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. 
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 ‘‘Protect Children’s In-
nocence Act’’. 
SEC. 2. GENDER AFFIRMING CARE ON MINORS PROHIB-
ITED. 
Chapter 110 of title 18, United States Code, is 
amended— 
(1) by adding at the end the following: 
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‘‘§ 2260B. Gender affirming care for minors 
‘‘(a) IN GENERAL.—Whoever, in any circumstance 
described in subsection (e), knowingly performs any gen-
der affirming care on a minor is guilty of a class C felony. 
‘‘(b) PROHIBITION ON PROSECUTION OF PERSON ON 
WHOM INTERVENTION IS PERFORMED.—No person on 
whom the gender affirming care under subsection (a) is 
performed may be arrested or prosecuted for an offense 
under this section. 
‘‘(c) CIVIL ACTION.—A person on whom gender af-
firming care is performed under this section may bring 
a civil action for appropriate relief, including compen-
satory and punitive damages, against each person who 
performed the gender affirming care. 
‘‘(d) DEFINITIONS.—In this section: 
‘‘(1) GENDER AFFIRMING CARE.— 
‘‘(A) IN GENERAL.—For purposes of this 
chapter, except as provided in subparagraph 
(B), the term ‘gender affirming care’ means, 
with respect to an individual, any of the fol-
lowing: 
‘‘(i) Performing any surgery for the 
purpose of changing the body of such indi-
vidual to correspond to a sex that differs 
from their biological sex, including— 
‘‘(I) castration; 
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‘‘(II) orchiectomy; 
‘‘(III) scrotoplasty; 
‘‘(IV) vasectomy; 
‘‘(V) hysterectomy; 
‘‘(VI) oophorectomy; 
‘‘(VII) ovariectomy; 
‘‘(VIII) metoidioplasty; 
‘‘(IX) penectomy; 
‘‘(X) phalloplasty; 
‘‘(XI) vaginoplasty; 
‘‘(XII) vaginectomy; 
‘‘(XIII) vulvoplasty; 
‘‘(XIV) 
reduction 
thyrochondroplasty; 
‘‘(XV) chondrolaryngoplasty; and 
‘‘(XVI) mastectomy. 
‘‘(ii) Any plastic surgery that femi-
nizes or masculinizes the facial features for 
the purposes described in clause (i). 
‘‘(iii) Any placement of chest implants 
to create feminine breasts for the purposes 
described in clause (i). 
‘‘(iv) Any placement of fat or artificial 
implants in the gluteal region for the pur-
poses described in clause (i). 
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‘‘(v) Administering, supplying, pre-
scribing, dispensing, distributing, or other-
wise conveying to an individual medications 
for the purposes described in clause (i), in-
cluding— 
‘‘(I) gonadotropin-releasing hor-
mone (GnRH) analogues or other pu-
berty-blocking drugs to stop or delay 
normal puberty; 
‘‘(II) 
testosterone 
or 
other 
androgens to biological females at 
doses that are supraphysiologic to the 
female sex; and 
‘‘(III) 
estrogen 
to 
biological 
males 
at 
doses 
that 
are 
supraphysiologic to the male sex. 
‘‘(B) 
EXCEPTION.—Subparagraph 
(A) 
shall not apply to the following individuals: 
‘‘(i) An individual with both ovarian 
and testicular tissue. 
‘‘(ii) An individual with respect to 
whom a physician has determined through 
genetic or biochemical testing that the in-
dividual does not have normal sex chro-
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mosome structure, sex steroid hormone 
production, or sex steroid hormone action. 
‘‘(iii) An individual experiencing infec-
tion, disease, injury, or disorder caused or 
exacerbated by previous gender transition 
procedures. 
‘‘(iv) An individual suffering from a 
physical disorder, physical injury, or phys-
ical illness that would, as certified by a 
physician, place the individual in imminent 
danger of death or impairment of a major 
bodily function unless the procedure is per-
formed. 
‘‘(2) BIOLOGICAL
SEX.—The term ‘biological 
sex’ means the indication of male or female sex by 
reproductive potential or capacity, sex chromosomes, 
naturally occurring sex hormones, gonads, or inter-
nal or external genitalia present at birth. 
‘‘(3) MINOR.—The term ‘minor’ means any per-
son under the age of eighteen years. 
‘‘(e) CIRCUMSTANCES DESCRIBED.—For purposes of 
subsection (a), the circumstances described in this sub-
section are that— 
‘‘(1) the defendant or victim traveled in inter-
state or foreign commerce, or traveled using a 
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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 defendant used a means, channel, fa-
cility, or instrumentality of interstate or foreign 
commerce in furtherance of or in connection with 
the conduct described in subsection (a); 
‘‘(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 defendant 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-
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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. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed as prohibiting provision of the med-
ical services described in subsection (d)(1)(A) to address 
legitimate health issues, such as any male or female repro-
ductive cancers, apart from changing the body to cor-
respond to a sex that differs from one’s biological sex.’’; 
and 
(2) by amending the table of sections for such 
chapter by adding at the end the following: 
‘‘2260B. Gender affirming care on minors.’’. 
Æ 
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