Ensuring Military Readiness Act of 2023

I 118TH CONGRESS 1ST SESSION H. R. 1112 To provide requirements related to the eligibility of individuals who identify as transgender from serving in the Armed Forces. IN THE HOUSE OF REPRESENTATIVES FEBRUARY 21, 2023 Mr. BANKS introduced the following bill; which was referred to the Committee on Armed Services A BILL To provide requirements related to the eligibility of individ- uals who identify as transgender from serving in the Armed Forces. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Ensuring Military 4 Readiness Act of 2023’’. 5 SEC. 2. LIMITATIONS ON MILITARY SERVICE BY INDIVID- 6 UALS WHO IDENTIFY AS TRANSGENDER. 7 Not later than 90 days after the date of the enact- 8 ment of this Act, the Secretary of Defense shall prescribe 9 VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 1112 IH regulations regarding service of individuals who identify 1 as transgender as follows: 2 (1) Persons who identify as transgender with a 3 history of diagnosis of gender dysphoria are disquali- 4 fied from military service except under the following 5 limited circumstances: 6 (A) Individuals may serve in the Armed 7 Forces if they have been stable for 36 consecu- 8 tive months in their biological sex prior to ac- 9 cession. 10 (B) Members of the Armed Forces diag- 11 nosed with gender dysphoria after entering into 12 service may be retained if they do not undergo 13 gender transition procedures and remain 14 deployable within applicable retention standards 15 for their biological sex. 16 (C) Members of the Armed Forces serving 17 as of the date of the enactment of this Act who 18 have been diagnosed with gender dysphoria may 19 continue to serve only in their biological sex, ir- 20 respective of any changes previously made to 21 their gender marker in the Defense Enrollment 22 Eligibility Reporting System (DEERS), and re- 23 ceive medically necessary treatment for gender 24 VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 1112 IH dysphoria. Such treatment may not include gen- 1 der transition procedures. 2 (2) Persons who identify as transgender who 3 seek or have undergone gender transition are dis- 4 qualified from military service. 5 (3) Persons who identify as transgender with- 6 out a history or diagnosis of gender dysphoria, who 7 are otherwise qualified for service and meet all phys- 8 ical and mental requirements, may serve in the 9 Armed Forces in their biological sex. 10 SEC. 3. REVISED REGULATIONS REGARDING GENDER 11 MARKINGS. 12 Not later than 90 days after the date of the enact- 13 ment of this Act, the Secretary of Defense shall prescribe 14 regulations updating the Defense Enrollment Eligibility 15 Reporting System (DEERS) to require the gender mark- 16 ers for members of the Armed Forces to match their bio- 17 logical sex, irrespective of any previous changes allowed. 18 SEC. 4. DEFINITIONS. 19 In this Act: 20 (1) CROSS-SEX HORMONES.—The term ‘‘cross- 21 sex hormones’’ means testosterone or other 22 androgens given to biological females at doses that 23 are profoundly larger or more potent than would 24 normally occur naturally in healthy biological fe- 25 VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 1112 IH males, or estrogen given to biological males at doses 1 that are profoundly larger or more potent than 2 would normally occur naturally in healthy biological 3 males. 4 (2) GENDER.—The term ‘‘gender’’ means the 5 psychological, behavioral, social, and cultural aspects 6 of being male or female. 7 (3) GENDER DYSPHORIA.—The term ‘‘gender 8 dysphoria’’ means a marked incongruence between 9 one’s experienced or expressed gender and biological 10 sex. 11 (4) GENDER TRANSITION.—The term ‘‘gender 12 transition’’ means the process by which a person 13 goes from identifying with and living as a gender 14 that corresponds to his or her biological sex to iden- 15 tifying with and living as a gender different from his 16 or her biological sex, and may involve social, legal, 17 or physical changes. 18 (5) GENDER TRANSITION PROCEDURES.—The 19 term ‘‘gender transition procedures’’— 20 (A) means— 21 (i) any medical or surgical interven- 22 tion, including physician’s services, inpa- 23 tient and outpatient hospital services, or 24 prescribed drugs related to gender transi- 25 VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 1112 IH tion, that seeks to alter or remove physical 1 or anatomical characteristics or features 2 that are typical for the individual’s biologi- 3 cal sex or to instill or create physiological 4 or anatomical characteristics that resemble 5 a sex different from the individual’s birth 6 sex, including medical services that provide 7 puberty-blocking drugs, cross-sex hor- 8 mones, or other mechanisms to promote 9 the development of feminizing or 10 masculinizing features (in the opposite 11 sex); and 12 (ii) genital or non-genital gender tran- 13 sition surgery performed for the purpose of 14 assisting an individual with a gender tran- 15 sition; and 16 (B) does not include— 17 (i) services to those born with a medi- 18 cally-verifiable disorder of sex development, 19 including a person with external biological 20 sex characteristics that are irresolvably 21 ambiguous, such as those born with 46 XX 22 chromosomes with virilization, 46 XY chro- 23 mosomes with undervirilization, or having 24 both ovarian and testicular tissue; 25 VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 1112 IH (ii) services provided when a physician 1 has otherwise diagnosed a disorder of sex- 2 ual development, in which the physician 3 has determined through genetic or bio- 4 chemical testing that the person does not 5 have normal sex chromosome structure, sex 6 steroid hormone production, or sex steroid 7 hormone action for a biological male or bi- 8 ological female; or 9 (iii) the treatment of any infection, in- 10 jury, disease, or disorder that has been 11 caused by or exacerbated by the perform- 12 ance of gender transition procedures, 13 whether or not the gender transition proce- 14 dure was performed in accordance with 15 State and Federal law or whether or not 16 funding for the gender transition proce- 17 dure is permissible. 18 (6) GENDER TRANSITION SURGERY.—The term 19 ‘‘gender transition surgery’’ means any medical or 20 surgical service that seeks to surgically alter or re- 21 move healthy physical or anatomical characteristics 22 or features that are typical for the individual’s bio- 23 logical sex in order to instill or create physiological 24 or anatomical characteristics that resemble a sex dif- 25 VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 1112 IH ferent from the individual’s birth sex, including gen- 1 ital or non-genital gender reassignment surgery per- 2 formed for the purpose of assisting an individual 3 with a gender transition. 4 (7) GENITAL GENDER TRANSITION SURGERY.— 5 The term ‘‘genital gender transition surgery’’ in- 6 cludes surgical procedures such as penectomy, 7 orchiectomy, vaginoplasty, clitoroplasty, or 8 vulvoplasty for biologically male patients or 9 hysterectomy, ovariectomy, reconstruction of the 10 fixed part of the urethra with or without a 11 metoidioplasty or a phalloplasty, vaginectomy, 12 scrotoplasty, or implantation of erection or testicular 13 prostheses for biologically female patients, when per- 14 formed for the purpose of assisting an individual 15 with a gender transition. 16 (8) NON-GENITAL GENDER TRANSITION SUR- 17 GERY.—The term ‘‘non-genital gender transition 18 surgery’’— 19 (A) includes, when performed for the pur- 20 pose of assisting an individual with a gender 21 transition— 22 (i) surgical procedures such as aug- 23 mentation mammoplasty, facial feminiza- 24 tion surgery, liposuction, lipofilling, voice 25 VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 1112 IH surgery, thyroid cartilage reduction, gluteal 1 augmentation (implants or lipofilling), hair 2 reconstruction, or various aesthetic proce- 3 dures for biologically male patients; or 4 (ii) subcutaneous mastectomy, voice 5 surgery, liposuction, lipofilling, pectoral 6 implants or various aesthetic procedures 7 for biologically female patients; and 8 (B) does not include any procedure under- 9 taken because the individual suffers from a 10 physical disorder, physical injury, or physical 11 illness that would, as certified by a physician, 12 place the individual in imminent danger of 13 death or impairment of major bodily function 14 unless surgery is performed, unless the proce- 15 dure is for the purpose of a gender transition. 16 (9) PUBERTY-BLOCKING DRUGS.—The term 17 ‘‘puberty-blocking drugs’’ means, when used to delay 18 or suppress pubertal development in children for the 19 purpose of assisting an individual with a gender 20 transition— 21 (A) Gonadotropin-releasing hormone 22 (GnRH) analogues or other synthetic drugs 23 used in biological males to stop luteinizing hor- 24 VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 1112 IH mone secretion and therefore testosterone secre- 1 tion; and 2 (B) synthetic drugs used in biological fe- 3 males that stop the production of estrogen and 4 progesterone. 5 (10) SEX; BIRTH SEX; BIOLOGICAL SEX.—The 6 terms ‘‘sex’’, ‘‘birth sex,’’ and ‘‘biological sex’’ refer 7 to the biological indication of male and female in the 8 context of reproductive potential or capacity, such as 9 sex chromosomes, naturally occurring sex hormones, 10 gonads, and non-ambiguous internal and external 11 genitalia present at birth, without regard to an indi- 12 vidual’s psychological, chosen, or subjective experi- 13 ence of gender. 14 Æ VerDate Sep 11 2014 01:40 Mar 10, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\H1112.IH H1112 kjohnson on DSK79L0C42PROD with BILLS