What This Bill Does
This bill allows people to sue medical doctors if those doctors perform gender-transition procedures on minors (people under 18 years old). The bill defines gender-transition procedures as prescribing puberty-blocking drugs, cross-sex hormones, or performing surgery to change a person's body to match their gender identity when that identity differs from their biological sex. The bill also says no federal law can require doctors to perform these procedures.
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Who It Affects
- Children and young adults under 18 who receive gender-transition procedures
- Medical practitioners (licensed doctors and health care providers)
- Parents or legal guardians of minors
- States that receive federal funding from the Department of Health and Human Services
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Key Provisions
- A medical practitioner who performs a gender-transition procedure on someone under 18 can be sued by that person if they are injured physically, psychologically, emotionally, or physiologically (Sec. 2(a))
- Someone who received a gender-transition procedure as a minor can sue a doctor up to 30 years after turning 18 years old and request money damages, punitive damages (extra money as punishment), court orders, and attorney fees (Sec. 2(b))
- Lawsuits can happen if the procedure involved travel across state lines, used communication across state lines, used payment across state lines, or used medical instruments that traveled across state lines (Sec. 2(c))
- No federal law can require a medical practitioner to perform a gender-transition procedure (Sec. 3)
- States that require doctors to perform gender-transition procedures lose eligibility for federal funding from the Department of Health and Human Services (Sec. 4)
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What Changes
If this bill becomes law, doctors who perform gender-transition procedures on minors can be taken to court and ordered to pay money to injured patients. The bill creates a new reason to sue that did not exist before. States cannot require doctors to perform these procedures. Federal law cannot require doctors to perform these procedures.
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Important Definitions
- **Biological sex**: The genetic classification of a person as male or female based on sex chromosomes, naturally occurring hormones, and reproductive anatomy present at birth, without considering a person's personal sense of identity
- **Gender-transition procedure**: Prescribing or administering puberty-blocking drugs, cross-sex hormones, or performing surgery to change someone's body to match their gender identity when that identity differs from their biological sex. This does NOT include procedures for people born with ambiguous biological sex characteristics, treatment of infections or injuries caused by these procedures, or emergency procedures to prevent death or serious harm.
- **Medical practitioner**: A person licensed, certified, or authorized by state law to provide health care as part of their profession
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Effective Date
This Act shall take effect on the date of enactment (the date the President signs it into law).
II
118TH CONGRESS
1ST SESSION
S. 635
To protect children from medical malpractice in the form of gender transition
procedures.
IN THE SENATE OF THE UNITED STATES
MARCH 2, 2023
Mr. COTTON (for himself, Mr. BRAUN, Mr. CRUZ, Mr. DAINES, Mr.
LANKFORD, Mr. MULLIN, Mr. RUBIO, and Mr. VANCE) introduced the
following bill; which was read twice and referred to the Committee on the
Judiciary
A BILL
To protect children from medical malpractice in the form
of gender transition procedures.
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 ‘‘Protecting Minors
4
from Medical Malpractice Act of 2023’’.
5
SEC. 2. PRIVATE RIGHT OF ACTION FOR A GENDER-TRANSI-
6
TION PROCEDURE PERFORMED ON A MINOR.
7
(a) IN GENERAL.—A medical practitioner, in any cir-
8
cumstance described in subsection (c), who performs a
9
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gender-transition procedure on an individual who is less
1
than 18 years of age shall, as described in subsection (b),
2
be liable to the individual if injured (including any phys-
3
ical, psychological, emotional, or physiological harms) by
4
such procedure, related treatment, or the aftereffects of
5
the procedure or treatment.
6
(b) PRIVATE RIGHT OF ACTION.—An individual cov-
7
ered by subsection (a) who receives a gender-transition
8
procedure from a medical practitioner (or a representative,
9
including a legal guardian, on behalf of such individual)
10
may, not later than the day that is 30 years after the date
11
on which the individual turns 18 years of age, bring a civil
12
action against such medical practitioner in a court of com-
13
petent jurisdiction for—
14
(1) declaratory or injunctive relief;
15
(2) compensatory damages;
16
(3) punitive damages; and
17
(4) attorney’s fees and costs.
18
(c) CIRCUMSTANCES.—For the purposes of sub-
19
section (a), the circumstances described in this subsection
20
are that—
21
(1) the medical practitioner or the individual re-
22
ceiving the gender-transition procedure traveled in
23
interstate or foreign commerce, or traveled using a
24
means, channel, facility, or instrumentality of inter-
25
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state or foreign commerce, in furtherance of or in
1
connection with the conduct described in subsection
2
(a);
3
(2) the medical practitioner used a means,
4
channel, facility, or instrumentality of interstate or
5
foreign commerce in furtherance of or in connection
6
with the conduct described in subsection (a);
7
(3) any payment of any kind was made, directly
8
or indirectly, in furtherance of or in connection with
9
the conduct described in subsection (a) using any
10
means, channel, facility, or instrumentality of inter-
11
state or foreign commerce or in or affecting inter-
12
state or foreign commerce;
13
(4) the medical practitioner transmitted in
14
interstate or foreign commerce any communication
15
relating to or in furtherance of the conduct de-
16
scribed in subsection (a) using any means, channel,
17
facility, or instrumentality of interstate or foreign
18
commerce or in or affecting interstate or foreign
19
commerce by any means or in any manner, including
20
by computer, mail, wire, or electromagnetic trans-
21
mission;
22
(5) any instrument, item, substance, or other
23
object that has traveled in interstate or foreign com-
24
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merce was used to perform the conduct described in
1
subsection (a);
2
(6) the conduct described in subsection (a) oc-
3
curred within the special maritime and territorial ju-
4
risdiction of the United States, or any territory or
5
possession of the United States; or
6
(7) the conduct described in subsection (a) oth-
7
erwise occurred in or affected interstate or foreign
8
commerce.
9
SEC. 3. PRESERVING FREEDOM OF CONSCIENCE AND MED-
10
ICAL JUDGEMENT FOR MEDICAL PROVIDERS.
11
Notwithstanding any other provision of law, no provi-
12
sion of Federal law shall require, or be construed to re-
13
quire, a medical practitioner to perform a gender-transi-
14
tion procedure.
15
SEC. 4. PROHIBITION ON FUNDING FOR CERTAIN STATES.
16
Notwithstanding any other provision of law, any
17
State that requires medical practitioners to perform any
18
gender-transition procedure on an individual in the State
19
shall be ineligible to receive any Federal funding from the
20
Department of Health and Human Services.
21
SEC. 5. DEFINITIONS.
22
In this Act:
23
(1) BIOLOGICAL
SEX.—The term ‘‘biological
24
sex’’ means the genetic classification of an individual
25
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•S 635 IS
as male or female, as reflected in the organization
1
of the body of such individual for a reproductive role
2
or capacity, such as through sex chromosomes, natu-
3
rally occurring sex hormones, and internal and ex-
4
ternal genitalia present at birth, without regard to
5
the subjective sense of identity of the individual.
6
(2) GENDER-TRANSITION PROCEDURE.—
7
(A) IN GENERAL.—Except as provided in
8
subparagraph (B), the term ‘‘gender-transition
9
procedure’’ means—
10
(i) the prescription or administration
11
of puberty-blocking drugs for the purpose
12
of changing the body of an individual so
13
that it conforms to the subjective sense of
14
identity of the individual, in the case such
15
identity is at odds with the individual’s bi-
16
ological sex;
17
(ii) the prescription or administration
18
of cross-sex hormones for the purpose of
19
changing the body of an individual so that
20
it conforms to the subjective sense of iden-
21
tity of the individual, in the case such
22
identity is at odds with the individual’s bi-
23
ological sex; or
24
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•S 635 IS
(iii) a surgery to change the body of
1
an individual so that it conforms to the
2
subjective sense of identity of the indi-
3
vidual, in the case such identity is at odds
4
with the individual’s biological sex.
5
(B) EXCEPTION.—The term ‘‘gender-tran-
6
sition procedure’’ does not include—
7
(i) an intervention described in sub-
8
paragraph (A) that is performed on—
9
(I) an individual with biological
10
sex characteristics that are inherently
11
ambiguous, such as those born with
12
46 XX chromosomes with virilization,
13
46
XY
chromosomes
with
14
undervirilization, or having both ovar-
15
ian and testicular tissue; or
16
(II) an individual with respect to
17
whom a physician has determined
18
through genetic or biochemical testing
19
that the individual does not have nor-
20
mal sex chromosome structure, sex
21
steroid hormone production, or sex
22
steroid hormone action, for a biologi-
23
cal male or biological female;
24
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•S 635 IS
(ii) the treatment of any infection, in-
1
jury, disease, or disorder that has been
2
caused or exacerbated by the performance
3
of an intervention described in subpara-
4
graph (A) without regard to whether the
5
intervention was performed in accordance
6
with State or Federal law or whether the
7
intervention is covered by the private right
8
of action under section 2; or
9
(iii) any procedure undertaken be-
10
cause the individual suffers from a physical
11
disorder, physical injury, or physical illness
12
that would, as certified by a physician,
13
place the individual in imminent danger of
14
death or impairment of major bodily func-
15
tion unless the procedure is performed.
16
(3) MEDICAL PRACTITIONER.—The term ‘‘med-
17
ical practitioner’’ means a person who is licensed,
18
certified, or otherwise authorized by the laws of a
19
State to administer health care in the ordinary
20
course of the practice of the person’s profession.
21
SEC. 6. EFFECTIVE DATE.
22
This Act shall take effect on the date of enactment
23
of this Act.
24
Æ
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