[Congressional Record Volume 169, Number 52 (Wednesday, March 22, 2023)]
[Senate]
[Page S912]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 37. Mr. LEE submitted an amendment intended to be proposed by him 
to the bill S. 316, to repeal the authorizations for use of military 
force against Iraq; which was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. __. PROHIBITING MEDICARE PAYMENTS TO AND ENROLLMENT OF 
                   PROVIDERS WHO FURNISH GENDER-TRANSITION 
                   PROCEDURES TO MINORS.

       Section 1862 of the Social Security Act (42 U.S.C. 1395y) 
     is amended by adding at the end the following:
       ``(p) Prohibiting Payments to and Enrollment of Providers 
     Who Furnish Gender-transition Procedures to Minors.--
       ``(1) In general.--Effective on the date of the enactment 
     of this subsection--
       ``(A) no payment may be made under this title with respect 
     to any item or service that is furnished by a provider of 
     services or supplier who furnishes a gender-transition 
     procedure to an individual under the age of 18; and
       ``(B) a provider of services or supplier who furnishes a 
     gender-transition procedure to an individual under the age of 
     18 may not enroll or reenroll in the program under this title 
     under section 1866(j).
       ``(2) Definitions.--In this subsection:
       ``(A) Biological sex.--The term `biological sex' means the 
     genetic classification of an individual as male or female, as 
     reflected in the organization of the body of such individual 
     for a reproductive role or capacity, such as through sex 
     chromosomes, naturally occurring sex hormones, and internal 
     and external genitalia present at birth, without regard to 
     the subjective sense of identity of the individual.
       ``(B) Gender-transition procedure.--
       ``(i) In general.--Except as provided in clause (ii), the 
     term `gender-transition procedure' means--

       ``(I) the prescription or administration of puberty-
     blocking drugs for the purpose of changing the body of an 
     individual so that it conforms to the subjective sense of 
     identity of the individual, in the case such identity is at 
     odds with the individual's biological sex;
       ``(II) the prescription or administration of cross-sex 
     hormones for the purpose of changing the body of an 
     individual so that it conforms to the subjective sense of 
     identity of the individual, in the case such identity is at 
     odds with the individual's biological sex; or
       ``(III) a surgery to change the body of an individual so 
     that it conforms to the subjective sense of identity of the 
     individual, in the case such identity is at odds with the 
     individual's biological sex.

       ``(ii) Exception.--The term `gender-transition procedure' 
     does not include--

       ``(I) an intervention described in clause (i) that is 
     performed on--

       ``(aa) an individual with biological sex characteristics 
     that are inherently ambiguous, such as those born with 46 XX 
     chromosomes with virilization, 46 XY chromosomes with 
     undervirilization, or having both ovarian and testicular 
     tissue; or
       ``(bb) an individual with respect to whom a 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 biological male or biological female;

       ``(II) the treatment of any infection, injury, disease, or 
     disorder that has been caused or exacerbated by the 
     performance of an intervention described in clause (i) 
     without regard to whether the intervention was performed in 
     accordance with State or Federal law; or
       ``(III) any procedure undertaken because the individual 
     suffers from a physical disorder, physical injury, or 
     physical illness 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.''.

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