II 118th CONGRESS 1st Session S. 1597 IN THE SENATE OF THE UNITED STATES May 15, 2023 Mr. Marshall (for himself, Mrs. Blackburn , Mr. Cramer , Mr. Braun , Mr. Daines , Mrs. Hyde-Smith , Mr. Mullin , and Mr. Wicker ) introduced the following bill; which was read twice and referred to the Committee on the Judiciary A BILL To amend chapter 110 of title 18, United States Code, to prohibit gender transition procedures on minors, and for other purposes.

1. Short title This Act may be cited as the Protecting Children From Experimentation Act of 2023 . 2. Gender transition procedures on minors prohibited Chapter 110 of title 18, United States Code, is amended— (1) by adding at the end the following: 2260B. Gender transition procedures on minors (a) In general Any physical or mental healthcare professional who knowingly performs or provides a referral for any gender transition procedure on a minor shall be fined under this title, imprisoned not more than 5 years, or both. (b) Prohibition on prosecution of person on whom procedures are performed No person on whom the gender transition procedure under subsection (a) is performed may be arrested or prosecuted for an offense under this section. (c) Civil action A person on whom a gender transition procedure is performed under this section may bring a civil action for appropriate relief against each person who performed the gender transition procedure. (d) Definitions In this section: (1) Biological sex The term biological sex means the biological indication of male and female in the context of reproductive potential or capacity, such as sex chromosomes, naturally occurring sex hormones, gonads, and nonambiguous internal and external genitalia present at birth, without regard to the psychological, chosen, or subjective experience of the gender of an individual. (2) Cross-sex hormones The term cross-sex hormones means— (A) testosterone or other androgens given to biological females at doses that are profoundly larger or more potent than would normally occur naturally in healthy biological females; and (B) estrogen given to biological males at doses that are profoundly larger or more potent than would normally occur naturally in healthy biological males. (3) Gender The term gender means the psychological, behavioral, social, and cultural aspects of being male or female. (4) Gender transition The term gender transition means the process in which an individual goes from identifying with and living as a gender that corresponds to his or her biological sex to identifying with and living as a gender different from his or her biological sex, and may involve social, legal, or physical changes. (5) Gender transition procedure (A) In general The term gender transition procedure means any medical or surgical service that seeks— (i) to alter or remove physical or anatomical characteristics or features that are typical for the individual’s biological sex; or (ii) to instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s birth sex. (B) Inclusions For purposes of subparagraph (A), the term medical or surgical service includes— (i) physician's services; (ii) inpatient and outpatient hospital services; (iii) prescribed drugs relating to gender transition; (iv) a medical service that provides— (I) puberty-blocking drugs; (II) cross-sex hormones; or (III) other mechanisms to promote the development of feminizing or masculinizing features (in the opposite sex); and (v) gender transition surgery. (C) Exclusions The term gender transition procedure does not include— (i) services to individuals born with a medically verifiable disorder of sex development, including an individual with external biological sex characteristics that are irresolvably ambiguous, such as an individual born with 46 XX chromosomes with virilization, an individual born with 46 XY chromosomes with undervirilization, or an individual born having both ovarian and testicular tissue; (ii) services provided when a physician has otherwise diagnosed a disorder of sexual development in which the 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; or (iii) the treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by the performance of gender transition procedures, whether or not the gender transition procedure was performed in accordance with State and Federal law or whether or not funding for the gender transition procedure is permissible under this section. (6) Gender transition surgery (A) In general The term gender transition surgery means any medical or surgical service that seeks to surgically alter or remove healthy physical or anatomical characteristics or features that are typical for the individual’s biological sex in order to instill or create physiological or anatomical characteristics that resemble a sex different from the individual’s birth sex. (B) Inclusions The term gender transition surgery includes genital gender transition surgery and non-genital gender transition surgery. (C) Exclusions The term gender transition surgery does not include 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 surgery is performed for the purpose of a gender transition or for the alleviation of psychological or mental distress. (7) Genital gender transition surgery The term genital gender transition surgery means a surgical procedure performed for the purpose of assisting an individual with a gender transition, including— (A) for biologically male patients, a penectomy, orchiectomy, vaginoplasty, clitoroplasty, and vulvoplasty; and (B) for biologically female patients, a hysterectomy/ovariectomy, reconstruction of the fixed part of the urethra with or without a metoidioplasty or a phalloplasty, vaginectomy, scrotoplasty, and implantation of erection or testicular prostheses. (8) Minor The term minor means an individual under the age of 18. (9) Non-genital gender transition surgery The term non-genital gender transition surgery means a surgical procedure performed for the purpose of assisting an individual with a gender transition, including— (A) for biologically male patients, augmentation mammoplasty, facial feminization surgery, liposuction, lipofilling, voice surgery, thyroid cartilage reduction, gluteal augmentation (implants/lipofilling), hair reconstruction, and various aesthetic procedures; and (B) for biologically female patients, subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants, and various aesthetic procedures. (10) Puberty-blocking drugs The term puberty-blocking drugs means— (A) Gonadotropin-releasing hormone (GnRH) analogues or other synthetic drugs used in biological males to stop luteinizing hormone secretion and therefore testosterone secretion; and (B) synthetic drugs used in biological females that stop the production of estrogen and progesterone, when used to delay or suppress pubertal development in children for the purpose of assisting an individual with a gender transition. ; and (2) by amending the table of sections for such chapter by adding at the end the following: 2260B. Gender transition procedures on minors. .