I 119th CONGRESS 1st Session H. R. 4953 IN THE HOUSE OF REPRESENTATIVES August 12, 2025 Ms. Mace introduced the following bill; which was referred to the Committee on the Judiciary A BILL To authorize a civil right of action for individuals on whom gender-related medical treatment was performed while such individual was a minor, and for other purposes.

1. Short title This Act may be cited as the Gender-Affirming Child Abuse Prevention Act . 2. Civil right of action related to gender-related medical treatment (a) Civil action (1) Right of action (A) Except as provided in paragraph (4), an individual on whom gender-affirming care was performed while such individual was a minor, in a circumstance described in paragraph (3) may bring a civil action in an appropriate district court of the United States against each person who performed the gender-affirming care for relief set forth in paragraph (2). (B) Rights on behalf of certain individuals In the case of an individual who is under 18 years of age, incompetent, incapacitated, or deceased, the legal guardian of the individual or representative of the individual’s estate, another family member, or any other person appointed as suitable by the court, may assume the individual’s rights under this section. (2) Relief An individual may recover the actual damages sustained by the individual or liquidated damages in the amount of $250,000 for each instance of gender affirming care being performed on the individual while such individual was a minor, and the cost of the action, including reasonable attorney’s fees and other litigation costs reasonably incurred. (3) Circumstances described For the purposes of paragraph (1), the circumstances described in this paragraph are that— (A) 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 paragraph (1); (B) 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 paragraph (1); (C) any payment of any kind was made, directly or indirectly, in furtherance of or in connection with the conduct described in paragraph (1) using any means, channel, facility, or instrumentality of interstate or foreign commerce or in or affecting interstate or foreign commerce; (D) the defendant transmitted in interstate or foreign commerce any communication relating to or in furtherance of the conduct described in paragraph (1) 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; (E) any instrument, item, substance, or other object that has traveled in interstate or foreign commerce was used to perform the conduct described in paragraph (1); (F) the conduct described in paragraph (1) occurred within the special maritime and territorial jurisdiction of the United States, or any territory or possession of the United States; or (G) the conduct described in paragraph (1) otherwise occurred in or affected interstate or foreign commerce. (b) Definitions In this section— (1) Gender-related medical treatment The term gender-related medical treatment — (A) means— (i) with respect to a female individual, medical treatments provided for purposes of addressing the perception of such individual that the gender or sex of such individual is not female, including— (I) surgical procedures, including— (aa) vaginectomy; (bb) hysterectomy; (cc) oophorectomy; (dd) reconstruction of the urethra; (ee) metoidioplasty; (ff) phalloplasty; (gg) salpingo-oophorectomy; (hh) scrotoplasty; (ii) implantation of erection or testicular protheses; (jj) subcutaneous mastectomy; (kk) vocal cord surgery; (ll) pectoral implants; and (mm) penile transplantation; (II) exogenous doses of testosterone or other androgens; (III) puberty blockers, including— (aa) GnRH agonists; and (bb) synthetic drugs that suppress the production of estrogen and progesterone or delay or suppress pubertal development in female individuals; and (IV) such other medical treatment, identified by the Secretary of Health and Human Services, that may be provided for purposes of addressing the perception of such individual that the gender or sex of such individual is not male. (ii) with respect to a male individual, medical treatments provided for purposes of addressing the perception of such individual that the gender or sex of such individual is not male, including— (I) surgical procedures, including— (aa) penectomy; (bb) orchiectomy; (cc) vaginoplasty; (dd) clitoroplasty; (ee) vulvoplasty; (ff) augmentation mammoplasty; (gg) facial feminization surgery; (hh) vocal cord surgery; (ii) chondrolaryngoplasty; (jj) gluteal augmentation; and (kk) uterine transplantation; (II) exogenous doses of estrogen; (III) puberty blockers, including— (aa) GnRH agonists; and (bb) synthetic drugs that suppress the production of testosterone or delay or suppress pubertal development in male individuals; and (IV) such other medical treatment, identified by the Secretary of Health and Human Services, that may be provided for purposes of addressing the perception of such individual that the gender or sex of such individual is not male. (B) does not include any medical treatment performed on an individual for the purposes of treating— (i) a disorder of sex development, diagnosed by a physician after such physician has determined through genetic or biochemical testing that such individual does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action; (ii) irresolvably ambiguous biological sex characteristics of such individual, including the presence of— (I) 46 XX chromosomes with virilization; (II) 46 XY chromosomes with undervirilization; or (III) both ovarian and testicular tissue; or (iii) an infection, injury, disease, or disorder caused or exacerbated by gender-related medical treatment that was furnished to an individual. (2) Sex The term sex means the biological determination as to whether an individual is male or female, as such terms are defined in this section. (3) Gender The term gender — (A) means— (i) males, females, or the natural differences between males and females, unless such term is otherwise specified or used alone (rather than with or as an adjective modifying other words); and (ii) a synonym for sex; and (B) does not mean a synonym for terms or ideas such as gender identity, experienced gender, gender expression, or gender roles. (4) Female The term female means an individual who naturally has, had, will have, or would have, but for a developmental or genetic anomaly or historical accident, the reproductive system that at some point produces, transports, and utilizes eggs for fertilization. (5) Male The term male means an individual who naturally has, had, will have, or would have, but for a developmental or genetic anomaly or historical accident, the reproductive system that at some point produces, transports, and utilizes sperm for fertilization. (6) Minor The term minor means an individual under the age of 18.