Prohibition on coverage of gender-related medical treatment under TRICARE

(a) TRICARE (1) In general Chapter 55 of title 10, United States Code, is amended by inserting after section 1076f the following new section: 1076g. TRICARE program: prohibition on coverage and furnishment gender-related medical treatment (a) Prohibition Except as provided by subsection (b), medical care under section 1076 of this title with respect to members of the armed forces and dependents of such members does not include gender-related medical treatment, and the Secretary of Defense may not furnish any such treatment. (b) Exceptions The prohibition in subsection (a) shall not apply to medical treatment provided for purposes of treating— (1) a disorder of sex development, diagnosed by a physician after such physician has determined through genetic or biochemical testing that such minor does not have normal sex chromosome structure, sex steroid hormone production, or sex steroid hormone action; (2) irresolvably ambiguous biological sex characteristics of such minor, including the presence of— (A) 46 XX chromosomes with virilization; (B) 46 XY chromosomes with undervirilization; or (C) both ovarian and testicular tissue; or (3) an infection, injury, disease, or disorder caused or exacerbated by gender-related medical treatment. (c) Definitions In this section: (1) The term female means an individual who naturally has, had, will have, or would have, but for a developmental or genetic anomaly or historical accident, the reproductive system that at some point produces, transports, and utilizes eggs for fertilization. (2) The term gender — (A) means— (i) males, females, or the natural differences between males and females, unless such term is otherwise specified or used alone (rather than with or as an adjective modifying other words); and (ii) is a synonym for sex; and (B) does not mean gender identity, experienced gender, gender expression, or gender roles. (3) The term gender-related medical treatment means— (A) with respect to a female individual, medical treatments provided for purposes of addressing the perception of such individual that the gender or sex of such individual is not female, including— (i) surgical procedures, including— (I) vaginectomy; (II) hysterectomy; (III) oophorectomy; (IV) reconstruction of the urethra; (V) metoidioplasty; (VI) phalloplasty; (VII) salpingo-oophorectomy; (VIII) scrotoplasty; (IX) implantation of erection or testicular protheses; (X) subcutaneous mastectomy; (XI) vocal cord surgery; (XII) pectoral implants; and (XIII) penile transplantation; (ii) exogenous doses of testosterone or other androgens; and (iii) puberty blockers, including— (I) GnRH agonists; and (II) synthetic drugs that suppress the production of estrogen and progesterone or delay or suppress pubertal development in female individuals; and (B) with respect to a male individual, medical treatments provided for purposes of addressing the perception of such individual that the gender or sex of such individual is not male, including— (i) surgical procedures, including— (I) penectomy; (II) orchiectomy; (III) vaginoplasty; (IV) clitoroplasty; (V) vulvoplasty; (VI) augmentation mammoplasty; (VII) facial feminization surgery; (VIII) vocal cord surgery; (IX) chondrolaryngoplasty; (X) gluteal augmentation; and (XI) uterine transplantation; (ii) exogenous doses of estrogen; and (iii) puberty blockers, including— (I) GnRH agonists; and (II) synthetic drugs that suppress the production of testosterone or delay or suppress pubertal development in male individuals. (4) The term male means an individual who naturally has, had, will have, or would have, but for a developmental or genetic anomaly or historical accident, the reproductive system that at some point produces, transports, and utilizes sperm for fertilization. (5) The term sex means the biological determination as to whether an individual is male or female. (d) Rule of construction Nothing in this section may be construed to entitle an individual to medical care under this chapter for which they are not otherwise entitled to under this chapter.. (b) Conforming amendments Such chapter is further amended as follows: (1) In section 1077(b), by adding at the end the following: (4) Treatment prohibited under section 1076g of this title with respect to members of the armed forces and dependents of such members.. (2) In section 1079(a)(20), by striking that could result in sterilization.