[Congressional Record Volume 172, Number 8 (Monday, January 12, 2026)]
[Senate]
[Pages S133-S135]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 4164. Mrs. BLACKBURN submitted an amendment intended to be
proposed by her to the bill H.R. 6938, making consolidated
appropriations for the fiscal year ending September 30, 2026, and for
other purposes; which was ordered to lie on the table; as follows:
[[Page S134]]
At the appropriate place, insert the following:
SEC. __. PROHIBITION ON CHEMICAL OR SURGICAL MUTILATION OF A
CHILD.
(a) Short Title.--This section may be cited as the ``Chloe
Cole Act''.
(b) Definitions.--In this section:
(1) Chemical or surgical mutilation.--
(A) In general.--The term ``chemical or surgical
mutilation'' means engaging in any one or more of the
following for the purpose of intentionally halting the
natural development of the individual's body so that it no
longer corresponds to the individual's sex or intentionally
changing the individual's body, including the individual's
external appearance or biological functions, to no longer
correspond to the individual's sex:
(i) The use of puberty blockers, including gonadotropin
releasing hormone agonists and other interventions, to delay
the onset or progression of normally timed puberty in an
individual.
(ii) The use of sex hormones, such as androgen blockers,
estrogen, progesterone, or testosterone.
(iii) Surgical procedures that attempt to transform an
individual's physical appearance or that attempt to alter or
remove an individual's sexual organs.
(B) Exclusions.--Such term does not include any of the
following:
(i) Appropriate and medically necessary procedures to treat
a verifiable disorder of sexual development, including an
individual born with 46 XX chromosomes with virilization,
with 46 XY chromosomes with undervirilization, or having both
ovarian and testicular tissue.
(ii) The treatment of any infection, injury, disease, or
disorder that has been caused or exacerbated by the
performance of an intervention described in subparagraph (A)
without regard to whether the intervention was performed in
accordance with State or Federal law or whether the
intervention is covered by the private right of action under
subsection (d).
(iii) Any intervention undertaken because the individual
suffers from any diagnosed and verifiable condition of the
body's organ systems, including the following:
(I) Traumatic bodily injuries (such as fractures, organ
rupture, or penetrating trauma).
(II) Congenital structural anomalies of major organs or
systems, including the cardiovascular, respiratory, renal,
hepatic, neurological, or musculoskeletal systems.
(III) Acute illnesses with a high probability of rapid
mortality.
(iv) Detransition treatment.
(2) Child.--The term ``child'' means an individual under 18
years of age.
(3) Detransition treatment.--The term ``detransition
treatment'' means any treatment, including a mental health
treatment, medical intervention, or surgery, that does either
or both of the following:
(A) Stops or reverses the effects of a prior chemical or
surgical mutilation.
(B) Helps an individual cope with the effects of a prior
chemical or surgical mutilation.
(4) Health care professional.--The term ``health care
professional'' means a person, including a physician, who is
licensed, certified, or otherwise authorized by the laws of a
State to administer health care in the ordinary course of the
practice of his or her profession or performing such acts
which require such licensure.
(5) Mental health professional.--The term ``mental health
professional'' means a person who is licensed to diagnose and
treat mental health conditions in a State.
(6) Participate.--The term ``participate'', with respect to
acts constituting chemical or surgical mutilation as defined
in paragraph (1), means directly engaging in the planning,
authorization, prescription, administration, or performance
of any such act, including any of the following:
(A) Prescribing puberty blockers, sex hormones, or related
medications with the intent to alter an individual's physical
appearance or reproductive function to align with an identity
differing from his or her sex.
(B) Administering medications or treatments described in
subparagraph (A) with such intent, whether by injection, oral
delivery, or other means.
(C) Performing surgical procedures that attempt to
transform an individual's physical appearance to confirm a
patient's physical appearance to be of the alternate sex, or
that alter or remove sexual organs as part of chemical or
surgical mutilation.
(D) Authorizing or directing such chemical or surgical
mutilation procedures as a supervising health care
professional or institutional representative.
(E) Knowingly planning or coordinating the provision of
treatments or procedures described above in subparagraph (A),
(C), or (D) with the intent to facilitate chemical or
surgical mutilation.
(7) Sex.--The term ``sex'' means a person's immutable
biological classification, determined at the moment of
conception, as either male or female, as follows:
(A) The term ``female'' is a person who naturally has, had,
will have, or would have but for a congenital anomaly or
intentional or unintentional disruption, the reproductive
system that produces, transports, and utilizes the large
gamete (ova) for fertilization.
(B) The term ``male'' is a person who naturally has, had,
will have, or would have but for a congenital anomaly or
intentional or unintentional disruption, the reproductive
system that produces, transports, and utilizes the small
gamete (sperm) for fertilization.
(c) Prohibition on Chemical or Surgical Mutilation.--
(1) In general.--No health care professional, hospital, or
clinic shall, in a circumstance described in paragraph (2),
participate in the chemical or surgical mutilation of a
child, and a health care professional, hospital, or clinic
may commence participation in a treatment that qualifies as
an exception specified in subclauses (i) through (iv) of
subsection (b)(1)(B) only after determining that clear and
convincing evidence supports a determination that the
treatment so qualifies.
(2) Circumstances described.--The circumstances described
in this paragraph are that--
(A) the defendant or child traveled in interstate or
foreign commerce, or traveled using a means, channel,
facility, or instrumentality of interstate or foreign
commerce, in furtherance of or in connection with the
participation in the chemical or surgical mutilation;
(B) the defendant used a means, channel, facility, or
instrumentality of interstate or foreign commerce in
furtherance of or in connection with the participation in the
chemical or surgical mutilation;
(C) any payment of any kind was made, directly or
indirectly, in furtherance of or in connection with the
participation in the chemical or surgical mutilation using
any means, channel, facility, or instrumentality of
interstate or foreign commerce or in or affecting interstate
or foreign commerce;
(D) the defendant transmitted in interstate or foreign
commerce any communication relating to or in furtherance of
the participation in the chemical or surgical mutilation
using any means, channel, facility, or instrumentality of
interstate or foreign commerce or in or affecting interstate
or foreign commerce by any means or in any manner, including
by computer, mail, wire, or electromagnetic transmission;
(E) any instrument, item, substance, or other object that
has traveled in interstate or foreign commerce was used to
perform the chemical or surgical mutilation;
(F) the chemical or surgical mutilation occurred within the
District of Columbia, the special maritime and territorial
jurisdiction of the United States, or any territory or
possession of the United States; or
(G) the chemical or surgical mutilation otherwise occurred
in or affected interstate or foreign commerce.
(d) Private Right of Action.--
(1) In general.--An individual subjected as a child to
chemical or surgical mutilation prohibited by subsection (c),
or the parents or legal guardians of such individual, may
bring a civil action in an appropriate district court of the
United States for damages against any health care
professional, hospital, or clinic, who participates in the
chemical or surgical mutilation of that child. Such a cause
of action shall be available regardless of whether the
alleged chemical or surgical mutilation occurred before, on,
or after the date of enactment of this Act.
(2) Damages.--Damages available pursuant to such an action
may include--
(A) compensatory damages, including all economic damages
associated with undoing, correcting, or ameliorating the
effects or results of any chemical or surgical mutilation
procedures;
(B) non-economic damages for emotional distress and pain
and suffering; and
(C) punitive damages, if the claimant proves by clear and
convincing evidence that the defendant against whom punitive
damages are sought acted maliciously, intentionally,
fraudulently, or recklessly.
(3) Strict liability.--Any health care professional,
hospital, or clinic whose participation in the chemical or
surgical mutilation of a child after the date of enactment of
this Act is proven by clear and convincing evidence shall be
strictly liable for damages for any such act of mutilation.
If a treatment qualifies under an exception specified in
clauses (i) through (iv) of subsection (b)(1)(B), and that is
raised as an affirmative defense to a violation of this
section, the health care professional, hospital, or clinic
shall bear the burden of proving by clear and convincing
evidence that such exception applies.
(e) Rules of Construction.--In this section:
(1) No private right of action is established based on
counseling, referrals to mental health professionals, or
discussions of treatment options, including counseling,
referrals, or options available upon reaching adulthood, or
in circumstances not described in subsection (c)(2), provided
by health care professionals, or mental health professionals,
provided that such actions do not constitute participation in
chemical or surgical mutilation, as defined in subsection
(b).
(2) No liability for a health care professional under these
provisions may be waived.
(3) Any ambiguities shall be resolved against any party
found to have engaged in participation, as defined in
subsection (b)(6), in the chemical or surgical mutilation of
a child.
(4) In any cases in which chemical or surgical mutilation
of a child is shown to have occurred before the date of
enactment of this Act, there is limited deference to
prevailing standards of care to the extent that such
standards contradict the intent of this section and it is
shown that the health care professional knew or should have
known that
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such standards of care were in serious, scientific, and
medical dispute at the time of the chemical or surgical
mutilation.
(5) Nothing in this section shall be construed to prohibit
a health care professional or mental health professional from
providing information about all available treatment options,
discussing risks and benefits, or expressing professional
medical opinions, so long as such actions do not constitute
participation in chemical or surgical mutilation.
(f) Statute of Limitations.--An action under subsection (d)
may be brought within 25 years from the date of the
eighteenth birthday of an individual subjected to chemical or
surgical mutilation as a child or within 4 years from the
time the cost of a detransition treatment is incurred,
whichever date is later.
(g) Severability.--If any provision of this section, or the
application of such a provision to any person or
circumstance, is held to be unconstitutional, the remainder
of this section, and the application of the provision held to
be unconstitutional to any other person or circumstance,
shall not be affected.
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