Bill would restrict gender-related care through child-welfare funding rules

The U.S. health secretary would limit how recipients use federal child-welfare money and enforce the conditions by withholding or recovering funds and imposing penalties. The conditions would cover funded states, Tribes, and public or private organizations, including subrecipients, and could apply across every operation of a covered organization. Covered interventions include psychological or medical care, clothing, and access to sex-separated activities or spaces when intended to help a child reject or appear unlike the child's sex as the bill defines it. Written parental consent would be required before funded entities use pronouns or titles that do not match that defined sex; children age 4 or older would use private spaces separated on the same basis. Treatment for differences of sex development and for illnesses or injuries caused or worsened by covered interventions is excluded. Penalties would rise from 5% to 15% of a grant period's funds, with a 15% total cap for one recipient during that period.

Covered people could file in federal court without first finishing state or agency appeals. Potential plaintiffs would include parents, guardians, caregivers, children, foster parents, and prospective foster or adoptive parents affected by listed child-welfare or placement actions. A case document linking affirmation of a child's sex to the challenged action would create a presumption against the defendant, which must be disproved with strong evidence. Courts could block actions and award compensation for losses or emotional distress, but could not block an action if doing so would create an imminent risk of serious physical harm from separate conduct. Qualified immunity would not protect individual workers, and funding recipients would waive state or Tribal immunity from these suits. A claim generally would be due within four years after the person knew or reasonably should have known of the violation, or after an ongoing violation ended; extensions would apply for minors and related child-welfare cases.

State courts would be barred from taking or giving up authority over certain custody and visitation cases involving a covered intervention. The restrictions would apply when a party or child seeks a covered intervention in a state offering it, or when that request forms the basis for claimed custody authority. The rule would also cover abuse or safety claims based on seeking a covered intervention; a parent or guardian's refusal to consent could not itself count as abuse or an unsafe home. A court in a state that prohibits the intervention could not decline a custody modification when the child received or seeks the intervention in another state.