I 118th CONGRESS 1st Session H. R. 5636 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.

1. Short title This Act may be cited as the Protect Children’s Innocence Act . 2. Gender affirming care on minors prohibited Chapter 110 of title 18, United States Code, is amended— (1) by adding at the end the following: 2260B. Gender affirming care for minors (a) In general Whoever, in any circumstance described in subsection (e), knowingly performs any gender 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 affirming care is performed under this section may bring a civil action for appropriate relief, including compensatory 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 following: (i) Performing any surgery for the purpose of changing the body of such individual to correspond to a sex that differs from their biological sex, including— (I) castration; (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 feminizes 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 purposes described in clause (i). (v) Administering, supplying, prescribing, dispensing, distributing, or otherwise conveying to an individual medications for the purposes described in clause (i), including— (I) gonadotropin-releasing hormone (GnRH) analogues or other puberty-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 individual does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action. (iii) An individual experiencing infection, disease, injury, or disorder caused or exacerbated by previous gender transition procedures. (iv) An individual suffering 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 a major bodily function unless the procedure is performed. (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 internal or external genitalia present at birth. (3) Minor The term minor means any person under the age of eighteen years. (e) Circumstances described For purposes of subsection (a), the circumstances described in this subsection are that— (1) the defendant or victim traveled in interstate or foreign commerce, or traveled using a means, channel, facility, or instrumentality of interstate or foreign commerce, in furtherance of or in connection with the conduct described in subsection (a); (2) the defendant used a means, channel, facility, 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, directly or indirectly, in furtherance of or in connection with the conduct described in subsection (a) using any means, channel, facility, or instrumentality of interstate or foreign commerce or in or affecting 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 instrumentality of interstate or foreign commerce or in or affecting 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 commerce was used to perform the conduct described in subsection (a); (6) the conduct described in subsection (a) occurred within the special maritime and territorial jurisdiction 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 foreign commerce. (f) Rule of construction Nothing in this section shall be construed as prohibiting provision of the medical services described in subsection (d)(1)(A) to address legitimate health issues, such as any male or female reproductive cancers, apart from changing the body to correspond 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. .