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Creates a new federal crime for knowingly performing or attempting to perform certain gender-related medical treatments on anyone under 18, with penalties up to 10 years in prison and fines when interstate or other federal jurisdictional triggers apply. It also bars federal payment for such care, removes Medicare coverage and enrollment privileges for providers who furnish it to minors (subject to narrow medical exceptions), and prohibits use of federal funds to pay for these services for minors. The measure defines "gender-related medical treatment" to include specific surgeries, puberty blockers, and cross-sex hormones, exempts treatment for diagnosed disorders of sex development or medically necessary treatment for complications, and specifies that minors who seek or receive care are not criminally liable. Medicare coverage and provider participation changes, and the federal funding prohibition, take effect 90 days after enactment; the criminal provision is effective on enactment.
The bill trades reduced federal spending and a federal deterrent against providing gender‑related medical treatments to minors for significant restrictions on access to care, criminal risk for providers, increased costs and administrative burdens for families and health systems, and legal and privacy uncertainties.
Taxpayers and federal programs: The bill bars Medicare and other federal funds from paying for gender‑related medical treatments for minors and authorizes removing providers from Medicare enrollment, reducing federal spending on those services.
Minors: The bill makes provision of gender‑related medical treatments to persons under 18 a federal offense under specified interstate triggers, reducing availability of those treatments to minors under federal jurisdiction.
Providers and the public: The bill establishes criminal penalties (fines and up to 10 years imprisonment) for covered providers, creating a federal deterrent against furnishing the defined treatments to minors.
Minors seeking gender‑affirming care and their families: The bill will significantly reduce access to medically supervised gender‑related treatments for minors (via criminalization and funding bans), likely increasing unmet medical need and out‑of‑pocket costs and causing some families to travel or forgo care.
Healthcare providers: Criminalization exposes clinicians who provide defined gender‑related treatments to prosecution, deterring providers from offering care and risking professional and criminal consequences.
Clinics, hospitals and continuity of services: Tying Medicare and other federal reimbursement to the statute and permitting termination of provider enrollment may cut off payment to clinics that serve minors, disrupting services and reducing provider availability.
Introduced September 26, 2025 by Nancy Mace · Last progress September 26, 2025