
paragraph (A) or (B) of subsection (c)(1). 
‘‘(5) MINOR.—The term ‘minor’ means an indi-
vidual under 18 years of age. 
‘‘(6) SEX.—The term ‘sex’ means the biological 
and genetic indication of whether an individual is 
male or female, as determined by the organization of 
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body parts and gametes for reproduction (including 
sex chromosomes, naturally occurring sex chro-
mosomes, gonads, and nonambiguous internal and 
external genitalia present at birth) without regard to 
the psychological, behavioral, social, cultural, chosen, 
or subjective experience of gender of such indi-
vidual.’’. 
(b) CLERICAL AMENDMENT.—The table of sections 
for such chapter is amended by inserting after the item 
relating to section 116 the following new item: 
‘‘116A. Gender-related medical treatment for minors.’’. 
SEC. 
3. 
PROHIBITING 
PAYMENT 
AND 
PARTICIPATION 
UNDER MEDICARE WITH RESPECT TO GEN-
DER-RELATED MEDICAL TREATMENT FOR MI-
NORS. 
(a) EXCLUDING FROM COVERAGE GENDER-RELATED 
MEDICAL TREATMENT FOR MINORS.—Section 1862(a) of 
the Social Security Act (42 U.S.C. 1395y(a)) is amend-
ed— 
(1) in paragraph (24), by striking ‘‘or’’ at the 
end; 
(2) in paragraph (25), by striking the period at 
the end and inserting ‘‘; or’’; and 
(3) by inserting after paragraph (25) the fol-
lowing new paragraph: 
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‘‘(26) beginning on the date that is 90 days 
after the date of the enactment of the Childhood 
Genital Mutilation Prevention Act, which constitute 
gender-related medical treatment for minors de-
scribed in section 116A of chapter 7 of title 18, 
United States Code, and are not provided for the 
purposes described in subsection (c)(1) of such sec-
tion.’’. 
(b) EXCLUDING FROM PARTICIPATION PROVIDERS 
FURNISHING GENDER-RELATED MEDICAL TREATMENT 
FOR MINORS.—Section 1866 of the Social Security Act 
(42 U.S.C. 1395cc) is amended by adding at the end the 
following new subsection: 
‘‘(l) EXCLUSION OF PROVIDERS FURNISHING GEN-
DER-RELATED MEDICAL TREATMENT FOR MINORS.—Be-
ginning on the date that is 90 days after the date of the 
enactment of the Childhood Genital Mutilation Prevention 
Act, with respect to a provider of services or supplier that, 
on or after the date that is 90 days after such date of 
enactment, furnishes gender-related medical treatment for 
minors, as described in section 116A of chapter 7 of title 
18, United States Code to any individual (other than such 
a treatment that is furnished for the purposes described 
in subsection (c)(1) of such section), regardless of whether 
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such individual is entitled to benefits under part A or en-
rolled under part B— 
‘‘(1) if such provider of services or supplier is 
enrolled in the program under this title, the Sec-
retary shall terminate such enrollment; and 
‘‘(2) the Secretary may not enroll such provider 
of services or supplier as a new provider of services 
or supplier in the program under this title.’’. 
SEC. 4. PROHIBITION ON FEDERAL FUNDING FOR GENDER- 
RELATED MEDICAL TREATMENT FOR MI-
NORS. 
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 
obligated or expended for any gender-related medical 
treatment furnished to a minor (as such terms are used 
for purposes of section 116A of chapter 7 of title 18, 
United States Code) or for any health benefits coverage 
that includes coverage for gender-related medical treat-
ment furnished to a minor. 
Æ 
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