[Congressional Record Volume 169, Number 123 (Tuesday, July 18, 2023)]
[Senate]
[Pages S3078-S3079]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 902. Mr. RUBIO submitted an amendment intended to be proposed by
him to the bill S. 2226, to authorize appropriations for fiscal year
2024 for military activities of the Department of Defense, for military
construction, and for defense activities of the Department of Energy,
to prescribe military personnel strengths for such fiscal year, and for
other purposes; which was ordered to lie on the table; as follows:
At the end of title V, add the following:
Subtitle J--Ensuring Military Readiness Act of 2023
SEC. 595. SHORT TITLE.
This subtitle may be cited as the ``Ensuring Military
Readiness Act of 2023''.
SEC. 596. LIMITATIONS ON MILITARY SERVICE BY INDIVIDUALS WHO
IDENTIFY AS TRANSGENDER.
Not later than 90 days after the date of the enactment of
this Act, the Secretary of Defense shall prescribe
regulations regarding service of individuals who identify as
transgender as follows:
(1) Persons who identify as transgender with a history of
diagnosis of gender dysphoria are disqualified from military
service except under the following limited circumstances:
(A) Individuals may serve in the Armed Forces if they have
been stable for 36 consecutive months in their biological sex
prior to accession.
(B) Members of the Armed Forces diagnosed with gender
dysphoria after entering into service may be retained if they
do not undergo gender transition procedures and remain
deployable within applicable retention standards for their
biological sex.
(C) Members of the Armed Forces serving as of the date of
the enactment of this Act who have been diagnosed with gender
dysphoria may continue to serve only in their biological sex,
irrespective of any changes previously made to their gender
marker in the Defense Enrollment Eligibility Reporting System
(DEERS), and receive medically necessary treatment for gender
dysphoria. Such treatment may not include gender transition
procedures.
(2) Persons who identify as transgender who seek or have
undergone gender transition are disqualified from military
service.
(3) Persons who identify as transgender without a history
or diagnosis of gender dysphoria, who are otherwise qualified
for service and meet all physical and mental requirements,
may serve in the Armed Forces in their biological sex.
SEC. 597. REVISED REGULATIONS REGARDING GENDER MARKINGS.
Not later than 90 days after the date of the enactment of
this Act, the Secretary of Defense shall prescribe
regulations updating the Defense Enrollment Eligibility
Reporting System (DEERS) to require the gender markers for
members of the Armed Forces to match their biological sex,
irrespective of any previous changes allowed.
SEC. 598. DEFINITIONS.
In this subtitle:
(1) Cross-sex hormones.--The term ``cross-sex hormones''
means testosterone or other androgens given to biological
females at doses that are profoundly larger or more potent
than would normally occur naturally in healthy biological
females, or estrogen given to biological males at doses that
are profoundly larger or more potent than would normally
occur naturally in healthy biological males.
(2) Gender.--The term ``gender'' means the psychological,
behavioral, social, and cultural aspects of being male or
female.
(3) Gender dysphoria.--The term ``gender dysphoria'' means
a marked incongruence between one's experienced or expressed
gender and biological sex.
(4) Gender transition.--The term ``gender transition''
means the process by which a person goes from identifying
with and living as a gender that corresponds to his or her
biological sex to identifying with and living as a gender
different from his or her biological sex, and may involve
social, legal, or physical changes.
(5) Gender transition procedures.--The term ``gender
transition procedures''--
(A) means--
(i) any medical or surgical intervention, including
physician's services, inpatient and outpatient hospital
services, or prescribed drugs related to gender transition,
that seeks to alter or remove physical or anatomical
characteristics or features that are typical for the
individual's biological sex or to instill or create
physiological or anatomical characteristics that resemble a
sex different from the individual's birth sex, including
medical services that provide puberty-blocking drugs, cross-
sex hormones, or other mechanisms to promote the development
of feminizing or masculinizing features (in the opposite
sex); and
(ii) genital or non-genital gender transition surgery
performed for the purpose of assisting an individual with a
gender transition; and
(B) does not include--
(i) services to those born with a medically verifiable
disorder of sex development, including a person with external
biological sex characteristics that are irresolvably
ambiguous, such as those born with 46 XX chromosomes with
virilization, 46 XY chromosomes with undervirilization, or
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 person does not have normal sex chromosome
structure, sex steroid hormone production, or sex steroid
hormone action for a biological male or biological female; or
(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.
(6) Gender transition surgery.--The term ``gender
transition surgery'' means any medical or surgical service
that seeks to surgically alter or remove healthy physical or
anatomical characteristics or features that are typical for
the individual's biological sex in order to instill or create
physiological or anatomical characteristics that resemble a
sex different from the individual's birth sex, including
genital or non-genital gender reassignment surgery performed
for the purpose of assisting an individual with a gender
transition.
(7) Genital gender transition surgery.--The term ``genital
gender transition surgery'' includes surgical procedures such
as penectomy, orchiectomy, vaginoplasty, clitoroplasty, or
vulvoplasty for biologically male patients or hysterectomy,
ovariectomy, reconstruction of the fixed part of the urethra
with or without a metoidioplasty or a phalloplasty,
vaginectomy, scrotoplasty, or implantation of erection or
testicular prostheses for biologically
[[Page S3079]]
female patients, when performed for the purpose of assisting
an individual with a gender transition.
(8) Non-genital gender transition surgery.--The term ``non-
genital gender transition surgery''--
(A) includes, when performed for the purpose of assisting
an individual with a gender transition--
(i) surgical procedures such as augmentation mammoplasty,
facial feminization surgery, liposuction, lipofilling, voice
surgery, thyroid cartilage reduction, gluteal augmentation
(implants or lipofilling), hair reconstruction, or various
aesthetic procedures for biologically male patients; or
(ii) subcutaneous mastectomy, voice surgery, liposuction,
lipofilling, pectoral implants or various aesthetic
procedures for biologically female patients; and
(B) does not include 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 surgery is
performed, unless the procedure is for the purpose of a
gender transition.
(9) Puberty-blocking drugs.--The term ``puberty-blocking
drugs'' means, when used to delay or suppress pubertal
development in children for the purpose of assisting an
individual with a gender transition--
(A) Gonadotropin-releasing hormone (GnRH) analogues or
other synthetic drugs used in biological males to stop
luteinizing hormone secretion and therefore testosterone
secretion; and
(B) synthetic drugs used in biological females that stop
the production of estrogen and progesterone.
(10) Sex; birth sex; biological sex.--The terms ``sex'',
``birth sex,'' and ``biological sex'' refer to the biological
indication of male and female in the context of reproductive
potential or capacity, such as sex chromosomes, naturally
occurring sex hormones, gonads, and non-ambiguous internal
and external genitalia present at birth, without regard to an
individual's psychological, chosen, or subjective experience
of gender.
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