H.R. 7651 — Chloe Cole Act of 2026

This section establishes definitions for terms used in the Act, including (1) "child" as an individual under 18 years of age; (2) "covered intervention" as providing puberty blockers (including gonadotropin releasing hormone agonists and antagonists), sex hormones (such as androgen blockers, estrogen, anti-estrogen, progesterone, testosterone, or dihydrotestosterone blockers), or surgical procedures intended to delay, halt, or disrupt puberty or change an individual's body (including external appearance or biological functions) to no longer correspond to the individual's sex, excluding treatments for verifiable disorders of sexual development, complications from prior interventions, or conditions affecting major organ systems (e.g., traumatic injuries, congenital anomalies, acute illnesses); (3) "detransition treatment" as any treatment, intervention, or surgery that stops, reverses the effects of, or aids recovery from a prior covered intervention; (4) "health care professional" as an individual licensed, certified, or authorized by state law to provide health care; (5) "participate" in a covered intervention as directly engaging in its planning, authorization, prescription, administration, or performance (e.g., prescribing or administering relevant medications or performing relevant surgeries with specified intent, or authorizing or coordinating them); and (6) "sex" as a person's immutable biological classification as male or female, determined by reproductive systems for large gametes (ova) or small gametes (sperm), respectively.

This section establishes a private right of action in an appropriate U.S. district court for damages against any health care professional, hospital, or clinic that participates in a covered intervention on a child. Such actions may be brought by the individual subjected to the intervention or by their parents or legal guardians and apply regardless of whether the intervention occurred before, on, or after the date of enactment. Damages include (1) compensatory damages, including economic damages to undo, correct, or ameliorate effects; (2) non-economic damages for emotional distress and pain and suffering; and (3) punitive damages if the defendant acted maliciously, intentionally, fraudulently, or recklessly as proven by clear and convincing evidence. The section imposes strict liability on providers for any covered intervention on a child after enactment if proven by clear and convincing evidence, with defendants bearing the burden to prove by clear and convincing evidence any exception under section 2(2)(B)(i)-(iii) raised as an affirmative defense. Federal jurisdiction exists if any of the following circumstances apply: (1) the defendant or child traveled in interstate or foreign commerce in connection with the intervention; (2) the defendant used an interstate commerce means, channel, facility, or instrumentality in connection with the intervention; (3) any payment related to the intervention used or affected interstate commerce; (4) the defendant transmitted any related communication in interstate commerce; (5) an item that traveled in interstate commerce was used in the intervention; (6) the intervention occurred in the District of Columbia, special maritime and territorial jurisdiction, or any U.S. territory or possession; or (7) the intervention otherwise occurred in or affected interstate or foreign commerce.

This section establishes rules of construction for the Act's liability provisions applicable to health care professionals. Specifically, it (1) prohibits waiver of liability for participation in a covered intervention on a child; (2) requires ambiguities to be resolved against any party that participated in such an intervention; (3) limits deference to prevailing standards of care for pre-enactment interventions to the extent those standards contradict the Act's intent and the professional knew or should have known they were in serious scientific and medical dispute; and (4) permits health care professionals to provide information on treatment options, discuss risks and benefits, or express professional medical opinions without constituting participation in a covered intervention.

This section establishes a statute of limitations for actions under section 3 of 25 years from the date of the eighteenth birthday of an individual subjected to a covered intervention as a child or within 4 years from the time the cost of a detransition treatment is incurred, whichever date is later.

This section includes a severability clause, providing 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 the provision to other persons or circumstances shall not be affected.