I 
117TH CONGRESS 
1ST SESSION H. R. 1927 
To prohibit taxpayer-funded gender reassignment medical interventions, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 16, 2021 
Mr. LAMALFA (for himself, Mr. NORMAN, Mr. ALLEN, Mr. GROTHMAN, Mr. 
DUNCAN, Mr. LAMBORN, Mr. HICE of Georgia, Mrs. MILLER of Illinois, 
Mr. STEUBE, Mr. KELLY of Mississippi, Mr. JORDAN, Mr. BANKS, Mr. 
WEBER of Texas, Mr. ADERHOLT, Mr. BABIN, and Mr. GOOD of Vir-
ginia) introduced the following bill; which was referred to the Committee 
on Energy and Commerce, and in addition to the Committees on the Ju-
diciary, 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 taxpayer-funded gender reassignment medical 
interventions, 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 2021’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—PROHIBITING FEDERALLY FUNDED GENDER 
REASSIGNMENT MEDICAL INTERVENTIONS 
Sec. 101. Prohibiting taxpayer-funded gender reassignment medical interven-
tions. 
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 REAS-
SIGNMENT MEDICAL INTER-
VENTIONS 
SEC. 101. PROHIBITING TAXPAYER-FUNDED GENDER REAS-
SIGNMENT MEDICAL INTERVENTIONS. 
Title 1, United States Code, is amended by adding 
at the end the following new chapter: 
‘‘CHAPTER 
4—PROHIBITING 
TAXPAYER- 
FUNDED 
GENDER 
REASSIGNMENT 
MEDICAL INTERVENTIONS 
‘‘301. Prohibition on funding for gender reassignment medical interventions. 
‘‘302. Prohibition on funding for health benefits plans that cover gender reas-
signment medical interventions. 
‘‘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 reassignment 
medical interventions. 
‘‘307. Treatment of individuals born with medically verifiable disorder of sex de-
velopment. 
‘‘308. Gender reassignment medical intervention defined. 
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‘‘§ 306. Construction relating to complications arising 
from gender reassignment medical inter-
ventions 
‘‘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 reassignment medical intervention. 
This rule of construction shall be applicable without re-
gard to whether the gender reassignment medical inter-
vention was performed in accord with Federal or State 
law, and without regard to whether funding for the gender 
reassignment medical intervention is permissible under 
section 307. 
‘‘§ 307. Treatment of individuals born with medically 
verifiable disorder of sex development 
‘‘The limitations established in sections 301, 302, 
and 303 shall not apply with respect to the following indi-
viduals: 
‘‘(1) An individual with external biological sex 
characteristics that are irresolvably ambiguous, such 
as those born with 46 XX chromosomes with viriliza-
tion, 46 XY chromosomes with undervirilization, or 
having both ovarian and testicular tissue. 
‘‘(2) An individual with respect to whom a phy-
sician has determined through genetic or biochemical 
testing that the individual does not have normal sex 
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chromosome structure, sex steroid hormone produc-
tion, or sex steroid hormone action for a biological 
male or female. 
‘‘§ 308. Gender reassignment medical intervention de-
fined 
‘‘For purposes of this chapter, the term ‘gender reas-
signment medical intervention’ means— 
‘‘(1) performing a surgery that sterilizes an in-
dividual, including castration, vasectomy, hysterecto-
my, oophorectomy, metoidioplasty, penectomy, phal-
loplasty, and vaginoplasty, to change the body of 
such individual to correspond to a sex that is dis-
cordant with biological sex; 
‘‘(2) performing a mastectomy on an individual 
for the purpose described in paragraph (1); and 
‘‘(3) administering or supplying to an individual 
medications for the purpose described in paragraph 
(1), including— 
‘‘(A) GnRH agonists or other puberty- 
blocking drugs to stop or delay normal puberty; 
‘‘(B) testosterone or other androgens to bi-
ological females at doses that are supraphysio-
logic to the female sex; and 
‘‘(C) estrogen to biological males at doses 
that are supraphysiologic to the male sex.’’. 
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SEC. 102. AMENDMENT TO TABLE OF CHAPTERS. 
The table of chapters for title 1, United States Code, 
is amended by adding at the end the following new item: 
‘‘4. Prohibiting taxpayer-funded gender reassignment 
medical interventions ..........................................
301’’. 
TITLE II—APPLICATION UNDER 
THE AFFORDABLE CARE ACT 
SEC. 201. CLARIFYING APPLICATION OF PROHIBITION TO 
PREMIUM CREDITS AND COST-SHARING RE-
DUCTIONS UNDER ACA. 
(a) IN GENERAL.— 
(1) DISALLOWANCE OF REFUNDABLE CREDIT 
AND
COST-SHARING
REDUCTIONS
FOR
COVERAGE 
UNDER QUALIFIED HEALTH PLAN WHICH PROVIDES 
COVERAGE
FOR
GENDER
REASSIGNMENT
MEDICAL 
INTERVENTIONS.— 
(A) IN
GENERAL.—Subparagraph (A) of 
section 36B(c)(3) of the Internal Revenue Code 
of 1986 is amended by inserting before the pe-
riod at the end the following: ‘‘or any health 
plan that includes coverage for gender reassign-
ment medical interventions (other than any 
gender reassignment medical intervention or 
treatment described in section 306 or 307 of 
title 1, United States Code)’’. 
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(B) OPTION TO PURCHASE OR OFFER SEP-
ARATE COVERAGE OR PLAN.—Paragraph (3) of 
section 36B(c) of such Code is amended by 
adding at the end the following new subpara-
graph: 
‘‘(C) SEPARATE COVERAGE OR PLAN FOR 
GENDER
REASSIGNMENT
MEDICAL
INTERVEN-
TIONS ALLOWED.— 
‘‘(i) OPTION TO PURCHASE SEPARATE 
COVERAGE OR PLAN.—Nothing in subpara-
graph (A) shall be construed as prohibiting 
any individual from purchasing separate 
coverage for gender reassignment medical 
interventions described in such subpara-
graph, or a health plan that includes such 
gender reassignment medical interventions, 
so long as no credit is allowed under this 
section with respect to the premiums for 
such coverage or plan. 
‘‘(ii) OPTION TO OFFER COVERAGE OR 
PLAN.—Nothing in subparagraph (A) shall 
restrict any non-Federal health insurance 
issuer offering a health plan from offering 
separate coverage for gender reassignment 
medical interventions described in such 
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subparagraph, or a plan that includes such 
gender reassignment medical interventions, 
so long as premiums for such separate cov-
erage or plan are not paid for with any 
amount attributable to the credit allowed 
under this section (or the amount of any 
advance payment of the credit under sec-
tion 1412 of the Patient Protection and 
Affordable Care Act).’’. 
(2) DISALLOWANCE
OF
SMALL
EMPLOYER 
HEALTH
INSURANCE
EXPENSE
CREDIT
FOR
PLAN 
WHICH
INCLUDES
COVERAGE
FOR
GENDER
REAS-
SIGNMENT
MEDICAL
INTERVENTIONS.—Subsection 
(h) of section 45R of the Internal Revenue Code of 
1986 is amended— 
(A) by striking ‘‘Any term’’ and inserting 
the following: 
‘‘(1) IN GENERAL.—Any term’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(2) EXCLUSION OF HEALTH PLANS INCLUDING 
COVERAGE
FOR
GENDER
REASSIGNMENT
MEDICAL 
INTERVENTIONS.— 
‘‘(A) IN
GENERAL.—The term ‘qualified 
health plan’ does not include any health plan 
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that includes coverage for gender reassignment 
medical interventions (other than any gender 
reassignment medical intervention or treatment 
described in section 306 or 307 of title 1, 
United States Code). 
‘‘(B) SEPARATE COVERAGE OR PLAN FOR 
GENDER
REASSIGNMENT
MEDICAL
INTERVEN-
TIONS ALLOWED.— 
‘‘(i) OPTION TO PURCHASE SEPARATE 
COVERAGE OR PLAN.—Nothing in subpara-
graph (A) shall be construed as prohibiting 
any employer from purchasing for its em-
ployees separate coverage for gender reas-
signment medical interventions described 
in such subparagraph, or a health plan 
that includes such gender reassignment 
medical interventions, so long as no credit 
is allowed under this section with respect 
to the employer contributions for such cov-
erage or plan. 
‘‘(ii) OPTION TO OFFER COVERAGE OR 
PLAN.—Nothing in subparagraph (A) shall 
restrict any non-Federal health insurance 
issuer offering a health plan from offering 
separate coverage for gender reassignment 
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