Child welfare agencies would face limits on gender transition care

Covered agencies would have to protect adults from discrimination or harmful agency actions for raising children according to their biological sex. The rules would cover recipients of federal child abuse prevention grants and their workers. Protected adults would include parents, guardians, caregivers, and current or prospective foster or adoptive parents. Raising a child this way includes refusing consent to gender transition treatment. Agencies could still investigate or respond to genuine reports of physical abuse, sexual abuse, or neglect.

Covered foster care settings would have to prohibit gender transition treatment and support. The rules would cover children in state-supervised foster care and placement settings receiving the specified federal foster care funds. The definition covers psychological, medical, or surgical steps intended to change a child's body or appearance away from the child's biological sex. Exceptions would allow treatment of differences in sex development and medical problems caused or worsened by the covered interventions. Covered interventions could not begin or continue when a child is removed from a parent's custody, care, or control.

Covered foster care homes and institutions would have to provide private or sex-separated spaces. The requirements would apply to children age four or older in foster care homes and institutions receiving the specified federal foster care funds. Sleeping quarters shared only with a sibling would be exempt from the separation rule. Covered placement settings would have to meet these requirements to receive a license.

Covered adults and children could bring claims in federal court against funded child welfare agencies. Parents, guardians, caregivers, and current or prospective foster or adoptive parents could sue over protected-rights violations or prohibited agency actions. Children could sue over prohibited agency actions. Courts could award damages or orders stopping violations, but not such orders if the agency proves an immediate risk of serious physical harm from separate conduct. Successful claimants would receive legal fees and court costs.

State courts could not take custody or visitation cases on specified grounds tied to seeking gender transition care or support. The bar would apply when taking the case rests on someone seeking a covered intervention available in that state, including related claims of abuse. Covered interventions include different pronouns. Treatment of differences in sex development is excluded. Emergency care is excluded unless it treats problems caused or worsened by covered interventions.