S. 4426 — STOP Act

This section establishes definitions for terms used in the Act, including (1) "caretaker," meaning an adult non-parent with whom a child resides and who provides parental-level care, maintenance, and supervision; (2) "detransition treatment," meaning any treatment, including mental health services, medical intervention, or surgery, that stops or reverses gender transition effects or helps cope with prior effects; (3) "female," meaning a natural person with a reproductive system that produces, transports, and utilizes eggs for fertilization (absent congenital anomaly or disruption); (4) "gender transition," meaning a process halting natural body development to mismatch sex, transforming appearance to the opposite sex, or altering/removing sexual organs; and (5) "gender transition procedure," meaning specified hormonal, pharmaceutical, or surgical interventions (listing 34 procedures, e.g., puberty blockers, cross-sex hormones, mastectomy, phalloplasty, vaginoplasty) for gender transition purposes, excluding treatments for disorders of sex development, infections/injuries from prior procedures, imminent physical dangers unrelated to mental distress, detransition restoration, precocious puberty, and male circumcision. (The definition of "male" is incomplete in the provided text.)

This section prohibits any person from knowingly performing, attempting to perform, conspiring to perform, or aiding or abetting a gender transition procedure on a minor if the conduct involves an interstate or foreign commerce nexus (e.g., travel, payments, communications, or use of instruments across state lines; occurrence in federal jurisdictions; or other interstate activity). It holds employers and contractors jointly and severally liable with their employees or workers for violations occurring in the scope of employment or contracted services. This section authorizes the Secretary to impose civil monetary penalties of not less than $100,000 per violation (considering factors such as nature, gravity, culpability, and prior violations), with collection by civil action from the Attorney General; penalties may be compromised by the Secretary but not below $100,000, standard medical practice is not a defense, and no penalties apply to the minor, parent, guardian, or caretaker.

This section establishes a grant program administered by the Secretary to support individuals seeking to reverse gender transition procedures, awarding grants to private nonprofit entities for providing information and referrals—or direct provision of—(1) medical advice and care to reverse such procedures, (2) education and employment assistance including high school completion support, and (3) voluntary mental health and substance use disorder services. Eligible entities must submit applications with assurances of deidentified reporting, no charges to individuals, provision of accurate reversal information, and HIPAA-comparable privacy protections; entities are ineligible if they or affiliates perform, induce, refer for, or counsel in favor of gender transition procedures or abortions (except in cases of rape, incest, or physician-certified life-threatening physical conditions). Grant funds are prohibited from use for gender transition procedures or abortions (same exceptions), or requiring any person to perform or facilitate abortions; the Secretary must prioritize applicants with demonstrated capacity in detransition services and monitor grantees for compliance, ceasing funding for noncompliance.