S.Amdt. 37

SA 37. Mr. LEE submitted an amendment intended to be proposed by him
to the bill S. 316, to repeal the authorizations for use of military
force against Iraq; which was ordered to lie on the table; as follows:

At the appropriate place, insert the following:

SEC. __. PROHIBITING MEDICARE PAYMENTS TO AND ENROLLMENT OF
PROVIDERS WHO FURNISH GENDER-TRANSITION
PROCEDURES TO MINORS.

Section 1862 of the Social Security Act (42 U.S.C. 1395y)
is amended by adding at the end the following:
``(p) Prohibiting Payments to and Enrollment of Providers
Who Furnish Gender-transition Procedures to Minors.--
``(1) In general.--Effective on the date of the enactment
of this subsection--
``(A) no payment may be made under this title with respect
to any item or service that is furnished by a provider of
services or supplier who furnishes a gender-transition
procedure to an individual under the age of 18; and
``(B) a provider of services or supplier who furnishes a
gender-transition procedure to an individual under the age of
18 may not enroll or reenroll in the program under this title
under section 1866(j).
``(2) Definitions.--In this subsection:
``(A) Biological sex.--The term `biological sex' means the
genetic classification of an individual as male or female, as
reflected in the organization of the body of such individual
for a reproductive role or capacity, such as through sex
chromosomes, naturally occurring sex hormones, and internal
and external genitalia present at birth, without regard to
the subjective sense of identity of the individual.
``(B) Gender-transition procedure.--
``(i) In general.--Except as provided in clause (ii), the
term `gender-transition procedure' means--

``(I) the prescription or administration of puberty-
blocking drugs for the purpose of changing the body of an
individual so that it conforms to the subjective sense of
identity of the individual, in the case such identity is at
odds with the individual's biological sex;
``(II) the prescription or administration of cross-sex
hormones for the purpose of changing the body of an
individual so that it conforms to the subjective sense of
identity of the individual, in the case such identity is at
odds with the individual's biological sex; or
``(III) a surgery to change the body of an individual so
that it conforms to the subjective sense of identity of the
individual, in the case such identity is at odds with the
individual's biological sex.

``(ii) Exception.--The term `gender-transition procedure'
does not include--

``(I) an intervention described in clause (i) that is
performed on--

``(aa) an individual with biological sex characteristics
that are inherently ambiguous, such as those born with 46 XX
chromosomes with virilization, 46 XY chromosomes with
undervirilization, or having both ovarian and testicular
tissue; or
``(bb) an individual with respect to whom a physician has
determined through genetic or biochemical testing that the
individual does not have normal sex chromosome structure, sex
steroid hormone production, or sex steroid hormone action,
for a biological male or biological female;

``(II) the treatment of any infection, injury, disease, or
disorder that has been caused or exacerbated by the
performance of an intervention described in clause (i)
without regard to whether the intervention was performed in
accordance with State or Federal law; or
``(III) any procedure undertaken because the individual
suffers from a physical disorder, physical injury, or
physical illness that would, as certified by a physician,
place the individual in imminent danger of death or
impairment of major bodily function unless the procedure is
performed.''.

______