Federal law criminalizes gender-affirming care for minors, exposing doctors to 10-year felonies

What it does

This bill amends federal law to criminalize genital mutilation, bodily mutilation, and chemical castration of minors, with penalties up to 10 years imprisonment. It defines these terms broadly to include female genital mutilation (FGM), gender-affirming surgeries and puberty blockers, and certain cosmetic procedures, while carving out narrow medical exceptions for health-necessary procedures and intersex conditions. The bill applies when the conduct involves interstate commerce or federal jurisdiction.

Why we flagged it

The bill's operative mechanism is to criminalize a category of medical treatments (gender-affirming care and puberty blockers) by redefining them as 'genital and bodily mutilation' and 'chemical castration.' While the title invokes child protection and references FGM (a harmful non-medical practice), the statutory definitions and exceptions are structured to capture and criminalize standard medical care for transgender and intersex minors.

What the text implies

• The definition of 'chemical castration' includes puberty blockers (GnRH agonists) at any dose, even though these are reversible, FDA-approved, and used in pediatric endocrinology for precocious puberty and gender dysphoria. Physicians prescribing them for either indication face felony liability.
• Subsection (g)(1)(B) excludes mental-health-based medical judgment: 'health of a minor does not include mental, behavioral, or emotional distress' or 'disorder.' This strips physicians of the ability to treat gender dysphoria (a recognized mental-health condition in DSM-5) as a medical indication, even when the treatment is reversible and evidence-based.
• The bill criminalizes physicians, not parents or minors (subsection (f) bars prosecution of victims), but creates a chilling effect: doctors face 10-year felony exposure for providing treatments they believe medically necessary, forcing them to choose between their medical judgment and criminal law.
• Interstate commerce jurisdictional hooks (subsection (d)) are extremely broad—any payment, communication, or instrument crossing state lines triggers federal jurisdiction, ensuring federal prosecution even for local medical care.
• The definitions of 'male' and 'female' (subsections (h)(6)–(7)) are biological-essentialist and exclude intersex individuals with atypical sex chromosomes or hormone production, yet the exemptions (subsection (g)(2)) carve out only narrow intersex conditions, leaving many intersex minors unprotected.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

The bill criminalizes medical treatments (puberty blockers, gender-affirming surgeries) that physicians currently provide to minors with parental consent and medical indication. Minors and their families lose access to treatments their doctors recommend; physicians face 10-year felony exposure for providing standard-of-care medicine. The medical exceptions are narrow and exclude mental-health-based medical judgment, shifting treatment decisions from doctors to prosecutors.

Named in the bill

U.S. Department of Justice, Federal prosecutors, Physicians and surgeons, Pediatric endocrinologists, Gender-affirming care providers, Minors under 18, Parents of transgender and intersex minors

Where it stands

44 cosponsors: 44 Republicans.

• May 19, 2025 — Introduced · Congress.gov: “Introduced in House”
• May 19, 2025 — Referred to House Committee on the Judiciary and Senate Committee on the Judiciary · Congress.gov: “Referred to the House Committee on the Judiciary”
• Jun 10, 2025 — Markup held in committee · Congress.gov: “Committee Consideration and Mark-up Session Held”
• Jun 10, 2025 — Reported out of committee · Congress.gov: “Ordered to be Reported in the Nature of a Substitute (Amended) by the Yeas and Nays: 17 - 10”
• Dec 17, 2025 — Passed the House · Congress.gov: “On passage Passed by the Yeas and Nays: 216 - 211 (Roll no. 351).”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

5 lobbying clients named this bill on 7 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $1,203,908 in lobbying spend. A filing names 97 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 78% of bills with at least one filing.

• American Federation of State County and Municipal Employees — $690,000 on 1 filing
• Human Rights Campaign — $439,908 on 2 filings
• Alliance Defending Freedom — $40,000 on 2 filings
• National Association of Pediatric Nurse Practitioners — $24,000 on 1 filing
• National Council of Jewish Women — $10,000 on 1 filing

Lobbying Disclosure Act filings through Jul 22, 2026. A filing shows who paid to lobby on a bill it names, not what changed.