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<dc:title>119 HR 2487 IH: Transgender Health Care Access Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2025-03-31</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">I</distribution-code><congress display="yes">119th CONGRESS</congress><session display="yes">1st Session</session><legis-num display="yes">H. R. 2487</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action display="yes"><action-date date="20250331">March 31, 2025</action-date><action-desc><sponsor name-id="B001318">Ms. Balint</sponsor> (for herself, <cosponsor name-id="A000381">Ms. Ansari</cosponsor>, <cosponsor name-id="C001130">Ms. Crockett</cosponsor>, <cosponsor name-id="D000096">Mr. Davis of Illinois</cosponsor>, <cosponsor name-id="E000297">Mr. Espaillat</cosponsor>, <cosponsor name-id="E000296">Mr. Evans of Pennsylvania</cosponsor>, <cosponsor name-id="J000305">Ms. Jacobs</cosponsor>, <cosponsor name-id="J000298">Ms. Jayapal</cosponsor>, <cosponsor name-id="J000288">Mr. Johnson of Georgia</cosponsor>, <cosponsor name-id="J000310">Ms. Johnson of Texas</cosponsor>, <cosponsor name-id="K000389">Mr. Khanna</cosponsor>, <cosponsor name-id="K000391">Mr. Krishnamoorthi</cosponsor>, <cosponsor name-id="L000601">Mr. Landsman</cosponsor>, <cosponsor name-id="L000602">Ms. Lee of Pennsylvania</cosponsor>, <cosponsor name-id="M001227">Ms. McClellan</cosponsor>, <cosponsor name-id="M001229">Mrs. McIver</cosponsor>, <cosponsor name-id="N000002">Mr. Nadler</cosponsor>, <cosponsor name-id="N000147">Ms. Norton</cosponsor>, <cosponsor name-id="O000172">Ms. Ocasio-Cortez</cosponsor>, <cosponsor name-id="P000607">Mr. Pocan</cosponsor>, <cosponsor name-id="R000617">Mrs. Ramirez</cosponsor>, <cosponsor name-id="R000621">Ms. Randall</cosponsor>, <cosponsor name-id="S001145">Ms. Schakowsky</cosponsor>, <cosponsor name-id="T000472">Mr. Takano</cosponsor>, <cosponsor name-id="T000488">Mr. Thanedar</cosponsor>, <cosponsor name-id="T000481">Ms. Tlaib</cosponsor>, <cosponsor name-id="T000487">Ms. Tokuda</cosponsor>, <cosponsor name-id="T000469">Mr. Tonko</cosponsor>, <cosponsor name-id="V000081">Ms. Velázquez</cosponsor>, and <cosponsor name-id="W000822">Mrs. Watson Coleman</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title display="yes">To improve access to evidence-based, lifesaving health care for transgender people, and for other purposes.</official-title></form><legis-body id="H518D88210DAE4E51A846AF815F4DF4E6" style="OLC"><section id="HC73B82F7451742C580F4D409E41D390F" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be referred to as the <quote><short-title>Transgender Health Care Access Act</short-title></quote>.</text></section><section id="H1F8450FF0B5C4E0284869ACCA24DD88A"><enum>2.</enum><header>Table of contents</header><text display-inline="no-display-inline">The table of contents of this Act is as follows:</text><toc container-level="legis-body-container" quoted-block="no-quoted-block" lowest-level="section" regeneration="yes-regeneration" lowest-bolded-level="division-lowest-bolded"><toc-entry idref="HC73B82F7451742C580F4D409E41D390F" level="section">Sec. 1. Short title.</toc-entry><toc-entry idref="H1F8450FF0B5C4E0284869ACCA24DD88A" level="section">Sec. 2. Table of contents.</toc-entry><toc-entry idref="H2C3C3574F87A40E2ACF23A4F55376EBB" level="section">Sec. 3. Findings.</toc-entry><toc-entry idref="H51473136BA3D4E4C8FE07E070B3B592D" level="section">Sec. 4. Definitions.</toc-entry><toc-entry idref="H0B3331CE36774E0BB36101AA4370FA2B" level="section">Sec. 5. Improving medical education curricula for gender-affirming care.</toc-entry><toc-entry idref="HEF4E3A1F229742AC94DA646603AEC75B" level="section">Sec. 6. Training demonstration program for gender-affirming care.</toc-entry><toc-entry idref="HB481CBA9D86E4763BB05315A6379800E" level="section">Sec. 7. Expanding capacity for gender-affirming care at community health centers.</toc-entry><toc-entry idref="HC42102FE33A94F089B714782107A9DF7" level="section">Sec. 8. Training rural providers in gender-affirming care.</toc-entry><toc-entry idref="H974B7249ED744F8AADAC042A156EE6E2" level="section">Sec. 9. Report to Congress.</toc-entry></toc></section><section id="H2C3C3574F87A40E2ACF23A4F55376EBB"><enum>3.</enum><header>Findings</header><text display-inline="no-display-inline">Congress finds the following:</text><paragraph id="H63CB121BB0D7475D990A8B207284CA1A"><enum>(1)</enum><text display-inline="yes-display-inline">Receiving gender-affirming care increases self-esteem and quality of life and decreases depression, self-harm, and suicidality in transgender people of all ages.</text></paragraph><paragraph id="H1A2DFC5912604ACF9B1740221711CF8A"><enum>(2)</enum><text>There is a strong medical consensus about the importance of health care for transgender people, including transgender young people. The American Academy of Child and Adolescent Psychiatry, American Academy of Dermatology, American Academy of Pediatrics, American Academy of Physician Assistants, American Medical Association, American Nurses Association, American Association of Clinical Endocrinology, American Association of Geriatric Psychiatry, American College Health Association, American College of Nurse-Midwives, American College of Obstetricians and Gynecologists, American College of Physicians, American Counseling Association, American Heart Association, American Medical Student Association, American Psychiatric Association, American Psychological Association, American Society for Reproductive Medicine, American Urological Association, Endocrine Society, Federation of Pediatric Organizations, GLMA: Health Professionals Advancing LGBTQ Equality, The Journal of the American Medical Association, National Association of Nurse Practitioners in Women’s Health, National Association of Social Workers, Pediatric Endocrine Society, Pediatrics (Journal of the American Academy of Pediatrics), United States Professional Association for Transgender Health (USPATH), World Health Organization (WHO), World Medical Association, and World Professional Association for Transgender Health, have all issued statements in support of health care for transgender people.</text></paragraph><paragraph id="HD317A627067B4EBDBCAC39E7D7A8FEE7"><enum>(3)</enum><text display-inline="yes-display-inline">There is a gap in education across health professions around treating transgender patients. One survey of students at 10 medical schools showed that approximately 80 percent of students did not feel competent at treating transgender patients.</text></paragraph><paragraph id="H393F4D49C21049988D8FAB006F472099"><enum>(4)</enum><text display-inline="yes-display-inline">Academic literature shows that this education gap is a significant barrier to appropriate health care.</text></paragraph><paragraph id="HCD71CBCD4F5C46DA9DACABDF8D6B456E"><enum>(5)</enum><text display-inline="yes-display-inline">Experts in gender-affirming care and culturally competent care for transgender people are improving access to gender-affirming care through peer-to-peer education.</text></paragraph></section><section id="H51473136BA3D4E4C8FE07E070B3B592D"><enum>4.</enum><header>Definitions</header><text display-inline="no-display-inline">In this Act:</text><paragraph id="H87DC19351D8C4D97A7B4BDF27222EEA1"><enum>(1)</enum><text>The term <term>gender-affirming care</term>—</text><subparagraph id="H2278790208E04F98A283E8C41AB53039" commented="no"><enum>(A)</enum><text>means health care designed to treat gender dysphoria;</text></subparagraph><subparagraph id="HD6A6B0DE12EE44498960B3FFFFDA727D"><enum>(B)</enum><text>includes all supplies, care, and services of a medical, behavioral health, mental health, surgical, psychiatric, therapeutic, diagnostic, preventative, rehabilitative, or supportive nature, including medication, relating to the treatment of gender dysphoria; and</text></subparagraph><subparagraph id="HFB16D76867834DA58430BC36D8CD91D7"><enum>(C)</enum><text>excludes conversion therapy.</text></subparagraph></paragraph><paragraph id="H76EADCF0843047459F65560EA0AE794F"><enum>(2)</enum><text>The term <term>Secretary</term> means the Secretary of Health and Human Services.</text></paragraph></section><section id="H0B3331CE36774E0BB36101AA4370FA2B"><enum>5.</enum><header>Improving medical education curricula for gender-affirming care</header><subsection id="H5B21DA6A3BA346C297CEAF9551834195"><enum>(a)</enum><header>Improving the provision of gender-Affirming care</header><paragraph id="HE97BABB2CF2D41A5A77011484E3345FB"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants to eligible entities for the development, evaluation, and implementation of model curricula, demonstration projects, and training projects to improve the provision of gender-affirming care.</text></paragraph><paragraph id="H30D24D62342E41D1B48A8719AB107C3C"><enum>(2)</enum><header>Eligible entities</header><text display-inline="yes-display-inline">To be eligible to receive a grant under paragraph (1), an entity shall be—</text><subparagraph id="HECEB2C44E9CB4832895A704C47EC9607"><enum>(A)</enum><text>a health care professions school;</text></subparagraph><subparagraph id="H9B2AB5E146EC44CB98B23C6FA06FFEDD"><enum>(B)</enum><text display-inline="yes-display-inline">a health care delivery site with fellows, residents, or other health care professional students or trainees; or</text></subparagraph><subparagraph id="H4FF238BB62834B8E9280539DDB3ED6C3"><enum>(C)</enum><text>a licensing or accreditation entity for health care professions schools.</text></subparagraph></paragraph></subsection><subsection id="H2B6AF988C53E4D229EB38BFAFE3ADE69"><enum>(b)</enum><header>Curricula</header><paragraph id="HF714FC89EBB04C57839F8D5457E50609"><enum>(1)</enum><header>Topics</header><text display-inline="yes-display-inline">The Secretary shall ensure that curricula developed pursuant to subsection (a) include instruction on one or more of the following topics:</text><subparagraph id="HC013239DAAE04FA28C4CE08A6FFFF8F4"><enum>(A)</enum><text display-inline="yes-display-inline">Gender-affirming care.</text></subparagraph><subparagraph id="HC0934E899D434E998212974F3CD4A6F7"><enum>(B)</enum><text display-inline="yes-display-inline">Cultural competency in treating transgender patients.</text></subparagraph></paragraph><paragraph id="H666195BCB077422B947B3F171C9F4DD3"><enum>(2)</enum><header>Pedagogical approaches</header><text>Curricula developed pursuant to subsection (a) may employ—</text><subparagraph id="H0A7B551A15CC494EB4F8C23012273BB2"><enum>(A)</enum><text>didactic education;</text></subparagraph><subparagraph id="H2542B94B35024664AACC8F268502CE01"><enum>(B)</enum><text>clinical education;</text></subparagraph><subparagraph id="H2B6E8EED438144D3B1A499B14714949E"><enum>(C)</enum><text>simulated or standardized patient education;</text></subparagraph><subparagraph id="H768F6A51AF624D2B89E40E19E7C97B62"><enum>(D)</enum><text>community-based research; and</text></subparagraph><subparagraph id="H816DE84B1011446684A9D66D418EB09C"><enum>(E)</enum><text>community-based learning.</text></subparagraph></paragraph></subsection><subsection id="H9A8621008B474DF3A1807EBFD00834FB"><enum>(c)</enum><header>Dissemination</header><text display-inline="yes-display-inline">The Secretary, acting through the Director of the National Library of Medicine and the Director of the National Institutes of Health, in collaboration with medical education accrediting organizations, shall disseminate model curricula developed under this section.</text></subsection><subsection id="H1EF31BBA9B32444DB3E3FE1AE42D21F0"><enum>(d)</enum><header>Duration of award</header><text>The period of a grant under this section shall be 3 years, subject to annual review and continuation by the Secretary.</text></subsection><subsection id="H21192A0DC03F4D3E8DE9DA1699A407E0"><enum>(e)</enum><header>Carryover funds</header><text>The Secretary shall make available funds to grantees under this section on an annual basis, but may authorize a grantee to retain the funds for obligation and expenditure through the end of the 3-year grant period referred to in subsection (f).</text></subsection><subsection id="HE853664F6F67422E83CD0210346AB4F5"><enum>(f)</enum><header>Authorizations of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $10,000,000 for each of fiscal years 2026 through 2030.</text></subsection></section><section id="HEF4E3A1F229742AC94DA646603AEC75B"><enum>6.</enum><header>Training demonstration program for gender-affirming care</header><subsection id="HAB19DA1B6FFC48449050E4F9DAE3DBAE"><enum>(a)</enum><header>In general</header><text>The Secretary shall establish a demonstration program to award grants to eligible entities to support—</text><paragraph id="H7F7DBD6B9341438DA0EA2DC208BD0989"><enum>(1)</enum><text>training for medical residents and fellows to practice gender-affirming care;</text></paragraph><paragraph id="HDB37F761409244D489675EC9A9DA5DDA"><enum>(2)</enum><text display-inline="yes-display-inline">training (including for individuals completing clinical training requirements for licensure) for nurse practitioners, physician assistants, health service psychologists, clinical psychologists, counselors, nurses, and social workers to practice gender-affirming care; and</text></paragraph><paragraph id="H29CAFE7328BB46DABC4186676FD11D17"><enum>(3)</enum><text>establishing, maintaining, or improving academic programs that—</text><subparagraph id="H82E558356D8244E0A66D08118F5D5A01"><enum>(A)</enum><text>provide training for students or faculty, including through clinical experiences, to improve their ability to provide culturally competent gender-affirming care; and</text></subparagraph><subparagraph id="H0613A8D939D2429882E43C5F4DA3E930"><enum>(B)</enum><text>conduct research to develop evidence-based practices regarding gender-affirming care, including curriculum content standards for programs that provide training for students or faculty as described in subparagraph (A).</text></subparagraph></paragraph></subsection><subsection id="H8245CF2BAB764AB4A3665565A5B6AB05"><enum>(b)</enum><header>Eligible entities</header><paragraph id="H5F4411461E9649B09F4BD814C8AC3154"><enum>(1)</enum><header>Training for residents and fellows</header><text>To be eligible to receive a grant under subsection (a)(1), an entity shall be—</text><subparagraph id="HF82B60B4F05D4C3E8FA5E5E34A95ABF1"><enum>(A)</enum><text>a consortium consisting of—</text><clause id="H4B2E331C73E94DE9A74A7166FCEB9AD1"><enum>(i)</enum><text>at least one teaching health center; and</text></clause><clause id="HB51CAFDA692A4AE08EE6CB7369DE3FC9"><enum>(ii)</enum><text>the sponsoring institution (or parent institution of the sponsoring institution) of—</text><subclause id="H321CB727C26B44ADA8D969C7A4347C0E"><enum>(I)</enum><text>a residency program in primary care, internal medicine, family medicine, pediatric medicine, gynecology, endocrinology, or surgery that is accredited by the Accreditation Council for Graduate Medical Education; or</text></subclause><subclause id="H0BDDA697A8744AFD809047838F93B74F"><enum>(II)</enum><text>a fellowship program in a field identified in subclause (I); or</text></subclause></clause></subparagraph><subparagraph id="HFB2CBF5A84D1422595A67C06E5131234"><enum>(B)</enum><text display-inline="yes-display-inline">an institution described in subparagraph (A)(ii) that provides opportunities for residents or fellows to train in community-based settings that provide health care to transgender populations.</text></subparagraph></paragraph><paragraph id="H6E450C8DECE740438B2617F4871E2B87"><enum>(2)</enum><header>Training for other providers</header><text>To be eligible to receive a grant under subsection (a)(2), an entity shall be—</text><subparagraph id="H5EA56CC5D090401D88E6C4C8515C9D17"><enum>(A)</enum><text display-inline="yes-display-inline">a teaching health center (as defined in section 749A(f)(3) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/293l-1">42 U.S.C. 293l–1(f)(3)</external-xref>));</text></subparagraph><subparagraph id="H25C2B7396087401293544434A7E0BD07"><enum>(B)</enum><text display-inline="yes-display-inline">a Federally-qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(l)(2)(B)</external-xref>));</text></subparagraph><subparagraph id="HB6FB6E91F5924DFCAB4F65A52D2015F9"><enum>(C)</enum><text display-inline="yes-display-inline">a community mental health center (as defined in section 1861(ff)(3)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(ff)(3)(B)</external-xref>));</text></subparagraph><subparagraph id="H2A7833392679454994FA655C7A3CCA69"><enum>(D)</enum><text display-inline="yes-display-inline">a rural health clinic (as defined in section 1861(aa)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)(2)</external-xref>));</text></subparagraph><subparagraph id="HBE5396FA7A6540A6A7E2F1B2CF7908C5"><enum>(E)</enum><text>a health center operated by the Indian Health Service, an Indian Tribe, a Tribal organization, or an Urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>)); or</text></subparagraph><subparagraph id="HEE07F6D8D1454622A601CDAE04CCE537"><enum>(F)</enum><text>an entity with a demonstrated record of success in providing training for nurse practitioners, physician assistants, health service psychologists, counselors, nurses, or social workers, including such entities that serve pediatric populations.</text></subparagraph></paragraph><paragraph id="HED61EE88DC1245B8A38C3613A1EA585F"><enum>(3)</enum><header>Academic units or programs</header><text>To be eligible to receive a grant under subsection (a)(3), an entity shall be—</text><subparagraph id="H220D590B488D404D9F587AB2FDC8DA15"><enum>(A)</enum><text>a school of medicine or osteopathic medicine;</text></subparagraph><subparagraph id="H73258EEF41584F92BF01CF155D57CEC9"><enum>(B)</enum><text>a school of nursing;</text></subparagraph><subparagraph id="H7EA0651E4B2F4F2AB31FE58BCE107207"><enum>(C)</enum><text>a physician assistant training program;</text></subparagraph><subparagraph id="H7E5B04CCF3704E5E81FA050FC66B865B"><enum>(D)</enum><text>a school of pharmacy;</text></subparagraph><subparagraph id="H216CE3D186854B108FBB589F64D47BCC"><enum>(E)</enum><text>a school of social work;</text></subparagraph><subparagraph id="H6830F4E74BC24AAFA9B2988CFA9E3FBB"><enum>(F)</enum><text>an accredited public or nonprofit private hospital;</text></subparagraph><subparagraph id="HB08EB171458D4B28BE3B34F0F613FA7E"><enum>(G)</enum><text>an accredited medical residency program; or</text></subparagraph><subparagraph id="HF29DDDDAD9D149ADA759556C987EC2CA"><enum>(H)</enum><text>a public or nonprofit private entity that the Secretary determines is capable of carrying out such a grant because of prior experience providing education on the provision of health care to transgender people.</text></subparagraph></paragraph></subsection><subsection id="H56072F6E4F8A4D63A9474EB130C47CDA"><enum>(c)</enum><header>Use of funds</header><paragraph id="HD4892BB5859542F89E3017A6AC58C22F"><enum>(1)</enum><header>Training grants</header><text>A recipient of a grant under subsection (a)(1) or (a)(2)—</text><subparagraph id="HF7AA961586EB4674B9F896248FC3EE6E"><enum>(A)</enum><text>shall use the grant funds to plan, develop, and operate a training program for residents and fellows; and</text></subparagraph><subparagraph id="H6AC87B4E9F834B31AB03841B713D4D97"><enum>(B)</enum><text>may use the grant funds to—</text><clause id="H5CE212BBCE724805B7EC9F015B5FE467"><enum>(i)</enum><text display-inline="yes-display-inline">support the administration of a program described in subparagraph (A);</text></clause><clause id="H241FFB0393964375A35C883F8DB7E76A"><enum>(ii)</enum><text display-inline="yes-display-inline">support professional development for faculty of a program described in subparagraph (A); or</text></clause><clause id="H2713C92AF0A94447AA6E50904794467E"><enum>(iii)</enum><text display-inline="yes-display-inline">establish, maintain, or improve departments, divisions, or other units necessary to implement a program described in subparagraph (A).</text></clause></subparagraph></paragraph><paragraph id="H49D32091610847D3B10BCE655F749756"><enum>(2)</enum><header>Grants to academic units or programs</header><text display-inline="yes-display-inline">A recipient of a grant under subsection (a)(3) shall enter into a partnership with education accrediting organizations or similar organizations to carry out activities under subsection (a)(3).</text></paragraph></subsection><subsection id="H1D7367E2FD98479B8F4A8E9D1B138549"><enum>(d)</enum><header>Priority</header><text>In making awards under this section, the Secretary shall give priority to eligible entities that—</text><paragraph id="H24963B91C3BF4D119D9A2746230E655F"><enum>(1)</enum><text>have a history of providing health care to transgender people; or</text></paragraph><paragraph id="H73C493B27EFD493FAA7212C72CB99712"><enum>(2)</enum><text display-inline="yes-display-inline">serve areas where access to gender-affirming care is limited.</text></paragraph></subsection><subsection id="H6ACBF00224EA47168CFE93BACE883251"><enum>(e)</enum><header>Minimum period of grants</header><text>The period of a grant under this section shall be not less than 5 years.</text></subsection><subsection id="HF7BC18F9AA0248F5BE9DA02D34B216E7"><enum>(f)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2026 through 2030.</text></subsection></section><section id="HB481CBA9D86E4763BB05315A6379800E"><enum>7.</enum><header>Expanding capacity for gender-affirming care at community health centers</header><subsection id="HD486D3FA4B0540CDAE2F62961B2F9617"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall award grants or cooperative agreements to eligible entities to promote the capacity of community health centers to provide gender-affirming care to transgender populations.</text></subsection><subsection id="HD9D9662EF2284EB9B5426C7A8B1142D7"><enum>(b)</enum><header>Eligible entities</header><text display-inline="yes-display-inline">To be eligible to receive a grant under subsection (a), an entity shall be—</text><paragraph id="HD0A0B3DD51834BD981EE50673BC80259"><enum>(1)</enum><text display-inline="yes-display-inline">a teaching health center (as defined in section 749A(f)(3) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/293l-1">42 U.S.C. 293l–1(f)(3)</external-xref>));</text></paragraph><paragraph id="HE5BEEE36593542F2A4404BE3EBBCD80B"><enum>(2)</enum><text display-inline="yes-display-inline">a Federally-qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(l)(2)(B)</external-xref>));</text></paragraph><paragraph id="HDBECF53FA12844E59A779312F98CFCA0"><enum>(3)</enum><text display-inline="yes-display-inline">a community mental health center (as defined in section 1861(ff)(3)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(ff)(3)(B)</external-xref>));</text></paragraph><paragraph id="HD98766F8A91B4D9A95CBC39EAD395906"><enum>(4)</enum><text display-inline="yes-display-inline">a rural health clinic (as defined in section 1861(aa)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(aa)(2)</external-xref>));</text></paragraph><paragraph id="H7904E25297F34F3A942D3A2E07188A15"><enum>(5)</enum><text display-inline="yes-display-inline">a health center operated by the Indian Health Service, an Indian Tribe, a Tribal organization, or an Urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>)); or</text></paragraph><paragraph id="H36783DE2FDE9448C9BC986369622E7D8"><enum>(6)</enum><text>a State or local entity, such as a State office of rural health.</text></paragraph></subsection><subsection id="H2DBF17AB2B2946A390CE614F3FD3F291"><enum>(c)</enum><header>Use of funds</header><text display-inline="yes-display-inline">A grant under subsection (a) shall be used to promote the capacity of community health centers to provide gender-affirming care, which may include—</text><paragraph id="HBACEE705F48A476AAB3B5D595C04C62E"><enum>(1)</enum><text>education and training, including professional development and training on nondiscrimination regulations, for health care professionals and other staff of health care providers;</text></paragraph><paragraph id="H3880A29611B54FA0840EF2AA3AAC9AF0"><enum>(2)</enum><text>establishing or sustaining a community review board;</text></paragraph><paragraph id="H7530117760C14B32A5DC354BF1230B65"><enum>(3)</enum><text>updating electronic health records; and</text></paragraph><paragraph id="HD9ACA23C1EFA416B97BBD361DC9BD336"><enum>(4)</enum><text>administrative, operational, or technical costs related to the effective provision of gender-affirming care.</text></paragraph></subsection><subsection id="H72C57235ADDF43A6ABCB080FE5C8CB43"><enum>(d)</enum><header>Minimum period of grants</header><text display-inline="yes-display-inline">The period of a grant under this section shall be not less than 3 years.</text></subsection><subsection id="H30C3B8CBC65B4DA0B759321A84C5D953"><enum>(e)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $15,000,000 for each of fiscal years 2026 through 2030.</text></subsection></section><section id="HC42102FE33A94F089B714782107A9DF7"><enum>8.</enum><header>Training rural providers in gender-affirming care</header><subsection id="H1A6656607BA64AE3804906EAA8DB5B72"><enum>(a)</enum><header>In general</header><text>The Secretary shall award grants or cooperative agreements to eligible entities to establish collaborative networks to improve the quality of gender-affirming care.</text></subsection><subsection id="H0B6FFA8235264A6D9889920A6E3D5ACC"><enum>(b)</enum><header>Eligible entities</header><text>To be eligible for a grant under subsection (a), an entity shall be—</text><paragraph id="HB7AB356343314DCA93032D3BCF2D9387"><enum>(1)</enum><text>a public or nonprofit private health care provider, such as a critical access hospital or health clinic;</text></paragraph><paragraph id="H6DC47F5323524CF9A98C60E10DF2F91C"><enum>(2)</enum><text display-inline="yes-display-inline">a Federally-qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396d">42 U.S.C. 1396d(l)(2)(B)</external-xref>));</text></paragraph><paragraph id="H6ABD33F2902149BB82CEAA7B81E1C03E"><enum>(3)</enum><text display-inline="yes-display-inline">a health care professions school;</text></paragraph><paragraph id="HA29CCD2CC8BE4416B2DEFF561A67F821"><enum>(4)</enum><text display-inline="yes-display-inline">a health care delivery site that has fellows, residents, or other health care professional students or trainees; and</text></paragraph><paragraph id="HDF720861A0994A00ADD5427077BC12F7"><enum>(5)</enum><text>a licensing or accreditation entity for health care professions schools.</text></paragraph></subsection><subsection id="H93FD849B080D4A5C9495DD2DCBD49D9F" commented="no"><enum>(c)</enum><header>Allowable activities</header><text display-inline="yes-display-inline">In establishing a collaborative network as described in subsection (a), a grantee may, with respect to gender-affirming care, use grant funds—</text><paragraph id="HB0EFCF6990E549DEA9BA3944941E3070" commented="no"><enum>(1)</enum><text>to assist rural health care providers in the network to conduct or pursue additional training;</text></paragraph><paragraph id="H15E599C6B0074760B35CF5FBE0BF4C57" commented="no"><enum>(2)</enum><text>to perform provider-to-provider education and outreach to rural health care providers; and</text></paragraph><paragraph id="H08EEC602651A4E8F88F8DD4C603F594C" commented="no"><enum>(3)</enum><text>to perform patient education.</text></paragraph></subsection><subsection id="H373F37935A844854BBB92C7B5485CA30"><enum>(d)</enum><header>Definition</header><text display-inline="yes-display-inline">In this section, the term <term>rural health care provider</term> means a health care provider serving an area that is not designated by the United States Census Bureau as an urbanized area or urban cluster.</text></subsection><subsection id="H3A68BF0221A94A7C9E6A098B8A553F02"><enum>(e)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">There is authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2026 through 2030.</text></subsection></section><section id="H974B7249ED744F8AADAC042A156EE6E2"><enum>9.</enum><header>Report to Congress</header><subsection id="HEC0D995AEC5B4383BD751A3C94A52C01"><enum>(a)</enum><header>Submission</header><text>Not later than 2 years after the date of enactment of this Act the Secretary shall submit a report to the Congress on the programs and activities under this Act.</text></subsection><subsection id="H9CF3E38F20EF472F9FFF66D942C56A34"><enum>(b)</enum><header>Content</header><text display-inline="yes-display-inline">Reports submitted under subsection (a) shall include—</text><paragraph id="H6DCC9ECD8A864486BA0BF1735A11B7AD"><enum>(1)</enum><text>a description of—</text><subparagraph id="H918CB89142E84A088C9567CCF038F173"><enum>(A)</enum><text>progress made in implementing programs and activities under this Act; and</text></subparagraph><subparagraph id="HE7ED1AE6DA114FF3A1613131FE4EECA8"><enum>(B)</enum><text>the extent to which such programs and activities have improved health equity for transgender populations; and</text></subparagraph></paragraph><paragraph id="HB0F316648C584AE5A272F4DF15A082B4"><enum>(2)</enum><text display-inline="yes-display-inline">recommendations for workforce development to improve access to, and the quality of, gender-affirming care for transgender populations.</text></paragraph></subsection></section></legis-body></bill> 

