H.R. 2387 — No Harm Act

This section prohibits the use of federal funds to pay for, sponsor, promote, assist, or support sex-trait altering treatments provided to minors. It authorizes any person, including a taxpayer, to bring a civil action in an appropriate U.S. district court against the United States or a relevant federal department or agency for violations, seeking legal damages and equitable relief.

This section prohibits the use of federal funds for any regulatory or subregulatory action to promote sex-trait altering treatments to minors. It authorizes any person, including a taxpayer, to bring a civil action in an appropriate U.S. district court against the United States or a relevant federal department or agency for violations, seeking legal damages and equitable relief.

This section amends the federal female genital mutilation (FGM) prohibition to clarify that, for purposes of the exception for surgical operations necessary to the health of the person, such necessity does not include change of gender or sex or affirmation of gender or sex. (Thus, gender-affirming genital procedures on minors are not exempt from prosecution as FGM if jurisdictional elements under 18 U.S.C. § 116 are met.)

This section prohibits federal funding to any medical institution—including a hospital, medical school, clinic, public health organization, federally qualified health center, rural health center, or medical practice—that provides sex-trait altering treatments to minors.

This section establishes a parental right to decline sex-trait altering treatment for a minor and prohibits specified federal funds—Medicaid (title XIX of the Social Security Act) or Temporary Assistance for Needy Families (TANF, part A of title IV of such Act)—from being made available to any state that (1) provides such treatment to a minor without consent of both parents or (2) separates a minor from a parent solely based on the parent's refusal to consent to such treatment. (As background, Medicaid provides health coverage primarily to low-income individuals, including children and families; TANF provides cash assistance and related services to low-income families with children.) It further authorizes a minor or parent harmed by a violation to bring a civil action against the United States or a violating state in federal district court for appropriate relief, with actions allowable up to 30 years after the minor reaches the age of majority.

This section prohibits a health care provider from furnishing sex-trait altering treatment to a minor unless, at least 72 hours prior to treatment, the provider (1) holds a consultation with the minor's parents, (2) provides the parents a complete printed list of potential side effects (including permanent risks to fertility and sexual function), and (3) obtains the parents' written informed consent. It authorizes a harmed minor or parent to bring a civil action against the provider in federal district court for appropriate relief, with a statute of limitations of 30 years after the minor attains the age of majority.

This section establishes a federal civil cause of action in U.S. district court against medical practitioners, hospitals, clinics, surgery centers, or other providers for physical, psychological, or physiological harm caused by sex-trait altering treatments performed or prescribed on a minor. Successful plaintiffs are awarded attorney's fees, litigation costs, and treble damages, with actions permitted up to 30 years after the individual attains the age of majority.

This section establishes a right of conscience for health care providers, prohibiting any penalties, retaliation, or discrimination against a provider who declines to perform, refer for, pay for, participate in, provide or sponsor coverage for, or facilitate or arrange sex-trait altering treatment. It withholds specified federal funds administered by the Department of Health and Human Services from any state that requires a health care provider to provide such treatment. The section authorizes harmed providers to bring civil actions for injunctive relief, declaratory relief, and compensatory damages and defines "health care provider" broadly to include individuals (e.g., physicians, nurses, pharmacists), facilities (e.g., hospitals, pharmacies), organizations (e.g., accountable care organizations, health maintenance organizations), insurers, health plans, and training programs.

This section prohibits federal funds from being provided to an elementary school or secondary school that allows school personnel to provide, assist in providing, or otherwise support sex-trait altering treatment to a student without notifying the student's parents and receiving their written approval. For this purpose, school personnel includes teachers, paraprofessionals, school leaders, specialized instructional support personnel, volunteers performing services for a school, and other support staff employed by or performing services for a school on a contractual basis; the terms elementary school, paraprofessional, parent, school leader, secondary school, and specialized instructional support personnel have the meanings given those terms in section 8101 of the Elementary and Secondary Education Act of 1965.

This section establishes definitions for terms used in the Act, including "(1) sex-trait altering treatment" as medical or surgical services related to gender transition (excluding excepted services such as those for disorders of sex development, emergencies, infections caused by such treatments, or mental health services); "(2) sex" as the biological indication of male or female (i.e., sex chromosomes, naturally occurring gametes, gonads, and nonambiguous genitalia at birth); "(3) gender transition hormone therapy" as testosterone, estrogen, or progesterone administered in amounts exceeding normal endogenous production; "(4) gender reassignment surgery," "(7) genital gender reassignment surgery," and "(8) nongenital gender reassignment surgery" as procedures to alter typical sex characteristics to resemble the opposite sex; "(9) puberty blocking drugs" as gonadotropin analogues or antiandrogens used for gender transition; and "(11) minor" as an individual under 18 years of age.