No official summary available for this bill.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 977 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 977
To prohibit taxpayer-funded gender transition procedures, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 12, 2025
Mr. Marshall (for himself, Mrs. Hyde-Smith, Mr. Cramer, Mr. Hawley, Mr.
Budd, Mr. Graham, Mr. Sheehy, Mrs. Blackburn, Mr. Banks, Mr. Wicker,
Mr. Lee, Ms. Lummis, and Mr. Risch) introduced the following bill;
which was read twice and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To prohibit taxpayer-funded gender transition procedures, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``End Taxpayer
Funding of Gender Experimentation Act of 2025''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--PROHIBITING FEDERALLY FUNDED GENDER TRANSITION PROCEDURES
Sec. 101. Prohibiting taxpayer-funded gender transition procedures.
Sec. 102. Amendment to table of chapters.
TITLE II--APPLICATION UNDER THE AFFORDABLE CARE ACT
Sec. 201. Clarifying application of prohibition to premium credits and
cost-sharing reductions under ACA.
TITLE I--PROHIBITING FEDERALLY FUNDED GENDER TRANSITION PROCEDURES
SEC. 101. PROHIBITING TAXPAYER-FUNDED GENDER TRANSITION PROCEDURES.
Title 1, United States Code, is amended by adding at the end the
following new chapter:
``CHAPTER 4--PROHIBITING TAXPAYER-FUNDED GENDER TRANSITION PROCEDURES
``Sec.
``301. Prohibition on funding for gender transition procedures.
``302. Prohibition on funding for health benefits plans that cover
gender transition procedures.
``303. Limitation on Federal facilities and employees.
``304. Construction relating to separate coverage.
``305. Construction relating to the use of non-Federal funds for health
coverage.
``306. Construction relating to complications arising from gender
transition procedures.
``307. Definitions.
``Sec. 301. Prohibition on funding for gender transition procedures
``No funds authorized or appropriated by Federal law, and none of
the funds in any trust fund to which funds are authorized or
appropriated by Federal law, shall be expended for any gender
transition procedures.
``Sec. 302. Prohibition on funding for health benefits plans that cover
gender transition procedures
``No funds authorized or appropriated by Federal law, and none of
the funds in any trust fund to which funds are authorized or
appropriated by Federal law, shall be expended for health benefits
coverage that includes coverage of gender transition procedures.
``Sec. 303. Limitation on Federal facilities and employees
``No health care service furnished--
``(1) by or in a health care facility owned or operated by
the Federal Government; or
``(2) by any physician or other individual employed by the
Federal Government to provide health care services within the
scope of the physician's or individual's employment,
may include gender transition procedures.
``Sec. 304. Construction relating to separate coverage
``Nothing in this chapter shall be construed as prohibiting any
individual, entity, or State or locality from purchasing separate
coverage for gender transition procedures or health benefits coverage
that includes gender transition procedures so long as such coverage is
paid for entirely using only funds not authorized or appropriated by
Federal law and such coverage shall not be purchased using matching
funds required for a federally subsidized program, including a State's
or locality's contribution of Medicaid matching funds.
``Sec. 305. Construction relating to the use of non-Federal funds for
health coverage
``Nothing in this chapter shall be construed as restricting the
ability of any non-Federal health benefits coverage provider from
offering coverage for gender transition procedures, or the ability of a
State or locality to contract separately with such a provider for such
coverage, so long as only funds not authorized or appropriated by
Federal law are used and such coverage shall not be purchased using
matching funds required for a federally subsidized program, including a
State's or locality's contribution of Medicaid matching funds.
``Sec. 306. Construction relating to complications arising from gender
transition procedures
``Nothing in this chapter shall be construed to apply to the
treatment of any infection, injury, disease, or disorder that has been
caused by or exacerbated by the performance of a gender transition
procedure.
``Sec. 307. Definitions
``For purposes of this chapter:
``(1) Female.--The term `female', when used to refer to a
natural person, means an individual who naturally has, had,
will have, or would have, but for a congenital anomaly,
historical accident, or intentional or unintentional
disruption, the reproductive system that at some point
produces, transports, and utilizes eggs for fertilization.
``(2) Gender transition.--The term `gender transition'
means the process in which an individual goes from identifying
with or presenting as his or her sex to identifying with or
presenting a self-proclaimed identity that does not correspond
with or is different from his or her sex, and may be
accompanied with social, legal, or physical changes.
``(3) Gender transition procedure.--
``(A) In general.--The term `gender transition
procedure' means any hormonal or surgical intervention
for the purpose of gender transition, including--
``(i) gonadotropin-releasing hormone (GnRH)
agonists or other puberty-blocking or
suppressing drugs to stop or delay normal
puberty;
``(ii) testosterone, estrogen,
progesterone, or other androgens to an
individual at doses that are supraphysiologic
to what would normally be produced endogenously
in a healthy individual of the same age and
sex;
``(iii) castration;
``(iv) orchiectomy;
``(v) scrotoplasty;
``(vi) implantation of erection or
testicular prostheses;
``(vii) vasectomy;
``(viii) hysterectomy;
``(ix) oophorectomy;
``(x) ovariectomy;
``(xi) reconstruction of the fixed part of
the urethra with or without a metoidioplasty or
a phalloplasty;
``(xii) metoidioplasty;
``(xiii) penectomy;
``(xiv) phalloplasty;
``(xv) vaginoplasty;
``(xvi) clitoroplasty
``(xvii) vaginectomy;
``(xviii) vulvoplasty;
``(xix) reduction thyrochondroplasty;
``(xx) chondrolaryngoplasty;
``(xxi) mastectomy;
``(xxii) tubal ligation;
``(xxiii) sterilization;
``(xxiv) any plastic, cosmetic, or
aesthetic surgery that feminizes or
masculinizes the facial or other physiological
features of an individual;
``(xxv) any placement of chest implants to
create feminine breasts;
``(xxvi) any placement of fat or artificial
implants in the gluteal region;
``(xxvii) augmentation mammoplasty;
``(xxviii) liposuction;
``(xxix) lipofilling;
``(xxx) voice surgery;
``(xxxi) hair reconstruction;
``(xxxii) pectoral implants; and
``(xxxiii) the removal of any otherwise
healthy or non-diseased body part or tissue.
``(B) Exclusions.--The term `gender transition
procedure' does not include the following when
furnished to an individual by a health care provider
with the consent of such individual or, if applicable,
such individual's parents or legal guardian:
``(i) Services to individuals born with a
medically verifiable disorder of sex
development, including an individual with
external sex characteristics that are
irresolvably ambiguous, such as an individual
born with 46 XX chromosomes with virilization,
an individual born with 46 XY chromosomes with
undervirilization, or an individual born having
both ovarian and testicular tissue.
``(ii) Services provided when a physician
has otherwise diagnosed a disorder of sexual
development in which the physician has
determined through genetic or biochemical
testing that the individual does not have
normal sex chromosome structure, sex steroid
hormone production, or sex steroid hormone
action for a healthy individual of the same sex
and age.
``(iii) The treatment of any infection,
injury, disease, or disorder that has been
caused by or exacerbated by the performance of
gender transition procedures, whether or not
the gender transition procedure was performed
in accordance with State and Federal law or
whether or not funding for the gender
transition procedure is permissible under this
section.
``(iv) Any procedure undertaken because the
individual suffers from a physical disorder,
physical injury, or physical illness (but not
mental, behavioral, or emotional distress or a
mental, behavioral, or emotional disorder) that
would, as certified by a physician, place the
individual in imminent danger of death or
impairment of major bodily function, unless the
procedure is performed.
``(v) Puberty suppression or blocking
prescription drugs for the purpose of
normalizing puberty for a minor experiencing
precocious puberty.
``(vi) Male circumcision.
``(4) Male.--The term `male', when used to refer to a
natural person, means an individual who naturally has, had,
will have, or would have, but for a congenital anomaly,
historical accident, or intentional or unintentional
disruption, the reproductive system that at some point
produces, transports, and utilizes sperm for fertilization.
``(5) Sex.--The term `sex', when referring to an
individual's sex, means to refer to either male or female, as
biologically determined.''.
SEC. 102. AMENDMENT TO TABLE OF CHAPTERS.
The table of chapters for title 1, United States Code, is amended
by adding at the end the following new item:
``4. Prohibiting taxpayer-funded gender transition 301''.
procedures.
TITLE II--APPLICATION UNDER THE AFFORDABLE CARE ACT
SEC. 201. CLARIFYING APPLICATION OF PROHIBITION TO PREMIUM CREDITS AND
COST-SHARING REDUCTIONS UNDER ACA.
(a) In General.--
(1) Disallowance of refundable credit and cost-sharing
reductions for coverage under qualified health plan which
provides coverage for gender procedures.--
(A) In general.--Subparagraph (A) of section
36B(c)(3) of the Internal Revenue Code of 1986 is
amended by inserting before the period at the end the
following: ``or any health plan that includes coverage
for gender transition procedures, as defined in section
307 of title 1, United States Code (other than any
procedure described in section 306 of such title)''.
(B) Option to purchase or offer separate coverage
or plan.--Paragraph (3) of section 36B(c) of such Code
is amended by adding at the end the following new
subparagraph:
``(C) Separate coverage or plan for gender
transition procedures allowed.--
``(i) Option to purchase separate coverage
or plan.--Nothing in subparagraph (A) shall be
construed as prohibiting any individual from
purchasing separate coverage for gender
transition procedures described in such
subparagraph, or a health plan that includes
such gender transition procedures, so long as
no credit is allowed under this section with
respect to the premiums for such coverage or
plan.
``(ii) Option to offer coverage or plan.--
Nothing in subparagraph (A) shall restrict any
non-Federal health insurance issuer offering a
health plan from offering separate coverage for
gender transition procedures described in such
subparagraph, or a plan that includes such
gender transition procedures, so long as
premiums for such separate coverage or plan are
not paid for with any amount attributable to
the credit allowed under this section (or the
amount of any advance payment of the credit
under section 1412 of the Patient Protection
and Affordable Care Act).''.
(2) Disallowance of small employer health insurance expense
credit for plan which includes coverage for gender transition
procedures.--Subsection (h) of section 45R of the Internal
Revenue Code of 1986 is amended--
(A) by striking ``Any term'' and inserting the
following:
``(1) In general.--Any term''; and
(B) by adding at the end the following new
paragraph:
``(2) Exclusion of health plans including coverage for
gender transition procedures.--
``(A) In general.--In this section, the term
`qualified health plan' does not include any health
plan that includes coverage for gender transition
procedures, as defined in section 307 of title 1,
United States Code (other than any procedure described
in section 306 of such title).
``(B) Separate coverage or plan for gender
transition procedures allowed.--
``(i) Option to purchase separate coverage
or plan.--Nothing in subparagraph (A) shall be
construed as prohibiting any employer from
purchasing for its employees separate coverage
for gender transition procedures described in
such subparagraph, or a health plan that
includes such gender transition procedures, so
long as no credit is allowed under this section
with respect to the employer contributions for
such coverage or plan.
``(ii) Option to offer coverage or plan.--
Nothing in subparagraph (A) shall restrict any
non-Federal health insurance issuer offering a
health plan from offering separate coverage for
gender transition procedures described in such
subparagraph, or a plan that includes such
gender transition procedures, so long as such
separate coverage or plan is not paid for with
any employer contribution eligible for the
credit allowed under this section.''.
(b) Application to Multi-State Plans.--Section 1334(a) of Public
Law 111-148 (42 U.S.C. 18054(a)) is amended by adding at the end the
following new paragraph:
``(8) Coverage consistent with federal policy regarding
gender transition procedures.--In entering into contracts under
this subsection, the Director shall ensure that no multi-State
qualified health plan offered in an Exchange provides health
benefits coverage for which the expenditure of Federal funds is
prohibited under chapter 4 of title 1, United States Code.''.
(c) Effective Date.--The amendments made by subsection (a) shall
apply to taxable years ending after the date that is 1 year after the
date of enactment of this Act, but only with respect to plan years
beginning after such date, and the amendment made by subsection (b)
shall apply to plan years beginning after such date.
<all>
Introduced in Senate
Read twice and referred to the Committee on Finance.
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