[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

[[Page S135]]

     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.
                                 ______