The bill forbids federal funding and coverage for gender-related medical treatments for minors and clarifies enforcement (reducing some federal spending), but in doing so creates federal criminal exposure for providers in interstate contexts and substantially reduces access, increases costs and administrative burdens, and raises legal and privacy risks for families and clinicians.
Taxpayers and federal programs: federal funds and trust funds (including some federal benefit plans) would not be used to pay for gender-related medical treatments for persons under 18, reducing federal spending on these services and clarifying that federal programs are not required to cover them.
Minors and clinicians: the bill explicitly states that minors who seek or receive gender-related medical treatment (and medically necessary treatment for disorders of sex development) are not criminally liable, preserving that patients/children will not themselves face federal criminal penalties for receiving care.
Federal programs and Medicare administration: the bill clarifies coverage expectations for federal health benefit plans and Medicare (including denying payment/enrollment for certain services), which supporters view as enforcing a uniform federal policy on coverage of gender-related treatments for minors.
Healthcare providers nationwide: providers who perform gender-related treatments for minors could face federal criminal penalties (including up to 10 years' imprisonment when interstate elements apply), creating severe legal risk and likely deterring providers from offering these services.
Minors who need gender-related care: children and adolescents who rely on federal programs (Medicaid, Medicare, federal employee plans, or other federally funded programs) may lose access to medically recommended gender-related treatments, harming health and wellbeing.
Providers and families nationwide: broad federal prohibitions and interstate criminal exposure (for travel, prescriptions, or communications) will create legal uncertainty and a chilling effect that reduces the number of clinicians willing to provide gender-related care to minors, shrinking access even in states where such care is legal.
Based on analysis of 4 sections of legislative text.
Makes it a federal crime to provide gender-related medical treatment to minors, bans federal funding and Medicare coverage/participation for such treatment, with narrow medical exceptions.
Introduced September 26, 2025 by Nancy Mace · Last progress September 26, 2025
Makes it a federal crime to knowingly perform or try to perform gender-related medical treatment on anyone under 18 when the conduct involves interstate commerce or other federal jurisdiction. It defines covered procedures and drugs, creates narrow medical exceptions, prohibits use of federal funds for such care, and removes Medicare coverage and Medicare enrollment privileges for providers who furnish these treatments to minors. The bill applies a criminal penalty (up to 10 years and/or fines), stops federal payment or coverage for the treatments, and requires termination or denial of Medicare participation for providers who give them, with the Medicare actions taking effect 90 days after enactment.