H.R. 5483 — Chloe Cole Act

This section defines terms used in the Act, including: (1) "chemical or surgical mutilation" as the use of puberty blockers, sex hormones, or surgeries intended to halt natural puberty or change an individual's body (including appearance or biological functions) to not correspond to the individual's sex, excluding treatments for verifiable disorders of sexual development, infections/injuries/diseases from prior interventions, certain acute medical conditions (e.g., traumatic injuries, congenital anomalies, high-mortality illnesses), and detransition treatment; (2) "child" as an individual under 18 years of age; (3) "detransition treatment" as any mental health treatment, medical intervention, or surgery that stops/reverses prior chemical or surgical mutilation or helps cope with its effects; (4) "health care professional" as a state-licensed physician or other authorized provider; (5) "mental health professional" as a state-licensed person authorized to diagnose and treat mental health conditions; (6) "participate," with respect to chemical or surgical mutilation, as directly planning, authorizing, prescribing, administering, or performing such acts (e.g., prescribing/administering puberty blockers or hormones, or performing surgeries, with intent to align appearance or function with an identity differing from sex); and (7) "sex" as a person's immutable biological classification as male or female, determined by reproductive system for large (ova) or small (sperm) gametes.

This section prohibits health care professionals, hospitals, or clinics from participating in the chemical or surgical mutilation of a child under any of seven specified circumstances involving interstate or foreign commerce (i.e., (1) travel by the child or defendant in furtherance of the mutilation; (2) use of interstate commerce means by the defendant; (3) payments made using interstate commerce; (4) communications transmitted in interstate commerce; (5) use of items that traveled in interstate commerce; (6) occurrence in the District of Columbia, U.S. territories, or special maritime jurisdiction; or (7) affecting interstate commerce). Such entities may commence treatments qualifying as exceptions under section 2(1)(B)(i)-(iv) only after determining, based on clear and convincing evidence, that the treatment so qualifies.

This section establishes a private right of action allowing individuals subjected as children to chemical or surgical mutilation prohibited by section 3, or their parents or legal guardians, to bring a civil suit for damages against participating health care professionals, hospitals, or clinics in an appropriate U.S. district court, regardless of whether the mutilation occurred before, on, or after the date of enactment. Available damages include (1) compensatory damages for economic losses associated with undoing, correcting, or ameliorating the mutilation's effects; (2) non-economic damages for emotional distress and pain and suffering; and (3) punitive damages if proven by clear and convincing evidence of malicious, intentional, fraudulent, or reckless conduct. After enactment, proven participants are strictly liable for such mutilation, and bear the burden of proving by clear and convincing evidence any exception under section 2(1)(B)(i) through (iv).

This section establishes rules of construction for the Act, specifying that (1) no private right of action exists for counseling, referrals to mental health professionals, or discussions of treatment options—including those available upon reaching adulthood or outside circumstances described in section 3(b)—provided by health care or mental health professionals, if such actions do not constitute participation in chemical or surgical mutilation as defined in section 2; (2) liability for health care professionals under the Act's provisions may not be waived; (3) ambiguities are resolved against any party that engaged in participation in chemical or surgical mutilation as defined in section 2(6); (4) for chemical or surgical mutilation of a child occurring before the date of enactment, deference to prevailing standards of care is limited if those standards contradict the Act's intent and the health care professional knew or should have known they were in serious scientific and medical dispute; and (5) nothing in the Act prohibits health care or mental health professionals from providing information about all treatment options, discussing risks and benefits, or expressing professional medical opinions, if such actions do not constitute participation in chemical or surgical mutilation.

This section establishes a statute of limitations for actions under section 4 of 25 years from the date of the eighteenth birthday of an individual subjected to chemical or surgical mutilation as a child or 4 years from the time the cost of a detransition treatment is incurred, whichever date is later.

This section provides a severability clause, stating that if any provision of the Act or its application to any person or circumstance is held unconstitutional, the remainder of the Act and the application of that provision to other persons or circumstances remains unaffected.