[House Report 119-311]
[From the U.S. Government Publishing Office]
119th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 119-311
========================================================================
PROTECT CHILDREN'S INNOCENCE ACT
----------------
September 26, 2025.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
----------------
Mr. Jordan, from the Committee on the Judiciary,
submitted the following
R E P O R T
together with
DISSENTING VIEWS
[To accompany H.R. 3492]
The Committee on the Judiciary, to whom was referred the
bill (H.R. 3492) to amend section 116 of title 18, United
States Code, with respect to genital and bodily mutilation and
chemical castration of minors, having considered the same,
reports favorably thereon with an amendment and recommends that
the bill as amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 4
Background and Need for the Legislation.......................... 4
Hearings......................................................... 14
Committee Consideration.......................................... 15
Committee Votes.................................................. 15
Committee Oversight Findings..................................... 20
New Budget Authority and Tax Expenditures........................ 20
Congressional Budget Office Cost Estimate........................ 20
Committee Estimate of Budgetary Effects.......................... 20
Duplication of Federal Programs.................................. 20
Performance Goals and Objectives................................. 20
Advisory on Earmarks............................................. 21
Federal Mandates Statement....................................... 21
Advisory Committee Statement..................................... 21
Applicability to Legislative Branch.............................. 21
Section-by-Section Analysis...................................... 21
Changes in Existing Law Made by the Bill, as Reported............ 22
Dissenting Views................................................. 27
The amendment is as follows:
Strike all that follows after the enacting clause and insert
the following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Protect Children's Innocence Act''.
SEC. 2. GENITAL AND BODILY MUTILATION OF A MINOR; CHEMICAL CASTRATION
OF A MINOR.
(a) In General.--Section 116 of title 18, United States Code, is
amended to read as follows:
``Sec. 116. Genital and bodily mutilation of a minor; chemical
castration of a minor
``(a) Genital or Bodily Mutilation.--Except as provided in subsection
(g), whoever, in any circumstance described in subsection (d),
knowingly performs, or attempts to perform, genital or bodily
mutilation on another person who is a minor, shall be fined under this
title, imprisoned not more than 10 years, or both.
``(b) Chemical Castration of a Minor.--Except as provided in
subsection (g), whoever, in any circumstance described in subsection
(d), knowingly chemically castrates a minor shall be fined under this
title, imprisoned not more than 10 years, or both.
``(c) Certain Offense Related to Female Genital Mutilation.--Except
as provided in subsection (g), whoever, in any circumstance described
in subsection (d), knowingly--
``(1) facilitates or consents to female genital mutilation of
a minor; or
``(2) transports a minor for the purpose of the performance
of female genital mutilation on such minor,
shall be fined under this title, imprisoned not more than 10 years, or
both.
``(d) Circumstances Described.--For the purposes of subsections (a)
and (b), the circumstances described in this subsection are that--
``(1) the defendant or victim 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 conduct described in
subsection (a) or (b);
``(2) the defendant used a means, channel, facility, or
instrumentality of interstate or foreign commerce in
furtherance of or in connection with the conduct described in
subsection (a) or (b);
``(3) any payment of any kind was made, directly or
indirectly, in furtherance of or in connection with the conduct
described in subsection (a) or (b) using any means, channel,
facility, or instrumentality of interstate or foreign commerce
or in or affecting interstate or foreign commerce;
``(4) the defendant transmitted in interstate or foreign
commerce any communication relating to or in furtherance of the
conduct described in subsection (a) or (b) 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 manner, including by computer, mail, wire, or
electromagnetic transmission;
``(5) any instrument, item, substance, or other object that
has traveled in interstate or foreign commerce was used to
perform the conduct described in subsection (a) or (b);
``(6) the conduct described in subsection (a) or (b) occurred
within the special maritime and territorial jurisdiction of the
United States, or any territory or possession of the United
States; or
``(7) the conduct described in subsection (a) or (b)
otherwise occurred in or affected interstate or foreign
commerce.
``(e) Prohibition on Certain Defense.--It shall not be a defense to a
prosecution under subsection (a) that female genital mutilation is
required as a matter of religion, custom, tradition, ritual, or
standard practice.
``(f) Prohibition on Prosecution of Victim.--No person who is
chemically castrated or on whom genital or bodily mutilation is
performed may be arrested or prosecuted for an offense under this
section.
``(g) Exceptions.--
``(1) Procedures.--
``(A) In general.--Genital or bodily mutilation or
chemical castration is not a violation of this section
if such genital or bodily mutilation or chemical
castration is--
``(i) necessary to the health of the minor on
whom it is conducted, and is conducted by a
person licensed in the place of such conduct as
a medical practitioner; or
``(ii) in the case of female genital
mutilation, performed on a minor in labor or
who has just given birth and is performed for
medical purposes connected with that labor or
birth by a person licensed in the place it is
performed as a medical practitioner, midwife,
or person in training to become such a
practitioner or midwife.
``(B) Health of a minor.--For the purposes of
subparagraph (A), the health of a minor does not
include--
``(i) mental, behavioral, or emotional
distress; or
``(ii) a mental, behavioral, or emotional
disorder.
``(2) Exemption.--Genital or bodily mutilation or chemical
castration is not a violation of this section if such genital
or bodily mutilation or chemical castration is conducted with
respect to any of the following individuals:
``(A) An individual with both ovarian and testicular
tissue.
``(B) 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.
``(C) An individual experiencing infection, disease,
injury, or disorder caused or exacerbated by a previous
genital or bodily mutilation procedure or chemical
castration.
``(D) An individual suffering from a physical
disorder, physical injury, or physical illness that
would, as certified by a physician, place the
individual in imminent danger of impairment of a major
bodily function unless the procedure is performed.
``(E) An individual diagnosed with precocious
puberty, to the extent such genital or bodily
mutilation or chemical castration is for the purpose of
normalizing puberty.
``(h) Definitions.--In this section:
``(1) Genital or bodily mutilation.--The term `genital or
bodily mutilation' means, with respect to an individual, any of
the following:
``(A) Female genital mutilation.
``(B) Any surgery performed for the purpose of
changing the body of such individual to correspond to a
sex that differs from their biological sex, including--
``(i) castration;
``(ii) orchiectomy;
``(iii) scrotoplasty;
``(iv) vasectomy;
``(v) hysterectomy;
``(vi) oophorectomy;
``(vii) ovariectomy;
``(viii) metoidioplasty;
``(ix) penectomy;
``(x) phalloplasty;
``(xi) vaginoplasty;
``(xii) vaginectomy;
``(xiii) vulvoplasty;
``(xiv) reduction thyrochondroplasty;
``(xv) chondrolaryngoplasty; and
``(xvi) mastectomy.
``(C) Any plastic surgery that feminizes or
masculinizes the facial or other physiological features
for the purposes described in subparagraph (B).
``(D) Any placement of chest implants to create
feminine breasts for the purposes described in
subparagraph (B).
``(E) Any placement of fat or artificial implants in
the gluteal region for the purposes described in
subparagraph (B).
``(F) Any surgery to reconstruct the fixed part of
the urethra, whether or not such surgery includes a
metoidioplasty or a phalloplasty, for the purposes
described in subparagraph (B).
``(2) Chemical castration.-- The term `chemical castration'
means administering, supplying, prescribing, dispensing,
distributing, or otherwise conveying to an individual
medications for the purposes described in paragraph (1)(B),
including--
``(A) gonadotropin-releasing hormone (GnRH) analogues
or other puberty-blocking drugs to stop or delay normal
puberty;
``(B) testosterone or other androgens to biological
females at doses that are supraphysiologic to the
female sex; and
``(C) estrogen to biological males at doses that are
supraphysiologic to the male sex.
``(3) Biological sex.--The term `biological sex' means, with
respect to a person, the classification of the person as male
or female at birth.
``(4) Female genital mutilation.--The term `female genital
mutilation' means any procedure performed for non-medical
reasons that involves partial or total removal of, or other
injury to, the external female genitalia, and includes--
``(A) a clitoridectomy or the partial or total
removal of the clitoris or the prepuce or clitoral
hood;
``(B) excision or the partial or total removal (with
or without excision of the clitoris) of the labia
minora or the labia majora, or both;
``(C) infibulation or the narrowing of the vaginal
opening (with or without excision of the clitoris); or
``(D) other procedures that are harmful to the
external female genitalia, including pricking,
incising, scraping, or cauterizing the genital area.
``(5) Minor.--The term `minor' means any person under the age
of eighteen years.
``(6) Male.--The term `male' means a person who naturally
has, had, will have, or would have, but for a congenital
anomaly, historical accident, or intentional or unintentional
disruption, the reproductive system that at some point
produces, transports, and utilizes sperm for fertilization.
``(7) Female.--The term `female' means a person who naturally
has, had, will have, or would have, but for a congenital
anomaly, historical accident, or intentional or unintentional
disruption, the reproductive system that at some point
produces, transports, and utilizes eggs for fertilization.''.
(b) Clerical Amendment.--The table of sections for chapter 7 of title
18, United States Code, is amended by striking the item related to
section 116 and inserting the following:
``116. Genital and bodily mutilation of a minor; chemical castration of
a minor.''.
Purpose and Summary
H.R. 3492, the Protect Children's Innocence Act, introduced
by Rep. Marjorie Taylor Greene (R-GA), amends 18 U.S.C. 116 to
prohibit doctors from performing genital or bodily mutilation
or chemical castration procedures on minors.
Background and Need for the Legislation
Left-wing activists and medical institutions have adopted a
treatment model grounded in a radical ideology that requires
practitioners to affirm the professed gender of minors, up to
and including by performing surgical procedures, without
sufficient regard for the consequences of these actions on the
health and wellbeing of children. In particular, they first
instruct vulnerable minors who are suffering from gender
dysphoria to spend time ``socially transitioning'' while
considering further medical intervention.\1\ ``Social
transitioning'' includes adopting an alternative name or
changing one's pronouns to match what they see as their
``gender identity.''\2\ It may also include altering one's
physical appearance to conform to an alternative gender role by
cutting or growing out the hair, changing the clothes, or
changing the person's pitch of voice or social behavior
entirely.\3\
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\1\Izz Scott LaMagdeleine, What is gender-affirming medical care
for transgender children? Here's what you need to know., Texas Tribune
(Aug. 4, 2021).
\2\Sarah Perry and Thomas Jipping, Public School Gender Policies
That Exclude Parents Are Unconstitutional, City Journal (June 12,
2024).
\3\Jason Rafferty, Ensuring Comprehensive Care and Support for
Transgender and Gender-
Diverse Children and Adolescents, Policy Statement, Pediatrics 1, 1-2
(2023).
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The World Professional Association for Transgender Health
(WPATH) is a nonprofit that provides standards for ``treatment
of gender dysphoria'' for medical professionals across the
globe.\4\ The WPATH Standards of Care (SOC), originally
published in 1979 and updated in 2022,\5\ recommend ``three
categories of physical interventions for adolescents,''
including ``fully reversible'' interventions such as puberty
blockers, ``partially'' reversible interventions such as
hormone therapy, and ``irreversible'' interventions such as
``gender-reassignment'' surgeries.\6\ WPATH promotes the use of
puberty blockers as soon as puberty starts in children,\7\ as
young as 8 years old for females and 9 years old for males.\8\
It suggests hormone therapy at the age of majority, as low as
15 in some countries, and irreversible surgeries at 18,
``except for chest `masculinizing' mastectomy, which [has] an
age minimum of 16 years.''\9\
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\4\About WPATH, WPATH, https://wpath.org/about/mission-and-vision/
(Last visited Mar. 24, 2025).
\5\Standards of Care for the Health of Transgender and Gender
Diverse People, Version 8 International Journal of Transgender Health,
5, 43-67 (2022).
\6\Id at 43.
\7\Id.
\8\Puberty, Cleveland Clinic, https://my.clevelandclinic.org/
health/body/puberty, (last visited Mar. 24, 2025).
\9\Standards of Care for the Health of Transgender and Gender
Diverse People, Version 8, supra note 5.
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Other recommendations include refraining from offering
``reparative'' therapy that tries to make a person's ``gender
expression more congruent with the sex assigned at birth,''
instructing children on ``chest binding and genital tucking,''
and involving the parent(s) or guardian(s) in decision making
``unless their involvement is determined to be harmful to the
adolescent or not feasible.''\10\
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\10\Id at 548.
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WPATH and other leftist medical institutions aim to advance
the narrative that childhood gender dysphoria is not a mental
health disorder, but rather an ``expected aspect of general
human development.''\11\ The WPATH SOC is based on the
principle that ``any'' therapy that attempts to counsel a child
with gender dysphoria to ``identify with, or behave in
accordance with, the gender associated with the sex assigned at
birth'' is ``harmful'' and far from the mission of transgender
health care professionals (HCP).\12\
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\11\Id at 567.
\12\Id.
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There is no standard age at which a child may be allowed to
consent to a medical intervention for gender dysphoria, as
transgender health care professionals say that it varies
depending on ``developmental differences.''\13\ The process of
informed consent for ``gender affirming care'' is outlined so
that an adolescent, as young as 8 years old, must comprehend
the medical treatment and process, potentially disastrous side
effects, and the long-term risk and consequences associated
with the treatment.\14\ In cases where a ``minor is consenting
for their own treatment without parental permission,''
transgender health care professionals will provide ``extra
care'' to the child, even discussing potential costs and
helping them develop a ``support'' plan.\15\
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\13\Id at 561.
\14\Id.
\15\Id at 562.
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The Lack of Evidence-Based Medicine in U.S.
Transgender Clinics
The American Academy of Pediatrics (AAP), one of the
largest organizations of pediatricians in the U.S.,\16\
advocates that medical professionals should immediately begin
the process of affirming children who ``assert an identity of
TGD (transgender and gender diverse),'' because they ``know
their gender . . . clearly and consistently.''\17\ It
recommends against the ``outdated approach'' in which a child
should wait to be ``affirmed'' until after puberty begins.\18\
This delayed approach is called ``watchful waiting.''\19\ The
AAP claims that ``watchful waiting'' is a disservice to the
child because it assumes the ``false'' premise that ``gender
diversity become[s] fixed at a certain age'' and that ``gender
diversity'' is abnormal or ``pathologized.''\20\
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\16\About the AAP, AAP, https://www.aap.org/en/about-the-aap/,
(last visited Mar. 25, 2025).
\17\Jason Rafferty, Ensuring Comprehensive Care and Support for
Transgender and Gender-
Diverse Children and Adolescents, Policy Statement, 142, Pediatrics 1,
1-14 (2023).
\18\Id. at 6.
\19\Id. at 4.
\20\Id.
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While U.S. medical institutions like the AAP push a
politically motivated ``gender-affirming care'' agenda, medical
professionals in progressive European countries are skeptical
of the research backing hormone therapy in minors.\21\ A
growing number of experts in Europe now assert that there is
limited existing evidence supporting ``gender-affirming''
treatments in children with gender dysphoria.\22\
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\21\Leor Sapir, Why Europe and America are going in opposite
directions on youth transgender medicine, The Hill (June 28, 2023).
\22\Id.
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For example, the National Health Service (NHS) of
England\23\ and the Swedish Agency for Health Technology
Assessment and Assessment of Social Services (SBU)\24\
conducted two recent systematic reviews to assess the evidence
of the effectiveness of hormone therapy, puberty blockers, and
``gender reassignment'' surgeries in adolescents with gender
dysphoria. The Swedish study determined that the ``scientific
evidence is insufficient'' to accurately evaluate the effects
of these treatments in minors, though both studies concluded
that there is some support to suggest that the hormone given to
delay puberty, GnRH, may inhibit normal bone development in
children.\25\
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\23\Nice Evidence Reviews, The National Archives, https://
webarchive.nationalarchives.gov.uk/ukgwa/20250310144323/https://
cass.independent-review.uk/nice-evidence-reviews/, (last accessed Mar.
25, 2025).
\24\Hormone treatment for gender dysphoria--children and young
people, SBU (Feb. 2, 2022).
\25\Id.
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In 2022, in response to the SBU study, the Swedish National
Board of Health and Welfare (NBHW) changed its recommendations
for treatment of minors with gender dysphoria, stating that due
to ``uncertain science and newly acquired knowledge,'' it
``recommends restraint when it comes to hormone
treatment.''\26\ The NBHW warned that based on the results of
numerous observational studies,\27\ ``the risks [of hormone
treatment] outweigh the benefits at this time.''\28\ It also
noted that there have recently been ``increasing reports of
detransition and transition-related regret'' in minors who have
received so-called ``gender-affirmation'' medical
treatments.\29\
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\26\Updated recommendations for hormone therapy for gender
dysphoria in young people, Socialstyrelsen, The National Board of
Health and Welfare, 2, 2-6 (2022).
\27\Id. at 3.
\28\Id. at 3.
\29\Id. at 4.
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There is also recent research that calls into question the
soundness of the leading study supporting so-called gender
affirmation. The ``Dutch Protocol,'' a methodology from two
Swedish studies from the mid-1990s,\30\ has become the
``foundation'' of the modern ``Gender Affirmative Model of
Treatment.''\31\ This study was the first that proposed the use
of puberty blocking hormone, GnRH, to ``treat'' minors with
gender dysphoria.\32\ Since its publication in 2006, the
implications of the ``Dutch Protocol'' have influenced other
studies that aim to provide a basis for ``gender transition''
procedures for minors and are often referenced in U.S. so-
called ``gender-affirming care'' practices.\33\
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\30\The Dutch Protocol, Our Duty, https://ourduty.group/education/
the-dutch-protocol/, (last accessed Mar. 25, 2025).
\31\Id.
\32\Id.
\33\The Dutch Studies, Democrats For An Informed Approach For
Gender (Diag), https://www.di-ag.org/the-dutch-studies, (last accessed
Mar. 25, 2025).
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Multiple evidence-based studies have since disproven and
called into question the validity of the findings of the
``Dutch Protocol.''\34\ According to a 2023 study, the premise
of the Dutch study is flawed on account of ``three
methodological biases [that] undermine the research.''\35\
These include ``dropping'' subjects from the study who
experienced unsuccessful results, altering the gender dysphoria
``scoring mechanism'' after the treatments were conducted in
order to guarantee ``a significant post-surgical drop in
`gender dysphoria' scores,'' and compromising findings of
``psychological benefits'' of hormone therapy by conflating the
results of several treatments and factors such as ``gender
reassignment, therapy, [and] psychological maturation.''\36\
Intentionally skewed data discredits the original information
source for ``gender-affirming care'' for minors, which has been
referred to by experts as the ```gold standard' in the
field.''\37\ The results of the Dutch study ``have never been
replicated,'' even though prominent gender clinics have
tried.\38\
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\34\E. Abbruzzese, Stephen B. Levine, and Julia W. Mason, The Myth
of `Reliable Research' in Pediatric Gender Medicine: A Critical
Evaluation of the Dutch Studies--and Research That Has Followed, 49,
Journal of Sex & Marital Therapy 673, 673-99 (2023).
\35\Id.
\36\Id.
\37\Id.
\38\Supra note 33.
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The puberty blocking hormone endorsed by the ``Dutch
Protocol'' and used by ``gender-affirming care'' clinics, GnRH,
has not been approved to treat gender identity disorders in
both the United States and Europe.\39\ Pediatric
endocrinologists use Food and Drug Administration (FDA)-
approved GnRH hormones to treat ``precocious,'' or early,
puberty,\40\ which can be detrimental to a child's long-term
health by causing metabolic disorders, increased risk of
cancer, psychological and behavioral issues, underdeveloped
physical growth, and more.\41\ In 2022, the FDA released a
warning that the use of GnRH hormones in children may result in
``pseudotumor cerebri,''\42\ a side effect that mimics a brain
tumor, causing brain swelling, severe headaches and nausea, and
potentially permanent vision loss.\43\
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\39\Stephanie A. Roberts, and Jeremi M Carswell, Growth, growth
potential, and influences on adult height in the transgender and
gender-diverse population,'' 9, Nat'l Institute of Health 1679, 1679-
1688 (2021).
\40\Precocious Puberty and Why it Matters, Columbia University
Irving Medical Center (Feb. 16, 2023).
\41\Id.
\42\Food and Drug Administration, Risk of pseudotumor cerebri added
to labeling for gonadotropin-releasing hormone agonists, AAP News (July
1, 2022).
\43\Alec Schemmel, FDA warns puberty blocker may cause brain
swelling, vision loss in children, CBS Austin (July 26, 2022).
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Doctors across the U.S. and in other countries are
beginning to take a stand against those in the medical
community who insist that these are ``lifesaving procedures''
and should not be questioned, especially well-known medical
organizations. In February 2024, the American College of
Pediatricians (ACPeds) released a position statement detailing
how ``social transition, puberty blockers and cross-sex
hormones have no demonstrable, long-term benefit on the
psychosocial well-being of adolescents with gender dysphoria .
. . .''\44\
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\44\Melissa Rudy `Gender-affirming' treatments don't benefit youth,
says pediatricians group: `Irreversible consequences', Fox News (Feb.
8, 2024).
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In June 2023, Ian Kingsbury, Ph.D. and Dr. Roy Eappen--a
member of the Endocrine Society--authored an op-ed in the Wall
Street Journal about the Endocrine Society's ``Dangerous
Transgender Politicization.''\45\ Founded in 1912, the
Endocrine Society is an international organization in the field
of endocrinology that aims to be a ``global community focused
on improving patient care, shaping effective policy, and
ensuring the future of [our] field.''\46\ Mr. Kingsbury and Dr.
Eappen wrote: ``over the past decade transgender activists have
co-opted the Endocrine Society and other professional
organizations to promote such treatments for adolescents and
even young children. Their guidelines are based on flimsy
evidence, giving the appearance that invasive and irreversible
treatments are beneficial for young patients despite a growing
body of evidence to the contrary . . . .''\47\ The two authors
also described attending the Endocrine Society's annual
meeting, where many of the doctors admitted that the
organization's evidence for pediatric gender transition is
``weak at best,'' but are were afraid to voice their
concerns.\48\
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\45\Roy Eappen and Ian Kingsbury, The Endocrine Society's Dangerous
Transgender Politicization, Wall St. J. (Jun. 28, 2023).
\46\The Endocrine Society, https://www.endocrine.org/ (last
accessed Mar. 28, 2025).
\47\Id.
\48\Id.
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The Endocrine Society President, Dr. Stephen Hammes,
published a response to Mr. Kingsbury's and Dr. Eappen a week
later, in which he argued that ``[m]ore than 2,000 studies
published since 1975 form a clear picture: Gender-affirming
care improves the well-being of transgender and gender-diverse
people and reduces the risk of suicide.''\49\ In response to
Dr. Hammes, 21 leading experts on pediatric gender medicine
from nine countries then wrote a letter to the Journal
expressing strong disagreement with the Endocrine Society over
its views and treatment of youth gender dysphoria.\50\ The
doctors pointed out that there is no reliable evidence to
suggest that hormonal therapy or transition is an effective
measure to prevent suicide.\51\
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\49\Stephen R. Hammes, M.D., Endocrine Society Responds on Gender-
Affirming Care, Wall St. J. (Jul. 5, 2023).
\50\Jesus L. Penabad, M.D., Youth Gender Transition is Pushed
Without Evidence, Wall St. J. (Jul. 13, 2023).
\51\Id.
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State Laws relating to So-called ``Gender-Affirming'' Care
How the states approach so-called ``gender-affirming'' care
is instructive about the prevailing attitude of the country on
this issue. To date, 27 states have adopted laws to protect
children from receiving so-called ``gender-affirming'' care.
Supreme Court Precedent on Parental Rights
For over 100 years since Meyer v. Nebraska, the Supreme
Court has held that the Due Process Clause of the Fourteenth
Amendment protects a parent's fundamental right ``to make
decisions as to the care, custody, and control of their
children.''\52\ This landmark case established that parents'
liberty interest in raising their children is protected and
enshrined in the Constitution. More recently in Troxel v.
Granville, the Court explained that the ``liberty interest'' of
``parents in the care, custody, and control of their children
are perhaps the oldest of the fundamental liberty interests
recognized by this Court.''\53\ The Court noted the Due Process
Clause of the Fourteenth Amendment ``provides heightened
protection against government interference with certain
fundamental rights and liberty interests.''\54\ These cases
serve as crucial building blocks as states look to best protect
the rights of both children and the fundamental rights of
parents--especially protecting parental rights when doctors are
forcing so-called ``gender-affirming care'' on minors.
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\52\Meyer v. Nebraska, 262 U.S. 390, 399 (1923).
\53\Troxel v. Granville, 530 U.S. 57 (2000).
\54\Id. (citing Washington v. Glucksberg, 521 U.S. 702, 720
(1997)).
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State Laws
Despite the radical left's insistence that children be
allowed to ``socially transition,'' 27 states have passed laws
to protect children, which either limit or completely prohibit
minors' from receiving so-called ``gender affirming'' care.\55\
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\55\KFF, Policy Tracker, Youth Access to Gender Affirming Care and
State Policy Restrictions https://www.kff.org/other/dashboard/gender-
affirming-care-policy-tracker/ (last accessed March 20, 2025).
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Washington and California
While some states have passed laws to protect children from
so-called ``gender-affirming care,''\56\ two leftist states--
Washington and California--went in the opposite direction.
Under the Washington law enacted in 2023, shelters serving
runaway and homeless youth are not required to inform parents
of kids in their shelters of the child's whereabouts if there
are ``compelling reasons'' not to do so.\57\ The bill specifies
that one of these compelling reasons is for children receiving
so-called ``gender affirming treatment.''\58\
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\56\Movement Advancement Project, ``Equality Maps: Bans on
Transgender Youth Participation in Sports,'' https://
www.mapresearch.org/equality-maps/youth/sports_participation_bans (last
accessed Mar. 28, 2025).
\57\SB 5599, Wash. State. Leg., https://lawfilesext.leg.wa.gov/
biennium/2023-24/Pdf/Bills/Session%20Laws/Senate/5599-
S.SL.pdf?q=20230616072207.
\58\Id.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Figure 1: States Protecting Children\59\
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\59\Lindsey Dawson & Jennifer Kates, Policy Tracker: Youth Access
to Gender Affirming Care and State Policy Restrictions, KFF, https://
www.kff.org/lgbtq/gender-affirming-care-policy-
tracker/
#::text=State%20laws%20and%20policies%20prohibiting,having%20passed%20s
uch%20
laws%2Fpolicies (last updated Aug. 12, 2025).
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In 2022, California passed a similar law directly aimed at
undermining the rights of parents in states that have passed
laws to protect minors.\60\ The bill allows minors to obtain
puberty blockers, cross-sex hormones, and irreversible
surgeries without parental consent, while also denying parents
access to the medical information of their children.\61\ In
2023, the California State Assembly passed A.B. 957,
legislation that allows judges to consider a parent's decision
to affirm their child's gender identity when making custody
decisions in family court.\62\ The bill construes the refusal
to affirm a gender identity as an affront to a child's
``health, safety, and welfare'' and effectively construes non-
affirmation of gender identity as abuse.\63\ This opens the way
for much broader applications. In a surprising decision,
California Governor Gavin Newsom vetoed the bill, saying its
approach ``could be used to diminish the civil rights of
vulnerable communities.''\64\
---------------------------------------------------------------------------
\60\Jo Yurcaba, California Governor Signs Bill Offering Legal
Refuge to Transgender Youths, NBC News (Sept. 30, 2022).
\61\Danielle Wallace, Newsom AG Sued Over Law Deeming California
`Sanctuary State' for Minors Seeking Transgender Procedures, Fox News
(Mar. 7, 2023).
\62\Andrew Haubner, California bill would include child's gender in
custody cases. Here's what opponents say, CBS News Sacramento (Jun. 13,
2023).
\63\Id.
\64\Jonathan Ayestas Newsom vetoes California bill involving
parent's affirmation of child's identity in custody cases, KCRA
(September 22, 2023).
---------------------------------------------------------------------------
However, in July 2024, Governor Newsom signed into law a
bill that prevents schools from requiring teachers and other
administrators to notify parents of a child's change in sexual
orientation or gender identity.\65\ This law chills parental
rights throughout the state. A southern California school
district is suing Governor Newsom, arguing that the legislation
violates the constitutional rights of parents as legal
guardians of their children.\66\
---------------------------------------------------------------------------
\65\David Zimmerman, Southern California School District Sues
Newsom over Transgender Parental-Notification Law, The National Review
(July 17, 2024).
\66\Id.
---------------------------------------------------------------------------
Other states such as Colorado, Illinois, Maryland, New
Mexico, Minnesota, and Maine passed bills to ``shield''
transgender healthcare through legal protections and healthcare
access.\67\ For example, in 2023, Governor Tim Walz in
Minnesota signed a bill into law that would prevent state
courts or officials from complying with child removal requests,
extraditions, arrests, or subpoenas related to ``gender-
affirming health care'' a person is receiving or provides in
the state.\68\ Both Minnesota and California are considered
``sanctuary'' states for ``gender-affirming care.''\69\
---------------------------------------------------------------------------
\67\Bente Birkeland, Dana Ferguson, Colin Jackson, Scott Maucione,
Rick Pluta, Acai Squires, Minnesota to join at least 4 other states in
protecting transgender care this year, NPR (Apr. 21, 2023).
\68\Id.
\69\Id.
---------------------------------------------------------------------------
Tennessee
Some states are taking an active stance against so-called
``gender-affirming care.'' One such state is Tennessee. A video
published in 2022 showed a doctor from Vanderbilt University
Medical Center (VUMC) touting pediatric ``gender-affirming
procedures'' as ``huge money makers'' for hospitals.\70\ The
video also showed the doctor speaking favorably on the profits
that hospitals can make from performing double mastectomies on
young girls and other procedures to help ``masculinize gender
affirmation.''\71\
---------------------------------------------------------------------------
\70\Kimberlee Kruesi, Social Media Posts Spark Calls to Investigate
Tenn.'s VUMC, AP (Sept. 21, 2022).
\71\Id.
---------------------------------------------------------------------------
Tennessee lawmakers sprang into action. In 2023, Tennessee
enacted the Prohibited Medical Procedures for Minors Act.\72\
This law prohibits medical providers from knowingly providing
to minors any procedures for: ``(A) enabling the minor to
identify with, or live as, a purported identity inconsistent
with the minor's sex; or (B) treating purported discomfort or
distress from a discordance between the minor's sex and
asserted identity.''\73\
---------------------------------------------------------------------------
\72\T.C.A. Sec. 68-33-103.
\73\T.C.A. Sec. 68-33-103(a)(1)(A)(B).
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In July 2023, the Biden-Harris DOJ intervened in a lawsuit
challenging the constitutionality of the Tennessee law.\74\ On
June 28, 2023, a judge in the U.S. District Court for the
Middle District of Tennessee blocked the enforcement of the
Tennessee law.\75\ Later in September 2023, a 2-1 panel on the
U.S. Court of Appeals for the Sixth Circuit ruled that
Tennessee (as well as Kentucky) could continue to ban these
treatments and procedures for minors.\76\ In December 2024, the
Supreme Court heard oral arguments on the case.\77\ In February
2025, President Trump's Justice Department withdrew the
challenge of the Tennessee law.\78\ While the Trump
Administration withdrew the challenge, it encouraged the
Supreme Court to still issue a decision.\79\ In June 2025, the
Court issued a decision upholding Tennessee's law.\80\
---------------------------------------------------------------------------
\74\Spencer Kimball, DOJ sues Tennessee, alleging it discriminates
against transgender youth with new law, CNBC (April 27, 2023).
\75\Press Release, American Civil Liberties Union, Federal Judge
Blocks Tennessee's Ban on Trans Youth's Health Care (June 28, 2023).
\76\Jonathan Mattise, Judges maintain bans on gender-affirming care
for youth in Tennessee and Kentucky, Associated Press (Sep. 29, 2023)
\77\U.S. v. Skrmetti, No. 23-477v (6th Cir.).
\78\John Fritze, Trump administration withdraws from gender-
affirming care dispute at the Supreme Court, CNN (Feb. 7, 2025)
\79\Id.
\80\U.S. v. Skrmetti, 605 U.S.____ (2025).
---------------------------------------------------------------------------
TRUMP ADMINISTRATION EFFORTS TO PROTECT CHILDREN
Executive Order 14187
President Trump has been vocal about the abuse children
experience through forced transgender procedures. As a
presidential candidate, in August 2024, President Trump stated:
``I will sign an executive order instructing every federal
agency to cease the promotion of sex or gender transition at
any age. They're not going to do it anymore . . .''\81\ In
October 2024, the Trump campaign highlighted Vice President
Kamala Harris' extreme views on so-called ``gender-affirming
care,'' with an ad stating, ``Kamala is for they/them.
President Trump is for you.''\82\
---------------------------------------------------------------------------
\81\Michael Martin and Mansee Khurana, What Trump's win could mean
for transgender health care access, athletes. NPR (Nov. 16, 2024).
\82\Susan Davis, GOP ads on transgender rights are dominating
airwaves in the election's closing days NPR (Oct. 19, 2024).
---------------------------------------------------------------------------
Within the first 30 days of the new administration,
President Trump issued five executive orders pertaining to
``gender-affirming care.''\83\ Most notably, on January 28,
2025, President Trump issued an executive order titled,
``Protecting Children from Chemical and Surgical
Mutilation.''\84\ This order defunds chemical and surgical
mutilation of children and halts the use of federal funds
supporting ``gender-affirming medical care'' for youth under 19
years old.\85\ The order directs the Attorney General to
enforce the ban on so-called ``gender-affirming care'' through
18 U.S.C. 116, which prohibits female genital mutilation (FGM)
on minors.\86\ It also convenes law enforcement entities,
including state attorneys general, to coordinate the
enforcement of laws against FGM throughout the country.\87\
Lastly, the executive order directs the Secretary of the
Department of Health and Human Services (HHS) to ``review
existing literature'' on best practices for promoting the
health of children who assert gender dysphoria or other
``identity-based confusion.''\88\
---------------------------------------------------------------------------
\83\Ivana Saric, All of the anti-trans executive orders Trump has
signed AXIOS (Feb. 5, 2025).
\84\Exec. Order No. 14187.
\85\Id.
\86\Id.
\87\Id.
\88\Id.
---------------------------------------------------------------------------
Shortly after President Trump issued the executive order,
far-left organizations began challenging the executive order in
court. On February 4, 2025, the American Civil Liberties Union
(ACLU) and other transgender rights organizations filed a
lawsuit in the U.S. District Court for the District of Maryland
challenging the executive order on behalf of a handful of
transgender adolescents and their families.\89\ On March 3,
2025, Judge Brendan Hurson of the U.S. District Court for the
District of Maryland issued a preliminary injunction and
blocked enforcement of the order, citing that cutting care and
the hardships faced by cutting ``essential care'' would be
``potentially catastrophic.''\90\ On March 7, 2025, the ACLU
and others filed an emergency motion to enforce the preliminary
injunction.\91\ On March 21, 2025, the Trump Administration
appealed the injunction.\92\ On March 28, 2025, Judge Hurson
denied ACLU's emergency motion, emphasizing it was dismissed
without prejudice.\93\ The government's appeal of the
preliminary injunction is currently pending before the U.S.
Court of Appeals for the Fourth Circuit.\94\
---------------------------------------------------------------------------
\89\PFLAG v. Trump, No. 8:25-cv-337 (D. Md. 2025).
\90\Chloe Atkins, Judge blocks Trump order threatening funding for
institutions that provide gender-affirming care for youths NBC (March
4, 2025).
\91\PFLAG v. Trump, No. 8:25-cv-337 (D. Md. 2025), emergency motion
to enforce prelim. Injunction (4th Cir. March 7, 2025).
\92\PFLAG v. Trump, No. 8:25-cv-337 (D. Md. 2025), appeal docketed,
(4th Cir. March 21, 2025).
\93\PFLAG v. Trump, No. 8:25-cv-337 (D. Md. 2025), order on
emergency motion to enforce prelim. Injunction (4th Cir. March 28,
2025).
\94\PFLAG v. Trump, No. 8:25-cv-00337 (4th Cir. 2025), briefing
order (4ths Cir. Jun. 25, 2025).
---------------------------------------------------------------------------
While no attorneys general have challenged the executive
order yet in court, Massachusetts Attorney General Andrea
Campbell and a coalition of 14 Democrat attorneys general
released a statement ``reaffirming their commitment'' to
``protecting access to gender-affirming care.''\95\
---------------------------------------------------------------------------
\95\Press Release, Massachusetts Office of the Attorney General, AG
Campbell Leads 14 AGs In Issuing Statement On Protecting Access To
Gender-Affirming Care (Feb. 5, 2025).
---------------------------------------------------------------------------
Department of Health and Human Services Report
As directed by President Trump's executive order, on May 1,
2025, HHS released a detailed report titled ``Treatment for
Pediatric Gender Dysphoriau Review of Evidence and Best
Practices.''\96\ The report examined the increasing number of
children questioning their gender identity, the questionable
``gender-affirming care model'' with its devastating yet
downplayed side effects, and other evidence-based information
about the medical transition of minors.\97\ Among other things,
the review found the current leading organizations and their
guidance on drugs and surgeries (such as the Endocrine Society
and American Academy of Pediatrics) are problematic because
these drugs and surgeries ``carry risk of significant harms
including infertility/sterility, sexual dysfunction, impaired
bone density accrual, adverse cognitive impacts, cardiovascular
disease and metabolic disorders, psychiatric disorders,
surgical complications, and regret.''\98\ On the release of the
report, Jay Bhattacharya, the Director of the National
Institutes of Health, stated, ``Our duty is to protect our
nation's children-not expose them to unproven and irreversible
medical interventions . . . . We must follow the gold standard
of science, not activist agendas.''\99\
---------------------------------------------------------------------------
\96\Dep't of Health and Human Services, Treatment for Pediatric
Gender Dysphoria Review of Evidence and Best Practices (May 1, 2025).
\97\Id at 9.
\98\Id at 10.
\99\Press Release, Dep't of Health and Human Services, HHS Releases
Comprehensive Review of Medical Interventions for Children and
Adolescents with Gender Dysphoria, (May 1, 2025), https://www.hhs.gov/
press-room/gender-dysphoria-report-release.html.
---------------------------------------------------------------------------
While the HHS report stirred criticism from some far-left
publications,\100\ even left-leaning news outlets like the
Washington Post conceded there are ``serious concerns'' about
the scientific basis of interfering with the growth process of
children and ``better evidence and reasoned discussion about
the trade-offs involved in intervening with the biological
process of puberty in children who experience gender
dysphoria'' is necessary.\101\
---------------------------------------------------------------------------
\100\Selena Simmons-Duffin, Health care for transgender children
questioned in 400-page Trump administration report NPR (May 1, 2025).
\101\Fenit Nirappil, Youth gender transition care criticized in HHS
report that conceals authors, Wash. Post (May 2, 2025).
---------------------------------------------------------------------------
DOJ Memorandum
On April 23, 2025, Attorney General Pam Bondi issued a
memorandum regarding ``Preventing the Mutilation of American
Children,'' as required by President Trump's executive
order.\102\ In this memorandum, Attorney General Bondi directed
all U.S. Attorneys to investigate suspected cases of FGM, which
includes ``gender-affirming care.''\103\ She also directed the
Civil Division to investigate and hold accountable
pharmaceutical companies and medical providers misrepresenting
about the long-term side effects of chemical and surgical
mutilations.\104\ Attorney General Bondi directed DOJ to
partner with state coalitions to hold medical professionals
accountable who hurt children.\105\ Finally, she directed the
DOJ Office of Legislative Affairs (OLA) draft legislation
amending 18 U.S.C. 116 to ``enhance protections for children
whose healthy body parts have been damaged by medical
professionals practicing chemical and surgical
mutilation.''\106\
---------------------------------------------------------------------------
\102\U.S. Dep't of Justice, Office of the Atty General, Memorandum
for Select Component Heads: Preventing the Mutilation of American
Children (April 23, 2025).
\103\See 18 U.S.C. Sec. 116(a)(l).
\104\U.S. Dep't of Justice, Office of the Atty General, Memorandum
for Select Component Heads: Preventing the Mutilation of American
Children (April 23, 2025).
\105\Id.
\106\Id.
---------------------------------------------------------------------------
Protecting Children's Innocence Act
The Protect Children's Innocence Act of 2025 would
complement the Trump Administration's efforts to protect
America's minors by amending 18 U.S.C 116 to explicitly
prohibit ``gender-affirming care.'' The bill expands covered
offenses to include the bodily mutilation and the chemical
castration of a minor. Victims are protected by ensuring that
they cannot be arrested or prosecuted if one of these or other
prohibited procedures are performed on them. The bill also
contains an exception for cases where there is a legitimate
medical need for a certain procedure.
Hearings
For the purposes of clause 3(c)(6)(A) of House rule XIII,
the following hearing was used to develop H.R. 3492: ``Ending
Lawfare Against Whistleblowers Who Protect Children,'' a
hearing held on April 9, 2025, before the Subcommittee on the
Constitution and Limited Government of the House Judiciary
Committee. The subcommittee heard from the following witnesses:
Dr. Eithan Haim, General Surgeon and Texas
Children's Hospital Whistleblower
Mark Lytle, Attorney for Dr. Haim
Vanessa Sivadge, Former Texas Children's
Hospital Nurse and Whistleblower
Bruce Lesley, President, First Focus on
Children
The hearing examined how Dr. Eithan Haim and nurse Vanessa
Sivadge anonymously came forward with proof that Texas
Children's Hospital secretly continued to perform
``transgender'' medical procedures on minors, contrary to the
hospital's public assertions.
Committee Consideration
On June 10, 2025, the Committee met in open session and
ordered the bill, H.R. 3492, favorably reported with an
amendment in the nature of a substitute, by a roll call vote of
17-10, a quorum being present.
Committee Votes
In compliance with clause 3(b) of House rule XIII, the
following roll call votes occurred during the Committee's
consideration of H.R 3492:
1. Vote on Amendment #2 to the H.R. 3492 ANS, offered
by Ms. Jayapal--failed 8 ayes to 12 nays.
2. Vote on Amendment #3 to the H.R. 3492 ANS, offered
by Ms. Balint--failed 10 ayes to 15 nays.
3. Vote on Amendment #4 to the H.R. 3492 ANS, offered
by Mr. Massie--failed 13 ayes to 15 nays.
4. Vote on favorably reporting H.R. 3492, as
amended--passed 17 ayes to 10 nays.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Committee Oversight Findings
In compliance with clause 3(c)(1) of House rule XIII, the
Committee advises that the findings and recommendations of the
Committee, based on oversight activities under clause 2(b)(1)
of rule X of the Rules of the House of Representatives, are
incorporated in the descriptive portions of this report.
New Budget Authority and Tax Expenditures
With respect to the requirements of clause 3(c)(2) of rule
XIII of the Rules of the House of Representatives and section
308(a) of the Congressional Budget Act of 1974 and with respect
to the requirements of clause 3(c)(3) of rule XIII of the Rules
of the House of Representatives and section 402 of the
Congressional Budget Act of 1974, the Committee has requested
but not received a cost estimate for this bill from the
Director of the Congressional Budget Office. The Committee has
requested but not received from the Director of the
Congressional Budget Office a statement as to whether this bill
contains any new budget authority, spending authority, credit
authority, or an increase or decrease in revenues or tax
expenditures. The Chairman of the Committee shall cause such
estimate and statement to be printed in the Congressional
Record upon its receipt by the Committee.
Congressional Budget Office Cost Estimate
With respect to the requirement of clause 3(c)(3) of rule
XIII of the Rules of the House of Representatives, a cost
estimate provided by the Congressional Budget Office pursuant
to section 402 of the Congressional Budget Act of 1974 was not
made available to the Committee in time for the filing of this
report. The Chairman of the Committee shall cause such estimate
to be printed in the Congressional Record upon its receipt by
the Committee.
Committee Estimate of Budgetary Effects
With respect to the requirements of clause 3(d)(1) of rule
XIII of the Rules of the House of Representatives, the
Committee adopts as its own the cost estimate prepared by the
Director of the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974.
Duplication of Federal Programs
Pursuant to clause 3(c)(5) of House rule XIII, no provision
of H.R. 3492 establishes or reauthorizes a program of the
federal government known to be duplicative of another federal
program.
Performance Goals and Objectives
The Committee states that pursuant to clause 3(c)(4) of
House rule XIII, H.R. 3492 would amend 18 U.S.C. 116 to
prohibit doctors from performing genital or bodily mutilation
or chemical castration procedures on minors.
Advisory on Earmarks
In accordance with clause 9 of House rule XXI, H.R. 3492
does not contain any congressional earmarks, limited tax
benefits, or limited tariff benefits as defined in clauses
9(d), 9(e), or 9(f) of House Rule XXI.
Federal Mandates Statement
An estimate of federal mandates prepared by the Director of
the Congressional Budget office pursuant to section 423 of the
Unfunded Mandates Reform Act was not made available to the
Committee in time for the filing of this report. The Chairman
of the Committee shall cause such estimate to be printed in the
Congressional Record upon its receipt by the Committee.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act (Pub. L. 104-
1).
Section-by-Section Analysis
Section 1. Short title
The ``Protect Children's Innocence Act.''
Section 2. Genital and bodily mutilation of a minor; chemical
castration of a minor
This section amends 18 U.S.C. 116 as follows:
(a)-(b) Genital and Bodily Mutilation of a Minor; Chemical
Castration of a Minor. These subsections state that anyone who
knowingly performs or attempts to perform genital or bodily
mutilation or chemical castration of a minor shall be fined,
imprisoned not more than 10 years, or both.
(c)-(d) Circumstances Described. This subsection sets forth
the circumstances when the prohibitions in subsections (a) and
(b) apply, including: 1) when the defendant or victim traveled
in interstate commerce; 2) the defendant used a means of
interstate or foreign commerce in furtherance of the genital or
bodily mutilation or chemical castration; 3) a payment was made
using means of interstate or foreign commerce; 4) the defendant
transmitted in interstate or foreign commerce any communication
relating to the above conduct; 5) any instrument to perform the
conduct traveled in interstate commerce; 6) the conduct
occurred in the special maritime or any territorial
jurisdiction of the United States; or 7) the conduct otherwise
occurred or affected interstate or foreign commerce.
(e). Prohibition on Certain Defense. This subsection states
that a defendant cannot use religion, custom, tradition, or
ritual as a defense to prosecution under the above sections.
(f)-(g). Prohibition on Prosecution of Victim; Exceptions.
This subsection states that a victim of bodily mutilation or
chemical castration may not be arrested or prosecuted. The
subsection also provides exceptions for legitimate medical
purposes and is necessary to the health of the minor. However,
the health of a minor does not include a mental health
disorder.
(h) Definitions: This section provides definitions for
terms described above including genital or bodily mutilation
(including female genital mutilation), and chemical castration.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
TITLE 18, UNITED STATES CODE
* * * * * * *
PART I--CRIMES
* * * * * * *
CHAPTER 7--ASSAULT
Sec.
* * * * * * *
[116. Female genital mutilation.]
116. Genital and bodily mutilation of a minor; chemical castration of a
minor.
* * * * * * *
[Sec. 116. Female genital mutilation
[(a) Except as provided in subsection (b), whoever, in any
circumstance described in subsection (d), knowingly--
[(1) performs, attempts to perform, or conspires to
perform female genital mutilation on another person who
has not attained the age of 18 years;
[(2) being the parent, guardian, or caretaker of a
person who has not attained the age of 18 years
facilitates or consents to the female genital
mutilation of such person; or
[(3) transports a person who has not attained the age
of 18 years for the purpose of the performance of
female genital mutilation on such person,
shall be fined under this title, imprisoned not more than 10
years, or both.
[(b) A surgical operation is not a violation of this section
if the operation is--
[(1) necessary to the health of the person on whom it
is performed, and is performed by a person licensed in
the place of its performance as a medical practitioner;
or
[(2) performed on a person in labor or who has just
given birth and is performed for medical purposes
connected with that labor or birth by a person licensed
in the place it is performed as a medical practitioner,
midwife, or person in training to become such a
practitioner or midwife.
[(c) It shall not be a defense to a prosecution under this
section that female genital mutilation is required as a matter
of religion, custom, tradition, ritual, or standard practice.
[(d) For the purposes of subsection (a), the circumstances
described in this subsection are that--
[(1) the defendant or victim 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 conduct described in subsection (a);
[(2) the defendant used a means, channel, facility,
or instrumentality of interstate or foreign commerce in
furtherance of or in connection with the conduct
described in subsection (a);
[(3) any payment of any kind was made, directly or
indirectly, in furtherance of or in connection with the
conduct described in subsection (a) using any means,
channel, facility, or instrumentality of interstate or
foreign commerce or in or affecting interstate or
foreign commerce;
[(4) the defendant transmitted in interstate or
foreign commerce any communication relating to or in
furtherance of the conduct described in subsection (a)
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
manner, including by computer, mail, wire, or
electromagnetic transmission;
[(5) any instrument, item, substance, or other object
that has traveled in interstate or foreign commerce was
used to perform the conduct described in subsection
(a);
[(6) the conduct described in subsection (a) occurred
within the special maritime and territorial
jurisdiction of the United States, or any territory or
possession of the United States; or
[(7) the conduct described in subsection (a)
otherwise occurred in or affected interstate or foreign
commerce.
[(e) For purposes of this section, the term ``female genital
mutilation'' means any procedure performed for non-medical
reasons that involves partial or total removal of, or other
injury to, the external female genitalia, and includes--
[(1) a clitoridectomy or the partial or total removal
of the clitoris or the prepuce or clitoral hood;
[(2) excision or the partial or total removal (with
or without excision of the clitoris) of the labia
minora or the labia majora, or both;
[(3) infibulation or the narrowing of the vaginal
opening (with or without excision of the clitoris); or
[(4) other procedures that are harmful to the
external female genitalia, including pricking,
incising, scraping, or cauterizing the genital area.]
Sec. 116. Genital and bodily mutilation of a minor; chemical castration
of a minor
(a) Genital or Bodily Mutilation.--Except as provided in
subsection (g), whoever, in any circumstance described in
subsection (d), knowingly performs, or attempts to perform,
genital or bodily mutilation on another person who is a minor,
shall be fined under this title, imprisoned not more than 10
years, or both.
(b) Chemical Castration of a Minor.--Except as provided in
subsection (g), whoever, in any circumstance described in
subsection (d), knowingly chemically castrates a minor shall be
fined under this title, imprisoned not more than 10 years, or
both.
(c) Certain Offense Related to Female Genital Mutilation.--
Except as provided in subsection (g), whoever, in any
circumstance described in subsection (d), knowingly--
(1) facilitates or consents to female genital
mutilation of a minor; or
(2) transports a minor for the purpose of the
performance of female genital mutilation on such minor,
shall be fined under this title, imprisoned not more than 10
years, or both.
(d) Circumstances Described.--For the purposes of subsections
(a) and (b), the circumstances described in this subsection are
that--
(1) the defendant or victim 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
conduct described in subsection (a) or (b);
(2) the defendant used a means, channel, facility, or
instrumentality of interstate or foreign commerce in
furtherance of or in connection with the conduct
described in subsection (a) or (b);
(3) any payment of any kind was made, directly or
indirectly, in furtherance of or in connection with the
conduct described in subsection (a) or (b) using any
means, channel, facility, or instrumentality of
interstate or foreign commerce or in or affecting
interstate or foreign commerce;
(4) the defendant transmitted in interstate or
foreign commerce any communication relating to or in
furtherance of the conduct described in subsection (a)
or (b) 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 manner, including by computer, mail, wire,
or electromagnetic transmission;
(5) any instrument, item, substance, or other object
that has traveled in interstate or foreign commerce was
used to perform the conduct described in subsection (a)
or (b);
(6) the conduct described in subsection (a) or (b)
occurred within the special maritime and territorial
jurisdiction of the United States, or any territory or
possession of the United States; or
(7) the conduct described in subsection (a) or (b)
otherwise occurred in or affected interstate or foreign
commerce.
(e) Prohibition on Certain Defense.--It shall not be a
defense to a prosecution under subsection (a) that female
genital mutilation is required as a matter of religion, custom,
tradition, ritual, or standard practice.
(f) Prohibition on Prosecution of Victim.--No person who is
chemically castrated or on whom genital or bodily mutilation is
performed may be arrested or prosecuted for an offense under
this section.
(g) Exceptions.--
(1) Procedures.--
(A) In general.--Genital or bodily mutilation
or chemical castration is not a violation of
this section if such genital or bodily
mutilation or chemical castration is--
(i) necessary to the health of the
minor on whom it is conducted, and is
conducted by a person licensed in the
place of such conduct as a medical
practitioner; or
(ii) in the case of female genital
mutilation, performed on a minor in
labor or who has just given birth and
is performed for medical purposes
connected with that labor or birth by a
person licensed in the place it is
performed as a medical practitioner,
midwife, or person in training to
become such a practitioner or midwife.
(B) Health of a minor.--For the purposes of
subparagraph (A), the health of a minor does
not include--
(i) mental, behavioral, or emotional
distress; or
(ii) a mental, behavioral, or
emotional disorder.
(2) Exemption.--Genital or bodily mutilation or
chemical castration is not a violation of this section
if such genital or bodily mutilation or chemical
castration is conducted with respect to any of the
following individuals:
(A) An individual with both ovarian and
testicular tissue.
(B) 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.
(C) An individual experiencing infection,
disease, injury, or disorder caused or
exacerbated by a previous genital or bodily
mutilation procedure or chemical castration.
(D) An individual suffering from a physical
disorder, physical injury, or physical illness
that would, as certified by a physician, place
the individual in imminent danger of impairment
of a major bodily function unless the procedure
is performed.
(E) An individual diagnosed with precocious
puberty, to the extent such genital or bodily
mutilation or chemical castration is for the
purpose of normalizing puberty.
(h) Definitions.--In this section:
(1) Genital or bodily mutilation.--The term ``genital
or bodily mutilation'' means, with respect to an
individual, any of the following:
(A) Female genital mutilation.
(B) Any surgery performed for the purpose of
changing the body of such individual to
correspond to a sex that differs from their
biological sex, including--
(i) castration;
(ii) orchiectomy;
(iii) scrotoplasty;
(iv) vasectomy;
(v) hysterectomy;
(vi) oophorectomy;
(vii) ovariectomy;
(viii) metoidioplasty;
(ix) penectomy;
(x) phalloplasty;
(xi) vaginoplasty;
(xii) vaginectomy;
(xiii) vulvoplasty;
(xiv) reduction thyrochondroplasty;
(xv) chondrolaryngoplasty; and
(xvi) mastectomy.
(C) Any plastic surgery that feminizes or
masculinizes the facial or other physiological
features for the purposes described in
subparagraph (B).
(D) Any placement of chest implants to create
feminine breasts for the purposes described in
subparagraph (B).
(E) Any placement of fat or artificial
implants in the gluteal region for the purposes
described in subparagraph (B).
(F) Any surgery to reconstruct the fixed part
of the urethra, whether or not such surgery
includes a metoidioplasty or a phalloplasty,
for the purposes described in subparagraph (B).
(2) Chemical castration.-- The term ``chemical
castration'' means administering, supplying,
prescribing, dispensing, distributing, or otherwise
conveying to an individual medications for the purposes
described in paragraph (1)(B), including--
(A) gonadotropin-releasing hormone (GnRH)
analogues or other puberty-blocking drugs to
stop or delay normal puberty;
(B) testosterone or other androgens to
biological females at doses that are
supraphysiologic to the female sex; and
(C) estrogen to biological males at doses
that are supraphysiologic to the male sex.
(3) Biological sex.--The term ``biological sex''
means, with respect to a person, the classification of
the person as male or female at birth.
(4) Female genital mutilation.--The term ``female
genital mutilation'' means any procedure performed for
non-medical reasons that involves partial or total
removal of, or other injury to, the external female
genitalia, and includes--
(A) a clitoridectomy or the partial or total
removal of the clitoris or the prepuce or
clitoral hood;
(B) excision or the partial or total removal
(with or without excision of the clitoris) of
the labia minora or the labia majora, or both;
(C) infibulation or the narrowing of the
vaginal opening (with or without excision of
the clitoris); or
(D) other procedures that are harmful to the
external female genitalia, including pricking,
incising, scraping, or cauterizing the genital
area.
(5) Minor.--The term ``minor'' means any person under
the age of eighteen years.
(6) Male.--The term ``male'' means a person who
naturally has, had, will have, or would have, but for a
congenital anomaly, historical accident, or intentional
or unintentional disruption, the reproductive system
that at some point produces, transports, and utilizes
sperm for fertilization.
(7) Female.--The term ``female'' means a person who
naturally has, had, will have, or would have, but for a
congenital anomaly, historical accident, or intentional
or unintentional disruption, the reproductive system
that at some point produces, transports, and utilizes
eggs for fertilization.
* * * * * * *
Dissenting Views
I oppose H.R. 3492, the so-called Protect Children's
Innocence Act of 2025. This deeply troubling bill would make it
a crime, punishable by up to ten years in prison, to provide
gender-affirming healthcare to minors. It would criminalize
more than a dozen medical interventions and procedures that are
used to treat gender dysphoria, including puberty blockers and
hormone therapy.
One of the basic tactics in every authoritarian's playbook
is to pick out a small minority group in society and scapegoat
them, castigate them, demonize them, eliminate their basic
rights and freedoms, dehumanize them, and deny their very
existence. History is, sadly, replete with examples of this--
Jews and gypsies in Nazi Germany, Christians in Pakistan today,
African Americans in Jim Crow America, gay people in Putin's
Russia, Uyghurs and Tibetans in China. Authoritarians say to
themselves, ``just pick out a minority and mobilize the society
against them, and you won't have to answer tough questions
about your own authoritarianism or corruption.''
Every day, I hear from constituents whose children are
transgender that they are considering leaving this country--
their country--because they fear that this anti-trans campaign
deliberately waged by Republicans have made this country unsafe
for their families.
And, indeed, the campaign of demonization, vilification,
and scapegoating began on his very first day in office, when
President Trump issued an executive order denying the very
existence of transgender Americans.\1\ That is an order that
George Orwell would have recognized well. President Trump's
Administration also purged government websites of any reference
to transgender Americans, just ``disappearing'' them.\2\ He
issued an executive order directing that Americans serving
honorably in the Armed Forces for years or decades be summarily
kicked out for being transgender.\3\ He has threatened to
defund schools just for supporting transgender students.\4\ He
is trying to bully schools into banning transgender girls from
playing sports with other girls.\5\ He ordered transgender
women incarcerated in women's facilities to be immediately
transferred out and placed in male facilities, putting their
bodily safety into jeopardy.\6\
---------------------------------------------------------------------------
\1\Defending Women from Gender Ideology Extremism and Restoring
Biological Truth to the Federal Government, The White House (Jan. 20,
2025), https://www.whitehouse.gov/
presidential-actions/2025/01/defending-women-from-gender-ideology-
extremism-and-restoring-
biological-truth-to-the-federal-government/.
\2\Karen Yourish, et al., Disappearing in the New Trump
Administration, N.Y. Times (Mar. 7, 2025), https://www.nytimes.com/
interactive/2025/03/07/us/trump-federal-agencies-websites-words-
dei.html.
\3\Prioritizing Military Excellence and Readiness, The White House
(Jan. 27, 2025), https://www.whitehouse.gov/presidential-actions/2025/
01/prioritizing-military-excellence-and-readiness/.
\4\Sareen Habeshian, Trump Threatens Funding for Schools that
Accommodate Transgender Children, Axios (Jan. 29, 2025), https://
www.axios.com/2025/01/29/trump-funding-schools-transgender-children.
\5\Marina Dunbar, Trump Signs Executive Order Banning Trans
Athletes from Women's Sports, The Guardian (Feb. 5, 2025), https://
www.theguardian.com/us-news/2025/feb/05/trump-trans-athletes-ban.
\6\Kaley Johnson & Sam Levin, Trans Women Transferred to Men's
Prisons Despite Rulings against Trump's Order, The Guardian (Mar. 7,
2025), https://www.theguardian.com/us-news/2025/mar/07/transgender-
women-prison-trump.
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And now, House Republicans seek to deny and criminalize
transgender youth access to potentially life-saving healthcare,
access to the treatments and medications prescribed to them by
their physicians, following established standards of care, and
in accordance with the wishes of their family. All major
medical associations in America agree evidence-based gender-
affirming care is necessary and, in many instances, life-saving
for transgender youth.\7\ And while my colleagues across the
aisle claim that there are young people across the country
being mutilated by evil, malicious doctors, that is not the
real story.
---------------------------------------------------------------------------
\7\Medical Association Statements in Support of Health Care for
Transgender People and Youth, GLAAD (June 26, 2024), https://glaad.org/
medical-association-statements-supporting-trans-youth-healthcare-and-
against- discriminatory/.
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Like all medical care, gender-affirming care is tailored to
the age and unique needs of individual patients in consultation
with medical doctors, mental health professionals, and--in the
case of youth seeking care--their parents. Before puberty, no
medical treatment is even recommended. And the majority of
medical experts agree that the standards of care for minors
very rarely require surgery. A recent study from the Harvard
T.H. Chan School of Public Health confirmed that U.S. surgeons
are following these guidelines and largely not performing
gender- affirming care that includes surgery on minors.\8\
---------------------------------------------------------------------------
\8\Maya Brownstein, Gender-affirming Surgeries Rarely Performed on
Transgender Youth, Harvard T.H. Chan School of Public Health (July 8,
2024), https://hsph.harvard.edu/news/gender-affirming-surgeries-rarely-
performed-on-transgender-youth/.
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Let's not turn the Congress of the United States into a
supreme medical board for the country that will override not
only states and the localities that protect this type of care
and the medical associations and the physicians, but even the
wishes of the parents. Let's stop attacking transgender kids.
Let's instead fight to support the programs all of us need. My
colleagues recently passed a law that threatens healthcare for
over 37 million children who rely on Medicaid and CHIP, the
Children's Health Insurance Program.\9\ They support cutting
benefits for nearly 15 million children who rely on SNAP
benefits to get adequate nutrition in America.\10\ They want to
gut the Department of Education, which ensures nearly 26
million low-income students and 7.5 million students with
disabilities will have access to meaningful educational
opportunities.\11\
---------------------------------------------------------------------------
\9\An Assault on Children: The Devastating Impact of Proposed
Budget Cuts on America's Kids, First Focus on Children (Apr. 3, 3025),
https://firstfocus.org/resource/an-assault-on-children-the-devastating-
impact-of-proposed- budget-cuts-on-americas-kids/.
\10\Bobby Kogan, Trump's Proposed Sweeping Spending Pause Would
Harm Americans, Center for American Progress (Jan. 28, 2025), https://
www.americanprogress.org/article/trumps-proposed-sweeping-spending-
pause- would-harm-americans/.
\11\Fact Sheet: President Donald J. Trump Empowers Parents, States,
and Communities to Improve Education Outcomes, The White House (Mar.
20, 2025), https://www.whitehouse.gov/fact-sheets/2025/03/fact-sheet-
president-donald-j-trump-empowers-parents-states-and-communities-to-
improve-education-outcomes/; Michael C. Bender & Dana Goldstein,
Education Department Fires 1,300 Workers, Gutting Staff, N.Y. TIMES
(Mar. 11, 2025), https://www.nytimes.com/2025/03/11/us/politics/trump-
education-department-firings.html.
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If we want to talk about children in America, let's talk
about children in America. Let's not demonize and scapegoat
less than one-half of one percent of the population. Somewhere
around 2.8 million people in America are transgender.\12\ So
let's not pounce on them and demonize them and vilify them and
the people who love them and are trying to take care of them.
---------------------------------------------------------------------------
\12\How Many Adults and Youth Identify as Transgender in the United
States?, UCLA School of Law Williams Inst. (Aug. 2025), https://
williamsinstitute.law.ucla.edu/publications/trans-adults-united-
states/.
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H.R. 3492 is the Republicans' latest effort to attack,
demean, and scapegoat transgender Americans. I will not stand
for it. I oppose this legislation, and I urge all of my
colleagues to do the same.
Jamie Raskin,
Ranking Member.
[all]