II 118th CONGRESS 1st Session S. 457 IN THE SENATE OF THE UNITED STATES February 15, 2023 Mr. Hawley introduced the following bill; which was read twice and referred to the Committee on the Judiciary A BILL To establish a Federal tort against pediatric gender clinics and other entities pushing gender-transition procedures that cause bodily injury to children or harm the mental health of children.

1. Short title This Act may be cited as the Protecting Our Kids from Child Abuse Act . 2. Federal tort for harm to children caused by gender-transition procedures (a) Definitions In this section: (1) Gender transition procedure (A) In general Except as provided in subparagraph (B), the term gender-transition procedure means— (i) the prescription or administration of gonadotropin-releasing hormone agonists or any other puberty-blocking drugs for the purpose of changing the body of an individual so that it conforms to the subjective sense of identity of the individual, in the case such identity is at odds with the individual's biological sex of male or female; (ii) the prescription or administration of testosterone (when prescribed to a female) or estrogen (when prescribed to a male) for the purpose of changing the body of an individual so that it conforms to the subjective sense of identity of the individual, in the case such identity is at odds with the individual’s biological sex of male or female; or (iii) a surgery to change the body of an individual so that it conforms to the subjective sense of identity of the individual, in the case such identity is at odds with the individual’s biological sex of male or female. (B) Exception The term gender-transition procedure does not include— (i) an intervention described in subparagraph (A) that is performed on— (I) an individual with biological sex characteristics that are inherently ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue; or (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, for a biological male or biological female; (ii) the treatment of any infection, injury, disease, or disorder that has been caused or exacerbated by the performance of an intervention described in subparagraph (A) without regard to whether the intervention was performed in accordance with State or Federal law or whether the intervention is covered by the private right of action under subsection (c); or (iii) any procedure undertaken because the individual suffers 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 major bodily function unless the procedure is performed. (2) Hospital The term hospital has the meaning given such term in section 1861(e) of the Social Security Act ( 42 U.S.C. 1395x(e) ). (3) Institution of higher education The term institution of higher education has the meaning given such term in section 101 of the Higher Education Act of 1965 ( 20 U.S.C. 1001 ). (4) Medical practitioner The term medical practitioner means a person who is licensed, certified, or otherwise authorized by the laws of a State to administer health care in the ordinary course of the practice of the person’s profession. (5) Minor The term minor means an individual who has not yet reached 18 years of age. (6) Pediatric gender clinic The term pediatric gender clinic means a medical facility that specializes in the diagnosis or treatment of gender discordance and gender dysphoria in minors, including medical interventions such as therapeutic diagnosis of gender dysphoria and performance of (or referral for) gender-transition procedures on minors. (b) Liability The following individuals and entities shall be liable in accordance with this section to any individual who suffers bodily injury or harm to mental health (including any physical, psychological, emotional, or physiological harm) that is attributable, in whole or in part, to a gender-transition procedure performed on the individual when the individual was a minor: (1) A pediatric gender clinic where the gender-transition procedure was provided. (2) Any medical practitioner who administered health care, at the time of the particular procedure, at the pediatric gender clinic where the gender-transition procedure was provided. (3) An institution of higher education that hosts, operates, partners with, provides funding to, or is otherwise affiliated with the pediatric gender clinic where the gender-transition procedure was provided. (4) A hospital that hosts, operates, partners with, provides funding to, or is otherwise affiliated with the pediatric gender clinic where the gender-transition procedure was provided. (5) Any medical practitioner who performed the gender-transition procedure on the individual. (c) Private right of action An individual who suffers bodily injury or harm to mental health that is attributable, in whole or in part, to a gender-transition procedure provided to the individual when the individual was a minor may, not later than 30 years after the date on which the individual turns 18 years of age, bring a civil action against an individual or entity described in subsection (b), in an appropriate district court of the United States or a State court of competent jurisdiction for— (1) compensatory damages; (2) punitive damages; and (3) attorney’s fees and costs. (d) Affirmative defense It shall be an affirmative defense to an action brought by or on behalf of an individual upon whom a gender-transition procedure was performed under subsection (c) that the pediatric gender clinic or medical practitioner who performed the gender-transition procedure on the individual, at all relevant times, did not know and had no reason to know that the individual in question was a minor. 3. Prohibition on funding No Federal funds may be made available— (1) to a pediatric gender clinic; (2) to an institution of higher education or hospital that hosts, operates, partners with, provides funding to, or is otherwise affiliated with, a pediatric gender clinic; or (3) for any gender-transition procedure performed on a minor. 4. Effective date and retroactive application This Act shall— (1) take effect on the date of enactment of this Act; and (2) apply to any gender-transition procedure that took place before, on, or after the effective date under paragraph (1). 5. Severability If any provision of this Act, or the application of such provision to any person or circumstance, is held to be unconstitutional, the remainder of this Act, and the application of the remaining provisions of this Act, to any person or circumstance, shall not be affected.