HouseH.R. 10745119th Congress
Yaeli Martinez Child Protection Act
Full Text
Official text as published. Use Ctrl+F / Cmd+F to search within the document.
[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10745 Introduced in House (IH)]
<DOC>
119th CONGRESS
2d Session
H. R. 10745
To prevent the removal of children for sex-rejecting interventions.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 5, 2026
Mrs. Miller of Illinois (for herself, Mr. Brecheen, Mrs. Biggs of South
Carolina, Mr. Moore of Alabama, Mr. Fine, Mr. Rose, Mr. Alford, Mr.
McCormick, Mr. Aderholt, Mr. Stutzman, Mrs. Houchin, Mrs. Harshbarger,
Mr. Harris of North Carolina, and Mr. Ogles) introduced the following
bill; which was referred to the Committee on Education and Workforce,
and in addition to the Committees on the Judiciary, and Ways and Means,
for a period to be subsequently determined by the Speaker, in each case
for consideration of such provisions as fall within the jurisdiction of
the committee concerned
_______________________________________________________________________
A BILL
To prevent the removal of children for sex-rejecting interventions.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Yaeli Martinez
Child Protection Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Intent; authority.
Sec. 4. Rules of Construction.
Sec. 5. Severability.
TITLE I--AMENDMENTS TO THE CHILD ABUSE PREVENTION AND TREATMENT ACT
Sec. 101. Grants to States for child abuse or neglect prevention and
treatment programs.
Sec. 102. Restrictions on uses of funds; protection of parental rights.
Sec. 103. Reports.
Sec. 104. Definitions.
Sec. 105. Rule of construction.
Sec. 106. Private right of action.
TITLE II--AMENDMENTS TO THE SOCIAL SECURITY ACT
Sec. 201. Amendments to part B of title IV of the Social Security Act.
Sec. 202. Amendments to part E of title IV of the Social Security Act.
Sec. 203. Amendments to the John H. Chafee Foster Care Program for
Successful Transition to Adulthood.
Sec. 204. Rules of construction; application to funding restrictions
under parts B and E of title IV of the
Social Security Act.
Sec. 205. Amendment to section 478 of the Social Security Act.
TITLE III--AMENDMENTS TO THE FULL FAITH AND CREDIT FOR CHILD CUSTODY
DETERMINATIONS
Sec. 301. Full faith and credit for child custody determinations.
SEC. 2. FINDINGS.
Congress finds as follows:
(1) Parents have the fundamental right under the
Constitution of the United States to direct the care,
upbringing, education, and welfare of their children, including
raising, treating, caring for, and referring to a child in a
manner consistent with the child's sex.
(2) Parents have the fundamental right to make health care
decisions for the purpose of protecting their child's bodily
integrity, development, and emotional and mental health.
(3) Parents have a right under the First Amendment to the
Constitution of the United States to direct the religious
upbringing of their children, including to inculcate the belief
that all humans are created male or female and to raise their
child as the child's sex in accordance with their religious
beliefs.
(4) No child should be removed from his or her family by
the State, or denied foster or adoptive placement, for the
purpose of subjecting the child to social, medical, or surgical
sex-rejecting interventions by the State.
(5) Raising a child according to his or her sex is not
abuse.
(6) Congress and the Supreme Court have long recognized
that parents possess the fundamental right to raise their
children in accordance with their beliefs, including through
Meyer v. Nebraska, 262 U.S. 390 (1923), Pierce v. Society of
Sisters, 268 U.S. 510 (1925), Quilloin v. Walcott, 434 U.S. 246
(1978), Parham v. J.R., 442 U.S. 584 (1979), Troxel v.
Granville, 530 U.S. 57 (2000), and Mahmoud v. Taylor, 606 U.S.
522 (2025). The Supreme Court, in Troxel v. Granville, 530 U.S.
57 (2000), held that ``the interest of parents in the care,
custody, and control of their children--is perhaps the oldest
of the fundamental liberty interests recognized by this
Court''.
(7) The right of parents to direct the upbringing and care
of their children, including the right to make medical
decisions on behalf of their children, is a fundamental liberty
interest protected by the Due Process Clause of the Fourteenth
Amendment to the Constitution of the United States, including
through Meyer v. Nebraska, 262 U.S. 390 (1923), Pierce v.
Society of Sisters, 268 U.S. 510 (1925), Parham v. J.R., 442
U.S. 584 (1979), and Troxel v. Granville, 530 U.S. 57 (2000).
(8) The Supreme Court has recognized that these
constitutional protections rest on the presumption that parents
love their children and possess what a child lacks in maturity,
experience, and capacity for judgment. The Supreme Court, in
Parham v. J.R., 442 U.S. 584 (1979), affirmed that parents
``have always been presumed to act in the best interests of
their children in making medical decisions''.
(9) The Supreme Court has stated, in Quilloin v. Walcott,
434 U.S. 246 (1978), that, absent a clear and convincing
finding of unfitness of parental abuse, neglect, or
abandonment, the State may not lawfully intervene in the
parent-child relationship. The Supreme Court has held that--
(A) ``the Due Process Clause does not permit a
State to infringe on the fundamental right of parents
to make child rearing decisions simply because a state
judge believes a `better' decision could be made''
(Troxel v. Granville, 530 U.S. 57 (2000)); and
(B) ``[s]imply because the decision of a parent is
not agreeable to a child or because it involves risks
does not automatically transfer the power to make that
decision from the parents to some agency or officer of
the state'' (Parham v. J.R., 442 U.S. 584 (1979)).
(10) A parent's decision to affirm a child's sex and
protect him or her from the harms of sex-rejecting
interventions is an exercise of fundamental parental rights.
Raising a child according to his or her sex is not abuse,
neglect, or maltreatment.
(11) The Supreme Court has recognized in United States v.
Skrmetti, 605 U.S. 495 (2025) that sex-rejecting interventions
are not settled science, that the gender distress of a child is
not immutable, and that the state may reasonably protect a
child from the harms of sex-rejecting interventions. Likewise,
parents have the right to make a reasonable choice in the best
interest of their child, to preserve for that child a future
free from these harms.
(12) The Supreme Court has recognized in Mahmoud v. Taylor,
606 U.S. 522 (2025), the rights of parents to direct the
religious upbringing of their children and that those rights
are violated by government policies that substantially
interfere with the religious development of children, including
where promotion of gender ideology would impose a substantial
burden on their religious beliefs.
(13) And yet, parents across the United States have
suffered grievous interference with their constitutional
rights. State child protection agencies and courts have
intervened forcefully to remove children from fit parents and
deny placement of children with foster and adoptive parents
simply because parents refuse to affirm a child's rejection of
his or her sex, or consent to social, medical or surgical sex-
rejecting interventions.
(14) State and Federal policies that require parental
``affirmation'' of a child's rejection of his or her sex are at
odds with the best available science, which recognizes the
evidence for sex-rejecting interventions is weak while the
risks of physical and psychological harm are high. This
unfavorable risk-benefit ratio has been clearly established in
the 2025 report of the Department of Health and Human Services,
titled ``Treatment for Pediatric Gender Dysphoria: Review of
Evidence and Best Practices'', and through multiple systematic
reviews conducted in the United Kingdom, Sweden, Finland, and
other countries. Risks include cancer, loss of bone density,
impaired cognitive development, adverse psychiatric events,
loss of sexual function, and infertility and sterility.
(15) The scientific literature shows that, in most
children, gender dysphoria resolves by adulthood if the child
is not medicalized or treated as the opposite sex. Affirmation
of a child's sex is consistent with both long-term health
outcomes and the child's natural developmental trajectory.
(16) Federal funds should not be used to mandate, promote,
or implement protocols treating sex-rejecting interventions as
evidence-based, safe, or in the best interests of children.
(17) Despite the lack of evidence for sex-rejecting
interventions, for many years, State child welfare systems have
trained personnel, from social workers to judges, to treat as
unsafe or abusive parents who decline to consent to these
interventions for their child.
(18) This training has resulted in States removing children
from loving families and denying the placement of children with
prospective foster and adoptive parents, on the sole or primary
basis that they affirm the child's sex.
(19) Removal from fit parents is contrary to the best
interests of children, creates trauma for the child, damages
familial bonds, and exposes the child to well-documented risks
in state custody. Children have suffered great harm and even
have died after being removed from loving families by the state
for sex-rejecting interventions.
(20) Where States have banned placement with foster and
adoptive parents on the grounds of their scientific or
religious convictions about sexuality, thousands of safe and
welcoming homes have been lost to the foster system, further
endangering children in desperate need.
(21) Children in foster care and State residential settings
are among the most vulnerable populations in the Nation; many
have experienced prior abuse or trauma. Sex-separated
facilities provide an essential safeguard for these children's
safety and well-being, and yet many State foster facilities now
house minor females with males.
(22) Many States have passed laws or enacted policies
arrogating custody to themselves if a child runs to or is taken
by an adult to the State for sex-rejecting interventions in
gross disregard of lawful custody orders and parental rights in
another State.
(23) These measures amount to State-sanctioned kidnapping
and directly conflict with the Full Faith and Credit Clause and
the Supremacy Clause of the Constitution of the United States
and the amendments made by the Parental Kidnapping Prevention
Act of 1980 (Public Law 96-611; 94 Stat. 3568).
(24) State policies offering free sex-rejecting
interventions to children have enticed many children to run
away from fit and loving parents who seek to protect them.
Nonprofit entities, including State and Federal-funded
entities, have encouraged and aided children in running away to
avoid the lawful authority and care of their parents.
(25) Federal funds provided under the Child Abuse
Prevention and Treatment Act (42 U.S.C. 5101 et seq.) and
subtitles B and E of title IV of the Social Security Act (42
U.S.C. 601 et seq.) have been used, directly or indirectly, to
fund investigations, removals, trainings, and programs that
treat parental affirmation of a child's sex as evidence of
child abuse, neglect, emotional abuse, or parental unfitness or
incapacity.
(26) Such uses of Federal funds are inconsistent with
Federal law, interstate compacts on juvenile runaways, multi-
State laws governing court jurisdiction over child custody
matters, the constitutional rights of parents, and the best
interests of children.
(27) The Federal child welfare system is premised on the
principle that child removal from parents is an extreme measure
of last resort, to be employed only when the child faces a
genuine risk of abuse or neglect that cannot be remediated
through less drastic means. Employing that system to remove
children from parents who are exercising their fundamental
constitutional right to raise their children in a manner
consistent with their sex distorts the purpose of the system,
causes serious harm to families, and undermines public
confidence in child welfare institutions.
(28) Parents and children have suffered unwarranted but
irreparable harm when their own or another State has wrongfully
asserted authority over the child in order to provide sex-
rejecting interventions against the parent's will.
(29) Existing State remedies and administrative processes
have failed to provide timely or effective relief for
violations of fundamental parental rights by public officials
or private entities exercising State-derived authority. Child
welfare systems and courts have compounded these violations by
drawing out proceedings past the age of majority, rendering
cases moot and injustice permanent.
(30) Congress must act to prevent the ongoing misuse of
public funds, harm to children in State care, and destruction
of families by the ideological weaponization child welfare
systems. Clear national standards for the use of Federal child
welfare funds, public accountability, and the establishment of
a clear cause of action against State child welfare services
and their employees and contractors are necessary to deter harm
to children and violations of parental rights and to ensure
meaningful remedies.
SEC. 3. INTENT; AUTHORITY.
(a) Intent.--It is the intent of Congress--
(1) to reaffirm and protect the fundamental right of
parents to direct the care, upbringing, education, and welfare
of their children, including the right to raise, care for,
treat, and refer to them in a manner consistent with the
child's sex;
(2) to stop the weaponization of the child welfare system
against parents who affirm their child's sex or decline to
consent to sex-rejecting interventions;
(3) to deter violations of parental rights by State actors,
nonprofit entities or other entities and persons exercising
State-delegated authority over child custody, placement, or
care;
(4) to protect children in foster care, residential
placements, and other out-of-home settings from being subjected
to sex-rejecting interventions or endangered by failure to
provide sex-separated sleeping, toileting, bathing, and other
facilities in which a child may be in a state of undress;
(5) to provide clear notice and training of constitutional
obligations within child welfare systems;
(6) to ensure that Federal funds are not used by States or
by private State-designated or State-funded entities to violate
the fundamental rights of parents or to enforce or further the
provision of sex-rejecting interventions to minors;
(7) to ensure that professional training, clinical
protocols, and administrative guidance funded with Federal
monies do not characterize parental affirmation of a child's
sex as child abuse, neglect, emotional abuse, or evidence of
parental unfitness or incapacity;
(8) to ensure that Federal funds are spent in accordance
with evidence-based practices that support child safety, family
preservation, and child well-being, and not on programs,
trainings, or protocols that promote sex-rejecting
interventions for children or that treat parental affirmation
of a child's sex as harmful to the child;
(9) to ensure that children in State care are housed on the
basis of their immutable sex;
(10) to provide parents, legal guardians, caregivers, and
children with access to meaningful and timely judicial relief
when rights recognized and established by this Act, including
the amendments made by this Act, are infringed through the
express provision of a right of action;
(11) to affirm that referring to the child by pronouns or
titles consistent with the child's sex, declining to consent to
puberty-blocking drugs or cross-sex hormones, and declining to
facilitate social, medical, or surgical sex-rejecting
interventions do not constitute child abuse, neglect, emotional
abuse, or maltreatment under Federal law; and
(12) to preserve the integrity of interstate custody
proceedings and prohibit courts of another State from assuming
jurisdiction over child custody or visitation on the basis of a
parent's or child's desire to obtain sex-rejecting
interventions.
(b) Authority.--This Act is enacted pursuant to the following
authorities of Congress:
(1) Section 5 of the Fourteenth Amendment to the
Constitution of the United States, to enforce the guarantees of
due process and equal protection for fundamental rights,
specifically the fundamental parental right to custody and care
of their child and to direct the upbringing, care, and control
of their child.
(2) The Spending Clause under section 8 of article I of the
Constitution of the United States, by which Congress may
condition the receipt of Federal funds on States' agreement to
comply with specific requirements related to the purposes of
the funded programs (South Dakota v. Dole, 483 U.S. 203
(1987)). The conditions established by this Act, including the
amendments made by this Act relate to the Federal interest in
child welfare, child safety, family preservation, and the
protection of parental rights.
(3) The Full Faith and Credit Clause of section 1 of
article IV of the Constitution of the United States, which
grants Congress the power to prescribe the manner in which full
faith and credit shall be given to the public acts, records,
and judicial proceedings of each State.
(4) The Commerce Clause of section 8 of article I of the
Constitution of the United States, to the extent that the
activities regulated substantially affect interstate commerce,
including the interstate movement of children across State
lines in the context of custody proceedings, foster care
placements, and the administration of federally funded child
welfare programs.
SEC. 4. RULES OF CONSTRUCTION.
(a) In General.--This Act shall be construed--
(1) broadly, with respect to the protection of
constitutional parental rights; and
(2) narrowly, with respect to any asserted justification
for government interference with constitutional parental
rights.
(b) Effect on Other Laws.--Nothing in this Act shall--
(1) limit the authority of child protective services
agencies to investigate or respond to genuine reports of
physical abuse, sexual abuse, or neglect of children; or
(2) preempt any State law that provides greater protection
to parents, legal guardians, or children than the rights
established by this Act, including the amendments made by this
Act.
(c) Construction of Terms Relating to Child Welfare and Affirmation
of a Child's Sex.--For purposes of this Act, including the amendments
made by this Act, the terms ``child abuse'', ``emotional abuse'',
``neglect'', ``maltreatment'', ``mistreatment'', ``parental unfitness
or incapacity'', and ``abandonment'' shall not be construed to include
affirming a child's sex, nor shall affirming a child's sex be construed
as contrary to the best interest of the child, or as contrary to a
child's safety, health, well-being, or welfare.
SEC. 5. SEVERABILITY.
If any provision of this Act, an amendment made by this Act, or the
application of such provision or amendment to any person or
circumstance is held to be invalid or unenforceable by any court of
competent jurisdiction, the remainder of this Act, the amendments made
by this Act, and the application of such provision or amendment to any
other person or circumstance shall not be affected thereby.
TITLE I--AMENDMENTS TO THE CHILD ABUSE PREVENTION AND TREATMENT ACT
SEC. 101. GRANTS TO STATES FOR CHILD ABUSE OR NEGLECT PREVENTION AND
TREATMENT PROGRAMS.
Section 106 of the Child Abuse Prevention and Treatment Act (42
U.S.C. 5106a) is amended--
(1) in subsection (b)--
(A) in paragraph (2)--
(i) in subparagraph (B)--
(I) in clause (vii), by inserting
``, except to the extent that such
report relates to a claim or suspicion
of child abuse based on a parent or
guardian affirming a child's sex''
before the semicolon at the end;
(II) in clause (xxiv), by striking
``; and'' and inserting a semicolon;
and
(III) by adding at the end the
following:
``(xxvi) provisions and procedures for--
``(I) protecting and promoting
children's right to be free from sex-
rejecting interventions; and
``(II) protecting children from the
use, without express parental consent,
of pronouns or titles that do not
correspond to the child's sex;
``(xxvii) provisions and procedures for
training child protective service workers,
guardians ad litem, minor's counsel, court
appointed special advocates, judges, and other
individuals providing services to children and
families on--
``(I) the medical, psychological,
and developmental harms of sex-
rejecting interventions to children and
the harms of using pronouns or titles
that do not correspond to a child's
sex;
``(II) the right of a parent or
legal guardian to affirm a child's sex
and of a parent, legal guardian,
caregiver, foster parent, or
prospective foster or adoptive parent
to be free from discrimination or
adverse State actions for affirming a
child's sex;
``(III) the principle that
affirmation of a child's sex by a
parent, legal guardian, caregiver,
foster parent, or prospective foster or
adoptive parent is not child abuse,
emotional abuse, neglect, maltreatment,
abandonment, contrary to the child's
best interest, contrary to the child's
health, safety, or welfare, or an
indication of parental unfitness or
incapacity; and
``(IV) the principle that
affirmation of a child's sex is
consistent with the child's best
interests, health, safety, and welfare;
and
``(xxviii) provisions and procedures
requiring any covered entity described in
section 111(a)(5)(A) to have in effect policies
and procedures that protect and promote the
right of a parent, legal guardian, or caregiver
to be free from any adverse State action.'';
(ii) in subparagraph (F), by striking ``;
and'' and inserting a semicolon;
(iii) in subparagraph (G), by striking the
period and inserting a semicolon; and
(iv) by adding at the end the following:
``(H) an assurance in the form of a certification
by the governor of the State that the programs,
projects, or trainings conducted or funded under this
title do not violate the limitations set forth in
section 115; and
``(I) an assurance in the form of a certification
by the governor of the State that the programs,
projects, or trainings conducted under this subchapter
comply with clauses (xxvi) through (xxviii) of
subparagraph (B).''; and
(B) in paragraph (3)--
(i) by striking ``such a disclosure where a
court orders'' and inserting ``such a
disclosure where--
``(A) a court orders'';
(ii) by striking the period and inserting a
semicolon; and
(iii) by adding at the end the following:
``(B) a report includes an allegation that the
child is being affirmed as his or her sex; or
``(C) the child has expressed a desire to be
treated in a manner that does not correspond to his or
her sex or has requested sex-rejecting
interventions.'';
(2) in subsection (c)(4)(B)(i)(I), by inserting ``, except
as requested by the Secretary'' before the semicolon;
(3) in subsection (d), by adding at the end the following:
``(19) Of the number of children described in paragraph
(1), the number who identify in a manner that does not
correspond to their sex and--
``(A) who were reported to the State to have run
away from home or eloped from a placement;
``(B) who have been given a placement outside of
the home;
``(C) who were removed from parent, legal guardian,
or caregiver; or
``(D) whose parents had their parental rights
terminated.''; and
(4) by adding at the end the following:
``(g) Scope of Application.--For purposes of clauses (xxvi) through
(xxviii) of subsection (b)(2)(B), if any covered entity described in
section 111(a)(5)(A) receives funds under this title, directly or as a
recipient of a subgrant, the provisions and procedures described in
such clauses shall apply to all of the operations, divisions,
facilities, or programs of that covered entity, regardless of whether
the specific operation, division, facility, or program received such
funds.''.
SEC. 102. RESTRICTIONS ON USES OF FUNDS; PROTECTION OF PARENTAL RIGHTS.
Title I of the Child Abuse Prevention and Treatment Act (42 U.S.C.
5101 et seq.) is amended by adding at the end the following:
``SEC. 115. RESTRICTIONS ON USES OF FUNDS; PROTECTION OF PARENTAL
RIGHTS.
``(a) In General.--In administering, enforcing, or awarding funds
under this title, the Secretary shall not treat affirmation of a
child's sex by a parent, legal guardian, caregiver, foster parent, or
prospective foster or adoptive parent as child abuse, emotional abuse,
neglect, maltreatment, abandonment, contrary to the child's best
interests, contrary to a child's health, safety, or welfare, or an
indication of parental unfitness or incapacity.
``(b) Condition on Receipt of Funds; Rights Protected.--As a
condition of receiving funds under this title, including any grants,
subgrants, or other allocations, a covered entity shall protect the
following rights and shall not discriminate or take an adverse State
action against an individual because such individual exercises, has
exercised, or intends to exercise any such right:
``(1) A parent or legal guardian has the right to affirm a
child's sex, including the right for the child not to be
subjected by any covered entity, even if the child is in the
legal or physical custody of the covered entity, to--
``(A) the provision, facilitation, funding,
authorization, or permission of any sex-rejecting
intervention for the child;
``(B) the use of pronouns or titles that do not
correspond to the child's sex, without the express
written consent of the child's parent or legal
guardian; or
``(C) if the child is 4 years of age or older,
being permitted or assigned the use of sleeping
quarters (other than sleeping quarters shared only with
a sibling), bathrooms, showers, locker rooms, changing
rooms, or any other area in which the child would be in
a state of undress, with individuals of the opposite
sex.
``(2) A parent or legal guardian has the right not to be
required to consent to the child being subjected to any of the
actions described in subparagraph (A), (B), or (C) of paragraph
(1) as a condition of custody or return of the child, or
visitation, communication, or reunification with the child.
``(3) A parent, legal guardian, caregiver, foster parent,
prospective foster parent, or prospective adoptive parent has a
right to be free from discrimination or adverse State action
for affirming or intending to affirm a child's sex.
``(4) A child has the right not to be subjected by any
covered entity, even if the child is in the legal or physical
custody of the covered entity, to any sex-rejecting
intervention.
``(c) Prohibited Uses of Funds.--The Secretary shall ensure that no
funds provided under this title, including any grants, subgrants, and
other allocations to States, Indian Tribes or Tribal organizations, and
public and private agencies and organizations, are used for any of the
following:
``(1) Conducting, supporting or promoting any program,
project, curriculum, guidance, protocol, or training that
supports or promotes a principle that--
``(A) sex-rejecting interventions are in the best
interest of the child or consistent with the health,
safety, and welfare of the child;
``(B) affirmation of a child's sex by a parent,
legal guardian, caregiver, foster parent, or
prospective foster or adoptive parent is child abuse,
emotional abuse, neglect, maltreatment, abandonment,
contrary to a child's best interests, contrary to a
child's health, safety, or welfare, or an indication of
parental unfitness or incapacity; or
``(C) a child's expression of psychological
distress, including a statement or report of suicidal
ideation, related to the affirmation of a child's sex
is grounds for removal of the child from the home,
intervention by a child welfare agency, or any other
adverse State action.
``(2) Conducting, supporting, or promoting any adverse
State action.
``(3) Providing, facilitating, funding, authorizing, or
permitting any sex-rejecting intervention for a child, or
referring a child for a sex-rejecting intervention.
``(4) Removing children from parents, legal guardians, or
caregivers and placing children into any home, institution, or
other placement setting that facilitates or provides sex-
rejecting interventions, or without parental consent, uses
pronouns or titles that do not correspond to the child's sex.
``(d) Obligations on Recipients and Subrecipients.--A State, Indian
Tribe or Tribal organization, or public or private agency or
organization receiving an award under this title, or a recipient of a
subgrant of such an award, may not use such award for programs,
trainings, or other activities that violate any of the restrictions on
uses of funds set forth in subsection (b) or (c).
``(e) Withholding and Recoupment for Noncompliance.--
``(1) Authority to withhold and recover funds.--
``(A) In general.--If the Secretary determines that
any State, Indian Tribe or Tribal organization, or
public or private agency or organization, including any
recipient of a subgrant, has violated the conditions
under subsection (b) or used funds in violation of
subsection (c), the Secretary shall disallow the costs
associated with such violation, withhold funds as
described in subparagraph (B) or recover funds as
described in subparagraph (C), as applicable, and
impose the applicable penalty amount determined under
paragraph (3).
``(B) Withholding of funds.--In the case of a
violation described in subparagraph (A), the Secretary
shall withhold from the recipient any future payments
or funding tranches not yet disbursed until the
Secretary certifies that the violation has been
remediated and that the recipient has adopted policies
and procedures sufficient to prevent recurrence.
``(C) Recovery of funds.--In the case of a
violation described in subparagraph (A), the Secretary
shall recover grant funds already disbursed to the
recipient, and such disbursed funds shall constitute a
debt to the Federal Government as of the date of the
Secretary's written determination of noncompliance,
collectible in accordance with parts 200 and 300 of
title 2, Code of Federal Regulations (or any successor
regulations), including through administrative offset
against any other Federal payments owed to the entity
under this title or any other Federal program
administered by the Department of Health and Human
Services.
``(D) Basis for determination.--In making a
determination under subparagraph (A), a violation
described in any of clauses (xxvi) through (xxviii) of
section 106(b)(2)(B) includes a State's failure to--
``(i) include in its State plan under
section 106(b), the certification and assurance
required under such clauses; or
``(ii) adequately enforce, or maintain in
effect, programs certified under any such
clause.
``(2) Subgrants.--The direct recipient of an award under
this title shall be responsible for ensuring that recipients of
subgrants awarded by such direct recipient complies with this
section, and any violation by a recipient of such a subgrant
shall be attributed to the direct recipient of the award from
the Secretary.
``(3) Penalties.--
``(A) In general.--The penalty amount applicable to
a recipient of a grant under this title awarded by the
Secretary and who has violated subsection (b) or (c)
shall be as follows:
``(i) For the first finding of such a
violation by the recipient within a grant
period, 5 percent of the total funds provided
to the recipient under this title for the
applicable grant period.
``(ii) For the second finding of such a
violation by the recipient within a grant
period, 10 percent of the total funds provided
to the recipient under this title for the
applicable grant period.
``(iii) For the third or any subsequent
finding of violation by the recipient within a
grant period, 15 percent of the total funds
provided to the direct recipient under this
title for the applicable grant period.
``(B) Limitation.--In no case shall the total
penalty imposed against a single direct recipient for
all findings within a single grant period exceed 15
percent of the total funds provided to the recipient
for the applicable grant period.
``(C) Required penalty.--The penalties described in
this paragraph are mandatory and the Secretary has no
discretion to waive or reduce such a penalty except
through the appeals process under subparagraph (D).
``(D) Appeals.--A direct recipient of a grant who
is assessed a penalty under this paragraph may file an
appeal of such penalty with the Secretary. Appeals from
any determination of noncompliance or penalty amount
under this subsection shall be governed by part 16 of
title 45, Code of Federal Regulations (or any successor
regulations). The filing of an appeal shall not stay
the withholding of future payments or funding tranches
pending resolution of the appeal, but any amounts
recovered by the Secretary from already-disbursed funds
shall not be collected pending final resolution of the
appeal.
``(4) Regulations.--The Secretary shall issue such
regulations as are necessary and appropriate to carry out this
subsection, including regulations establishing procedures for
written notice of noncompliance, opportunity to respond, and
administrative review prior to any final determination under
paragraph (1).
``(5) Clarifications.--Nothing in this subsection shall be
construed to limit the authority of the Secretary to pursue any
other remedy available under part 200 or 300 of title 2, Code
of Federal Regulations (or any successor regulations), or any
other applicable Federal law with respect to violations of any
other provision of this title, or to limit the Secretary's
authority to impose remedies in addition to the penalties
prescribed in paragraph (3) for violations of subsection (b) or
(c) where the Secretary determines that additional remedies are
necessary to protect Federal funds.''.
SEC. 103. REPORTS.
Section 107 of the Child Abuse Prevention and Treatment Act (42
U.S.C. 5106c) is amended--
(1) in subsection (e)(2)(A), by inserting ``, provided the
alternative does not violate the limitations set forth in
subsection (f)'' before the semicolon;
(2) by redesignating subsection (f) as subsection (g); and
(3) by inserting after subsection (e) the following:
``(f) Limitations.--
``(1) In general.--No State task force review or
recommendation made pursuant to this section shall--
``(A) recommend any reform of State law, ordinance,
regulation, protocol, or procedure that would expand
the definition of child abuse, child neglect, parental
unfitness or incapacity to encompass a parent's, legal
guardian's, or caregiver's affirmation of the child's
sex; or
``(B) recommend, promote, facilitate or endorse the
use of any training program, clinical protocol, or
professional standard that is inconsistent with section
115.
``(2) Withholding and recoupment for noncompliance.--A
State task force that issues any recommendation prohibited as
described in paragraph (1) shall be deemed to be in
noncompliance with this section, and the Secretary shall--
``(A) withhold any further assistance until such
prohibited recommendation is formally rescinded by the
State task force and the Secretary certifies that the
task force is in compliance with paragraph (1); and
``(B) if the funds have already been disbursed
during the period of noncompliance, recover such funds
in accordance with the graduated penalty formula set
forth in section 115(e)(3) for the total funds provided
for that grant period.''.
SEC. 104. DEFINITIONS.
Subsection (a) of section 111 of the Child Abuse Prevention and
Treatment Act (42 U.S.C. 5106g) is amended to read as follows:
``(a) Definitions.--For purposes of this title:
``(1)(A) The term `adverse State action' means any covered
action taken by a covered entity, if any of the following was a
motivating factor, without regard to how the covered entity
characterizes the reason for the covered action:
``(i) Affirmation of, or intent to affirm, the
child's sex by the parent, legal guardian, or
caregiver.
``(ii) The child's request to be treated in a
manner inconsistent with the child's sex or the child's
request for, or attempt to obtain, sex-rejecting
interventions.
``(iii) The child's expression of psychological
distress, including suicidal ideation or threat of
self-harm, related to affirmation of the child's sex by
the parent, legal guardian, or caregiver.
``(iv) That the child ran away, threatens to run
away, or intends to run away from or requests no
contact with a parent, legal guardian, or caregiver
because of a circumstance described in clause (i),
(ii), or (iii).
``(B) For purposes of subparagraph (A), a covered action
includes any of the following:
``(i) The removal or threat of removal of a child
from the home, or the removal or threat of removal of a
parent, legal guardian, or caregiver from the home,
including removal of the child or such parent, legal
guardian, or caregiver pursuant to any safety plan or
other protective-services action by a covered entity.
``(ii) Any assessment, investigation, or inquiry
conducted for the purpose of determining the existence
of child abuse, neglect, or parental unfitness or
incapacity.
``(iii) Any dependency, child welfare, or juvenile
court proceeding, including any investigation, removal
proceeding, proceeding to limit or condition the
exercise of parental rights, proceeding relating to
visitation, proceeding to terminate parental rights, or
other related child welfare or court proceeding.
``(iv) Denying, impeding, interfering with or
unreasonably delaying--
``(I) the parent's, legal guardian's, or
caregiver's visitation, communication, or
meeting with the child;
``(II) the parent's, legal guardian's, or
caregiver's scheduled meeting, case conference,
or other planned communication with an employee
or agent of a covered entity regarding the
child; or
``(III) the return of the child to the
parent, legal guardian, or caregiver.
``(v) The making of any finding or substantiation
of child abuse, neglect, or parental unfitness or
incapacity.
``(vi) Any case plan, safety plan, service plan, or
reunification plan recommendation or requirement
imposed by a covered entity as a condition of
visitation, communication, or meeting with a child,
reunification, return of a child, or continued family
preservation.
``(vii) The involuntary termination of parental
rights to a child or to a sibling of a child.
``(viii) Placement on a State child abuse registry
or index.
``(ix) The delay or denial of foster-care placement
or adoption.
``(2) The terms `affirm', `affirmed', and `affirmation',
with respect to the sex of a child, mean referring to or
raising the child, or intending to refer to or raise the child,
as his or her sex, including refusing to consent to sex-
rejecting interventions for the child.
``(3) The term `Alaska Native' has the meaning given the
term `Native' in section 3 of the Alaska Native Claims
Settlement Act (43 U.S.C. 1602).
``(4) The term `caregiver' means any person who provides
ongoing care, supervision, and decision-making for a child on a
regular basis, including a licensed foster parent, kinship
caregiver, pre-adoptive foster parent, or person acting in loco
parentis, but does not include any person who is a parent or
legal guardian.
``(5) The term `covered entity' means--
``(A) an entity that has received funds under this
title, directly or as a recipient of a subgrant,
including--
``(i) any State, and any agency of a State
that administers child protective services,
child welfare services, or related functions;
``(ii) any Indian Tribe or Tribal
organization; or
``(iii) any public or private agency or
organization that contracts with any entity
listed in clause (i) or (ii); or
``(B) any individual who is a contractor, employee,
or agent of any of the entities described in
subparagraph (A).
``(6) The term `disorder of sex development' means a
congenital condition involving atypical complement or structure
or development of sex chromosomes, gonads, internal genital
ducts, or external genitalia, including disorders of sex
hormone synthesis or action, but does not include psychological
or behavioral conditions, nor typical male or female sex
development with distress regarding sexed anatomy.
``(7) The term `infant or toddler with a disability' has
the meaning given the term in section 632 of the Individuals
with Disabilities Education Act (20 U.S.C. 1432).
``(8) The term `Native Hawaiian' has the meaning given the
term in section 6207 of the Elementary and Secondary Education
Act of 1965.
``(9) The term `sex' means an individual's immutable
biological sex, either--
``(A) male, whereby the individual naturally has,
had, will have, or would have, but for a disorder of
sex development or an intentional or unintentional
disruption, the reproductive system that produces,
transports, and utilizes the small gamete (sperm) for
fertilization; or
``(B) female, whereby the individual naturally has,
had, will have, or would have, but for a disorder of
sex development or an intentional or unintentional
disruption, the reproductive system that produces,
transports, and utilizes the large gamete (ova) for
fertilization.
``(10) The term `sex-rejecting intervention'--
``(A) means a psychological, medical, or surgical
intervention that is intended to promote, endorse, or
enable a child's rejection of the child's sex, to
promote, endorse, or enable a child to adopt an
appearance that does not correspond to the child's sex,
or to intentionally change the body of a child,
including the child's external appearance or biological
functions, to no longer correspond to the child's sex,
including--
``(i) intentionally delaying, halting, or
disrupting the natural development of the
child's body, including the onset or
progression of puberty, so that the child's
body does not develop or halts developing to
correspond to the child's sex, which may
include the use of puberty blocking drugs, such
as gonadotropin releasing hormone agonists or
antagonists;
``(ii) prescribing, administering, or
dispensing to the child androgen blockers or
sex hormones such as estrogen, progesterone, or
testosterone;
``(iii) prescribing or performing any
surgical procedure that attempts to transform
the physical appearance, or that attempts to
alter or remove the tissues, cavities, bone,
cartilage, or organs, of a child;
``(iv) providing compression materials or
garments that are designed to constrict female
breasts, or that flatten or tuck a male's
genitals, prosthetic breasts, genitals, or
hips, or any other materials that enable the
child to conceal his or her sex or to simulate
the physical characteristics of the opposite
sex; or
``(v) permitting or assigning a child who
is 4 years of age or older to--
``(I) use sleeping quarters,
bathrooms, locker rooms, changing
rooms, or other areas in which a child
may be in a state of undress, with
individuals of the opposite sex; or
``(II) participate in sex-separated
activities designated for individuals
of the opposite sex; and
``(B) does not include the treatment of a disorder
of sex development or the treatment of any infection,
injury, disease, or disorder that has been caused or
exacerbated by the performance of an intervention
described in any of clauses (i) through (iv) of
subparagraph (A).
``(11) The term `sexual abuse' includes--
``(A) the employment, use, persuasion, inducement,
enticement, or coercion of any child to engage in, or
assist any other person to engage in, any sexually
explicit conduct or simulation of such conduct for the
purpose of producing a visual depiction of such
conduct; or
``(B) the rape, and in cases of caretaker or inter-
familial relationships, statutory rape, molestation,
prostitution, or other form of sexual exploitation of
children, or incest with children.
``(12) The term `withholding of medically indicated
treatment' means the failure to respond to the infant's life-
threatening conditions by providing treatment (including
appropriate nutrition, hydration, and medication) which, in the
treating physician's or physicians' reasonable medical
judgment, will be most likely to be effective in ameliorating
or correcting all such conditions, except that the term does
not include the failure to provide treatment (other than
appropriate nutrition, hydration, or medication) to an infant
when, in the treating physician's or physicians' reasonable
medical judgment--
``(A) the infant is chronically and irreversibly
comatose;
``(B) the provision of such treatment would--
``(i) merely prolong dying;
``(ii) not be effective in ameliorating or
correcting all of the infant's life-threatening
conditions; or
``(iii) otherwise be futile in terms of the
survival of the infant; or
``(C) the provision of such treatment would be
virtually futile in terms of the survival of the infant
and the treatment itself under such circumstances would
be inhumane.''.
SEC. 105. RULE OF CONSTRUCTION.
Section 113(a) of the Child Abuse Prevention and Treatment Act (42
U.S.C. 5106i(a)) is amended--
(1) in paragraph (1), by striking ``; and'' and inserting a
semicolon;
(2) in paragraph (2), by striking the period and inserting
a semicolon; and
(3) by adding at the end the following:
``(3) as establishing a Federal requirement that a parent,
legal guardian or caregiver provide a child any medical service
or treatment against the religious beliefs of the parent or
legal guardian; or
``(4) as establishing that affirmation of a child's sex by
a parent, legal guardian, caregiver, foster parent, or
prospective foster or adoptive parent is child abuse, emotional
abuse, neglect, maltreatment, abandonment, contrary to the
child's best interests, contrary to a child's health, safety or
welfare, or indication of parental unfitness or incapacity.''.
SEC. 106. PRIVATE RIGHT OF ACTION.
Title I of Child Abuse Prevention and Treatment Act (42 U.S.C. 5101
et seq.), as amended by section 103, is further amended by adding at
the end the following:
``SEC. 116. PRIVATE RIGHT OF ACTION.
``(a) Cause of Action.--Any parent, legal guardian, caregiver, or
child who is aggrieved by an adverse State action alleged to have been
taken by a covered entity, or any parent, legal guardian, or caregiver
who is aggrieved by a violation of section 115(b) may bring a civil
action seeking relief in any United States district court, regardless
of whether the specific operation, division, facility, or program of
the covered entity that was engaged in such adverse State action was
itself funded, in whole or in part, by an award under this title.
``(b) Liability of a Covered Entity for the Conduct of Others.--For
purposes of subsection (a), a covered entity described in section
111(a)(5)(A) waives any defense based on the absence of respondeat
superior liability, and shall be vicariously liable under this section
for any adverse State action, or any violation of the right protected
under section 115(b), that is committed by any employee, contractor, or
agent of such covered entity, without regard to whether such adverse
State action or violation--
``(1) resulted from an official policy or custom of the
covered entity;
``(2) was known to any supervisory official of the covered
entity; or
``(3) was within the scope of such covered entity's
employment, contract, or agency.
``(c) Rebuttable Presumption.--
``(1) In general.--For purposes of any action brought under
this section, there is a rebuttable presumption that an adverse
State action or a violation of the right protected under
section 115(b) was because of the affirmation of a child's sex
if--
``(A) a case record, report, petition,
recommendation, or other agency or court document
includes the affirmation of the child's sex as a basis
for, contributing factor in, or concern related to the
adverse State action; or
``(B) a recommendation, order, or agreement has
been made that a child be removed from a parent, legal
guardian, or caregiver and be placed in a home,
institution, or other placement setting that--
``(i) provides, permits or encourages the
child to undergo any sex-rejecting
intervention, or
``(ii) without parental consent, uses
pronouns or titles that do not correspond to
the child's sex.
``(2) Rebuttal.--A covered entity bears the burden of
rebutting the presumption described in paragraph (1) by clear
and convincing evidence that the affirmation of the child's sex
was not a factor in the adverse State action or violation of
the right protected under section 115(b).
``(d) Nonapplication of Exhaustion of Remedies.--The exhaustion of
any State or administrative remedies is not required as a condition of
filing an action described in this section.
``(e) Relief.--As a condition of accepting funds under this title,
each of the remedies described in this subsection is available to a
prevailing parent, legal guardian, caregiver, or child. In any such
action, the court may award--
``(1) declaratory relief;
``(2) preliminary and permanent injunctive relief,
including an order enjoining, vacating, or prohibiting the
enforcement of any adverse State action or any violation of the
right protected under section 115(b), notwithstanding section
2283 of title 28, United States Code, except where the covered
entity demonstrates by clear and convincing evidence that such
relief would create an imminent risk of serious physical harm
to the child based on conduct independent of the adverse State
action or violation;
``(3) compensatory damages; and
``(4) damages for emotional distress suffered by a parent,
legal guardian, caregiver, or child.
``(f) Costs and Attorney's Fees.--In any action brought under this
section, the court shall award the prevailing parent, legal guardian,
caregiver, or child costs of litigation and attorney's fees.
``(g) Abrogation of Qualified Immunity.--In any action brought
under this section against an employee, contractor, or agent of a
covered entity, qualified immunity shall not be available as a defense.
To satisfy the requirement that the law be clearly established at the
time of the violation, it is sufficient that the conduct constituted an
adverse State action or violated the right protected under section
115(b). The absence of an express policy, procedure, or protocol by the
State or a covered entity described in section 111(a)(5)(A) shall not
preclude a finding that the law was clearly established or that the
employee, contractor, or agent of a covered entity knew or should have
known that the conduct was unlawful.
``(h) Waiver of Sovereign Immunity.--
``(1) In general.--
``(A) State immunity.--By accepting funds under
this title, a State and any covered entity described in
section 111(a)(5)(A)(i) shall waive immunity under the
Eleventh Amendment to the Constitution of the United
States from suit in Federal court for any adverse State
action or for any violation of the right protected
under section 115(b).
``(B) Tribal immunity.--By accepting funds under
this title, a covered entity described in section
111(a)(5)(A)(ii) shall waive immunity from suit in
Federal court for any adverse State action or for any
violation of the right protected under section 115(b).
``(2) Remedies available.--
``(A) State defendants.--In an action against a
State or covered entity described in section
111(a)(5)(A)(i) for any adverse State action or for any
violation of the right protected under section 115(b),
remedies (including remedies both at law and in equity)
are available to the same extent as such remedies are
available in an action against any public or private
entity other than a State.
``(B) Tribal defendants.--In an action against an
Indian Tribe or Tribal organization for any adverse
State action or for any violation of the right
protected under section 115(b), remedies (including
remedies both at law and in equity) are available to
the same extent as such remedies are available in an
action against any public or private entity other than
an Indian Tribe or Tribal organization.
``(i) Statute of Limitations.--
``(1) In general.--Except as provided in paragraph (3), an
action under this section shall commence not later than 4 years
after the date on which the cause of action accrues.
``(2) Accrual.--For purposes of paragraph (1), a cause of
action accrues on the date a parent, legal guardian, caregiver,
or child knew or reasonably should have known of the violation
giving rise to the claim, or, in the case of an ongoing
violation, on the date the violation ceases.
``(3) Tolling.--The limitations period under paragraph (1)
shall be tolled--
``(A) with respect to a claim brought on behalf of
a minor child until the later of--
``(i) the date the child attains the age of
18; or
``(ii) the date that is 4 years after the
date the violation occurred; and
``(B) during the pendency of any State or Indian
child welfare proceeding arising from the same facts as
the Federal claim, and for the 2-year period following
the final resolution of such proceeding.
``(j) Relationship to Other Laws.--
``(1) Non-preemption.--Nothing in this section shall be
construed to preempt any State law that provides greater
protection than the rights established under this section.
``(2) Other applicable laws.--The rights established under
this section are in addition to, and not in lieu of, any rights
available under the Constitution of the United States, section
1979 of the Revised Statutes (42 U.S.C. 1983), this Act, or any
other Federal or State law.
``(3) Jurisdiction.--Federal courts shall have original
jurisdiction over any civil action brought under this section.
No action shall be dismissed, stayed or otherwise abated on the
basis of--
``(A) the pendency of a State court proceeding;
``(B) any State court judgment or order;
``(C) any doctrine of equitable restraint,
abstention, or comity, including any doctrine under
which a court declines to exercise jurisdiction because
of the pendency or potential pendency of a State
judicial or administrative proceeding; or
``(D) the domestic relations exception in Federal
jurisdiction, if the action seeks enforcement of a
right established under this section, and does not seek
the issuance of an original divorce, alimony or child
custody decree in a domestic-relations proceeding
between private parties.
``(4) Other relief.--The relief available under this
section is in addition to, and not in lieu of, any remedy
available to the Secretary under section 115.''.
TITLE II--AMENDMENTS TO THE SOCIAL SECURITY ACT
SEC. 201. AMENDMENTS TO PART B OF TITLE IV OF THE SOCIAL SECURITY ACT.
(a) Stephanie Tubbs Jones Child Welfare Services Program State Plan
Requirements.--Section 422(b) of the Social Security Act (42 U.S.C.
622(b)) is amended--
(1) in paragraph (15)(A)--
(A) in clause (vii), by striking ``and'' after the
semicolon; and
(B) by inserting after clause (viii) the following
new clause:
``(ix) the procedures and protocols the
State has established to ensure that sex-
rejecting interventions are not initiated or
continued when a child is removed from the
custody, care, or control of the parent or
placed in foster care; and'';
(2) in paragraph (18), by striking ``and'' after the
semicolon;
(3) in paragraph (19)(B), by striking the period at the end
and inserting a semicolon; and
(4) by inserting after paragraph (19)(B) the following new
paragraphs:
``(20) provide that no placement of a child for adoption or
into foster care is prevented, denied, or delayed because the
foster parent, prospective foster parent, or prospective
adoptive parent may affirm a child's sex;
``(21) provide that children who are 4 years of age or
older in foster care placement are housed in accordance with
their sex, including--
``(A) requirements that a foster family home
provide either single occupancy or sex-separated multi-
occupancy sleeping quarters (other than sleeping
quarters shared only with a sibling), bathrooms,
showers, locker rooms, changing rooms, or any other
areas in which a child would be in a state of undress
when in use by the child;
``(B) requirements that a child-care institution
(including any group home, residential treatment
center, shelter, qualified residential treatment
program, settings for pregnant or parenting foster
youth described in section 472(k)(2)(B), setting for
sex trafficking victims described in section
472(k)(2)(D) or other congregate care setting) assign a
child to and provide either single occupancy or sex-
separated multi-occupancy sleeping quarters (other than
sleeping quarters shared only with a sibling),
bathrooms, showers, locker rooms, changing rooms, or
any other areas in which a child would be in a state of
undress, when in use by the child; and
``(C) requirements that licensing standards for
foster family homes, child-care institutions, or other
placement settings, include compliance with this
paragraph as a condition of licensure for any foster
family home, child-care institution, or other placement
setting receiving funds under this part or part E;
``(22) provide and have in effect policies and procedures,
and require any covered entity to have in effect policies and
procedures that--
``(A) protect and promote a child's right to be
free from sex-rejecting interventions; and
``(B) protect, without express parental consent, a
child from the use of pronouns or titles that do not
correspond to the child's sex;
``(23) provide for training for child protective services
workers, caseworkers, guardians ad litem, minor's counsel,
court appointed special advocates, judges, other individuals
providing services to children and families, foster parents,
prospective foster parents, prospective adoptive parents, and
parents that includes--
``(A) the medical, psychological, and developmental
harms of sex-rejecting interventions and the harms of
using pronouns or titles that do not correspond to the
child's sex;
``(B) the right of a parent or legal guardian to
affirm a child's sex and of a parent, legal guardian,
caregiver, foster parent, prospective foster parent, or
prospective adoptive parent to be free from
discrimination or adverse State action for affirming or
intending to affirm a child's sex;
``(C) the principle that affirmation of a child's
sex by a parent, legal guardian, caregiver, foster
parent, prospective foster parent, or prospective
adoptive parent is not child abuse, emotional abuse,
neglect, maltreatment, abandonment, contrary to the
child's best interests, contrary to a child's health,
safety, or welfare, or indication of parental unfitness
or incapacity;
``(D) the principle that affirmation of a child's
sex is consistent with the child's best interests,
health, safety, and welfare;
``(E) the prohibition under this part and part E
on--
``(i) providing, initiating, or continuing
sex-rejecting interventions to children in
foster care placements; and
``(ii) without parental consent, the use of
pronouns or titles that do not correspond to
the child's sex; and
``(F) the prohibition under this part and part E on
denying and delaying the placement of a child in a
foster or adoptive home placement because a foster
parent, prospective foster parent or prospective
adoptive parent may affirm the child's sex;
``(24) provide that the State shall have in effect policies
and procedures, and require any covered entity to have in
effect policies and procedures that protect and promote the
right of a parent, legal guardian, caregiver, foster parent,
prospective foster parent, or prospective adoptive parent to be
free from discrimination for affirming or intending to affirm a
child's sex and from any adverse State action;
``(25) provide that the State shall have in effect policies
and procedures, and shall require any covered entity to have in
effect policies and procedures, that no child, foster parent,
prospective foster parent, or prospective adoptive parent may
be denied a foster care or adoptive placement because the
foster parent, prospective foster parent, or prospective
adoptive parent may affirm a child's sex; and
``(26) provide that the State shall have in effect policies
and procedures that protect and promote the right of children
in foster care placements to be free from sex-rejecting
interventions and require any covered entity to have in effect
policies and procedures that include--
``(A) requirements ensuring that no child in foster
care under the supervision of the State is subjected to
sex-rejecting interventions;
``(B) requirements that no funds under this part or
part E shall be used to provide, facilitate, refer, or
permit sex-rejecting interventions for any child placed
in the covered entity's care;
``(C) requirements that no foster family home,
child-care institution, or other placement setting
receiving funds under this part or part E shall
provide, facilitate, fund, permit, aid or refer for
sex-rejecting interventions for any child placed in the
foster family home, child-care institution, or other
placement setting;
``(D) training for child protective service
workers, foster care caseworkers, supervisors, foster
parents, guardians ad litem, court-appointed special
advocates, minor's counsel, judges, and other
individuals providing services to children and
families, prospective foster parents, prospective
adoptive parents, and parents on--
``(i) the medical, psychological, and
developmental harms of sex-rejecting
interventions and the harms of using pronouns
or titles that do not correspond to the child's
sex;
``(ii) the right of a parent or legal
guardian to affirm a child's sex and of a
parent, legal guardian, caregiver, foster
parent, prospective foster parent, or
prospective adoptive parent to be free from
discrimination or adverse State action for
affirming or intending to affirm a child's sex;
``(iii) the principle that affirmation of a
child's sex by a parent, legal guardian,
caregiver, foster parent, prospective foster
parent, or prospective adoptive parent is not
child abuse, emotional abuse, neglect,
maltreatment, abandonment, contrary to the
child's best interests, contrary to the child's
health, safety, or welfare, or indication of
parental unfitness or incapacity;
``(iv) the principle that affirmation of a
child's sex is consistent with the child's best
interests, and the child's health, safety, and
welfare;
``(v) the prohibition on providing sex-
rejecting interventions to children in foster
care placements;
``(vi) the prohibition on the use of
pronouns or titles that do not correspond to
the child's sex without the parent's express
consent; and
``(vii) the prohibition on denying,
delaying or conditioning the placement of a
child in a foster or adoptive home placement
because a foster parent, prospective foster
parent, or prospective adoptive parent may
affirm the child's sex; and
``(E) procedures to prevent sex marker changes
(meaning the designation of the child's sex on any
official record, including records maintained under
this part or part E) to the child's records that differ
from the child's sex while the child is in foster
care.''.
(b) Marylee Allen Promoting Safe and Stable Families Program State
Plan Requirements.--Section 432(a) of the Social Security Act (42
U.S.C. 629b(a)) is amended--
(1) in paragraph (10), by striking ``and'' after the
semicolon;
(2) in paragraph (11), by striking the period at the end
and inserting ``; and''; and
(3) by inserting after paragraph (11), the following new
paragraph:
``(12) complies with the requirements of paragraphs (20)
through (26) of section 422(b), as applicable to the services
funded under this subpart.''.
(c) Common Provisions.--Subpart 3 of part B of title IV of the
Social Security Act (42 U.S.C. 629k et seq.) is amended by adding at
the end the following new sections:
``SEC. 444. LIMITATIONS ON THE SECRETARY; OBLIGATIONS ON RECIPIENTS AND
SUBRECIPIENTS; NONCOMPLIANCE.
``(a) Limitations on the Secretary.--The Secretary shall ensure
that no funds provided under this part, including any grants, subgrants
and other allocations of funding made pursuant to this part to States,
Indian tribes, or tribal organizations, and public and private agencies
and organizations, including subrecipients, are used to fund any of the
following:
``(1) Conducting, supporting, or promoting any program,
project, curriculum, guidance, protocol or training that--
``(A) sex-rejecting interventions are in the best
interests of the child or consistent with the health,
safety, and welfare of the child;
``(B) affirmation of a child's sex by a parent,
legal guardian, caregiver, foster parent, prospective
foster parent, or prospective adoptive parent is child
abuse, emotional abuse, neglect, maltreatment,
abandonment, contrary to the child's best interests,
contrary to the child's health, safety or welfare, or
indication of parental unfitness or incapacity; or
``(C) a child's expression of psychological
distress, including a statement or report of suicidal
ideation, related to the affirmation of a child's sex
is grounds for removal of the child from the home,
intervention by a welfare agency, or any other adverse
State action.
``(2) Discriminating against, or taking an adverse State
action against, a parent, legal guardian, caregiver, foster
parent, prospective foster parent, or prospective adoptive
parent because such individual affirms, has affirmed, or
intends to affirm a child's sex.
``(3) Conducting, supporting, or promoting any adverse
State action.
``(4) Providing, facilitating, funding, authorizing,
permitting for a child, or referring a child for any sex-
rejecting intervention.
``(5) Removing a child from a parent, legal guardian, or
caregiver and placing the child in a foster family home, child-
care institution, or other placement setting that--
``(A) provides, permits, or encourages the child to
undergo any sex-rejecting intervention; or
``(B) without parental consent, uses pronouns or
titles that do not correspond to the child's sex.
``(6) Placing a child in a foster care placement that fails
to provide either single occupancy or sex-separated multi-
occupancy spaces in compliance with section 422(b)(21).
``(b) Obligations on Recipients and Subrecipients.--Any State,
Indian tribe or tribal organization, or public and private agency or
organization, including any subrecipient that receives funds under this
part, shall not use such funds for any program, training, or other
activity that violates any of the limitations set forth in subsection
(a).
``(c) Withholding and Recoupment for Noncompliance.--
``(1) In general.--If the Secretary determines that any
State, Indian tribe, tribal organization, or public or private
agency or organization, including any subrecipient, has used
funds in violation of the limitations or obligations set forth
in subsection (a) or (b), paragraphs (20) through (26) of
section 422(b), or section 432(a)(12), or in violation of any
right, restriction, limitation, obligation, or condition
established under section 479C as applicable to this part or
part E, the Secretary shall disallow the costs associated with
such violation and shall impose the applicable penalty amount
determined under paragraph (2). Such withholding shall apply to
any future payments or funding tranches not yet disbursed and
shall remain in effect until the Secretary certifies that the
violation has been remediated and that the direct recipient has
adopted policies and procedures sufficient to prevent
recurrence. Recovery shall apply to funds already disbursed,
which shall constitute a debt to the Federal Government as of
the date of the Secretary's written determination of
noncompliance, collectible in accordance with parts 200 and 300
of title 2, Code of Federal Regulations (or any successor
regulation), including through administrative offset against
any other Federal payments owed to the entity under this or any
other Federal program administered by the Department of Health
and Human Services.
``(2) Direct recipients.--
``(A) In general.--The direct recipient of funds
provided under this part shall be strictly responsible
for ensuring compliance with this part by all
subrecipients to which it passes such funds, and any
violation by a subrecipient shall be attributed to the
direct recipient. The penalty amount subject to
disallowance, withholding, and recovery under paragraph
(1) shall be--
``(i) for the first finding of violation by
the direct recipient within a grant period, 5
percent of the total funds provided to the
direct recipient for that grant period;
``(ii) for the second finding of violation
by the direct recipient within a grant period,
10 percent of the total funds provided to the
direct recipient for that grant period; and
``(iii) for the third or any subsequent
finding of violation by the direct recipient
within a grant period, 15 percent of the total
funds provided to the direct recipient under
this part for that grant period.
``(B) Maximum penalty.--In no case shall the total
penalty imposed against a single direct recipient for
all findings within a single grant period exceed 15
percent of the total funds provided to that direct
recipient for that grant period.
``(C) No waiver.--A penalty required by this
subsection is mandatory and the Secretary shall not
have any discretion to waive or reduce the penalty
applicable except through the appeals process provided
in paragraph (3).
``(3) Appeals.--Appeals from any determination of
noncompliance or penalty amount under this subsection shall be
governed by part 16 of title 45, Code of Federal Regulations
(or any successor regulation). The filing of an appeal shall
not stay the withholding of future payments or funding tranches
pending resolution of the appeal, but any amounts recovered by
the Secretary from already-disbursed funds shall not be
collected pending final resolution of the appeal.
``(4) Regulations.--The Secretary shall issue such
regulations as are necessary and appropriate to carry out this
subsection, including regulations establishing procedures for
written notice of noncompliance, opportunity to respond, and
administrative review prior to any final determination under
paragraph (1).
``(5) Other remedies.--Nothing in this subsection shall be
construed to limit the authority of the Secretary to pursue any
other remedy available under parts 200 and 300 of title 2, Code
of Federal Regulations (or any successor regulation), or any
other applicable Federal law with respect to violations of any
other provision of this part, or to limit the Secretary's
authority to impose remedies in addition to the penalties
prescribed in paragraph (2) for violations described in
paragraph (1) where the Secretary determines that additional
remedies are necessary to protect Federal funds.
``SEC. 445. PRIVATE RIGHT OF ACTION.
``(a) Causes of Action.--
``(1) In general.--Any parent, legal guardian, caregiver,
foster parent, prospective foster parent, prospective adoptive
parent, or child who is aggrieved by an adverse State action
or, in the case of a parent, legal guardian, caregiver, foster
parent, prospective foster parent, or prospective adoptive
parent, a violation of a right protected under section 479C(b),
that is alleged to have been taken by a covered entity may
bring an action seeking relief from a covered entity in any
United States district court regardless of whether the specific
operation, division, facility, or program of the covered entity
that engaged in such adverse State action was itself funded, in
whole or in part, by an award or payment made under this part
or part E.
``(2) Liability of a covered entity for conduct of
others.--For purposes of paragraph (1), a covered entity
described in subparagraph (A), (B), or (C) of section 475(19)
waives any defense based on the absence of respondeat superior
liability, and shall be vicariously liable under this section
for any adverse State action or any violation of the right
protected under section 479C(b) that is committed by any
employee, contractor, or agent of such covered entity, without
regard to whether such adverse State action or violation--
``(A) resulted from an official policy or custom of
the covered entity;
``(B) was known to any supervisory official of the
covered entity; or
``(C) was within the scope of such covered entity's
employment, contract, or agency.
``(3) Rebuttable presumption.--For purposes of any action
brought under this section, there is a rebuttable presumption
that an adverse State action or a violation of the right
protected under section 479C(b) was because of the affirmation
of a child's sex if--
``(A) a case record, report, petition,
recommendation, or other agency or court document
includes the affirmation of the child's sex as a basis
for, contributing factor in, or concern related to the
adverse State action; or
``(B) a recommendation, order, or agreement has
been made that a child be removed from a parent, legal
guardian, or caregiver and be placed in a foster family
home, child-care institution, or other placement
setting that--
``(i) provides, permits, or encourages the
child to undergo any sex-rejecting
intervention; or
``(ii) without parental consent, uses
pronouns or titles that do not correspond to
the child's sex.
``(4) Rebuttal.--A covered entity bears the burden of
rebutting the presumption described in paragraph (3) by clear
and convincing evidence that the affirmation of the child's sex
was not a factor in the adverse State action or violation of
the rights protected under section 479C(b).
``(b) Nonapplication of Exhaustion of Remedies.--Exhaustion of any
State or administrative remedies shall not be required as a condition
of bringing an action described in subsection (a).
``(c) Relief.--
``(1) In general.--As a condition of accepting funds under
this part, each of the remedies described in paragraph (2) is
available to a prevailing parent, legal guardian, caregiver,
foster parent, prospective foster parent, prospective adoptive
parent, or child in an action brought under this section.
``(2) Remedies.--The remedies described in this paragraph
are--
``(A) declaratory relief;
``(B) preliminary and permanent injunctive relief,
including an order enjoining, vacating, or prohibiting
the enforcement of any adverse State action or any
violation of the right protected under section 479C(b),
notwithstanding section 2283 of title 28, United States
Code, except where the covered entity demonstrates by
clear and convincing evidence that such relief would
create an imminent risk of serious physical harm to the
child based on conduct independent of the adverse State
action or violation;
``(C) compensatory damages; and
``(D) damages for emotional distress suffered by a
parent, legal guardian, caregiver, foster parent,
prospective foster parent, prospective adoptive parent,
or child.
``(d) Costs and Attorney's Fees.--In any action brought under this
section, the court shall award the prevailing parent, legal guardian,
caregiver, foster parent, prospective foster parent, prospective
adoptive parent, or child, costs of litigation and attorney's fees.
``(e) Abrogation of Qualified Immunity.--In any action brought
under this section against an employee, contractor, or agent of a
covered entity described in subparagraph (D) of section 475(19),
qualified immunity shall not be available as a defense. To satisfy the
requirement that the law be clearly established at the time of the
violation, it is sufficient that the conduct constituted an adverse
State action or violated the right protected under section 479C(b). The
absence of an express policy, procedure, or protocol by a covered
entity described in subparagraph (A), (B), or (C) of section 475(19)
shall not preclude a finding that the law was clearly established or
that the employee, contractor, or agent of a covered entity described
in subparagraph (D) of section 475(19) knew or should have known that
the conduct was unlawful.
``(f) Waiver of Sovereign Immunity.--
``(1) In general.--
``(A) State immunity.--A covered entity described
in subparagraph (A) of section 475(19), as a condition
of accepting funds under this part, shall waive
immunity under the Eleventh Amendment to the
Constitution of the United States from suit in Federal
court for any adverse State action or any violation of
the right protected under section 479C(b).
``(B) Tribal immunity.--A covered entity described
in subparagraph (B) of section 475(19), as a condition
of accepting funds under this part, shall waive
immunity from suit in Federal court for any adverse
State action or any violation of the right protected
under section 479C(b).
``(2) Remedies available.--In any action against a State or
Indian tribe or tribal organization for any adverse State
action or any violation of the right protected under section
479C(b), remedies (including remedies both at law and in
equity) are available in a suit against any public or private
entity other than a State or Indian tribe, or tribal
organization.
``(g) Statute of Limitations.--
``(1) In general.--Except as provided in paragraph (3), an
action under this section may not be commenced later than 4
years after the date on which the cause of action accrues.
``(2) Accrual.--For purposes of paragraph (1), a cause of
action accrues on the date a parent, legal guardian, caregiver,
foster parent, prospective foster parent, prospective adoptive
parent, or child knew or reasonably should have known of the
violation giving rise to the claim, or, in the case of an
ongoing violation, on the date the violation ceases.
``(3) Tolling.--The limitations period under paragraph (1)
shall be tolled--
``(A) with respect to a claim brought on behalf of
a minor child, until the later of--
``(i) the date the child attains the age of
18; or
``(ii) the date that is 4 years after the
date the violation occurred; and
``(B) during the pendency of any State or Indian
child welfare proceeding arising from the same facts as
the Federal claim, and for the 2-year period following
the final resolution of such proceeding.
``(h) Relationship to Other Laws.--
``(1) Non-preemption.--Nothing in this section shall be
construed to preempt any State law that provides greater
protection than the rights established under this section.
``(2) Other applicable laws.--The rights established under
this section are in addition to, and not in lieu of, any rights
available under the Constitution of the United States, section
1979 of the Revised Statues (commonly referred to as `section
1983') (42 U.S.C. 1983), the Yaeli Martinez Child Protection
Act, or any other Federal or State law.
``(3) Jurisdiction.--Federal courts shall have original
jurisdiction over any civil action brought under this section.
No action shall be dismissed, stayed or otherwise abated on the
basis of--
``(A) the pendency of a State court proceeding;
``(B) any State court judgment or order;
``(C) any doctrine of equitable restraint,
abstention, or comity, including any doctrine under
which a court declines to exercise jurisdiction because
of the pendency or potential pendency of a State
judicial or administrative proceeding; or
``(D) the domestic relations exception in Federal
jurisdiction, if the action seeks enforcement of a
right established under this section, and does not seek
the issuance of an original divorce, alimony, or child
custody decree in a domestic-relations proceeding
between private parties.''.
SEC. 202. AMENDMENTS TO PART E OF TITLE IV OF THE SOCIAL SECURITY ACT.
(a) State Plan Requirements.--Section 471(a) of the Social Security
Act (42 U.S.C. 671(a)) is amended--
(1) in paragraph (10)--
(A) in subparagraph (A), by inserting ``, and which
do not violate paragraphs (38) through (42)'' after
``prudent parenting standard''; and
(B) in subparagraph (D), by inserting ``, except
that there can be no waiver of the requirements of
paragraphs (38) through (42)'' after ``children in
care'';
(2) in paragraph (15)--
(A) in subparagraph (A), by inserting ``, and that,
in determining such reasonable efforts to be made with
respect to a child, and in making such reasonable
efforts, a parent's, legal guardian's, or caregiver's
affirmation of a child's sex shall be considered in
furtherance of the child's health and safety, and
affirmation of a child's sex, shall not serve as a
basis to limit or deny reasonable efforts to preserve
and reunify families'' after ``paramount concern''; and
(B) in paragraph (D)(iii), by inserting ``, except
if the termination was because the parent affirmed the
sibling's sex'' after ``involuntarily'';
(3) in paragraph (18)--
(A) in the matter preceding subparagraph (A), by
inserting ``(in the case of subparagraphs (A) and (B),
and in the case of subparagraph (C), not later than 1
year after the date of enactment of the Yaeli Martinez
Child Protection Act)'' after ``January 1, 1997,'';
(B) in subparagraph (A), by striking ``or'' after
the semicolon;
(C) in subparagraph (B), by adding ``or'' after the
semicolon; and
(D) by inserting after subparagraph (B), the
following new subparagraph:
``(C) delay or deny to any person the opportunity
to become an adoptive or foster parent because the
person may affirm the child's sex;'';
(4) in paragraph (22), by inserting ``, and, not later than
1 year after the date of enactment of the Yaeli Martinez Child
Protection Act, that comply with paragraphs (38) through (42),
and that protect against the use of pronouns or titles, without
express parental consent, that do not correspond to the child's
sex'' after ``safety and health of the children'';
(5) in paragraph (36)(D), by striking ``and'' after the
semicolon;
(6) in paragraph (37), by striking the period at the end
and inserting a semicolon; and
(7) by inserting after paragraph (37), the following new
paragraphs:
``(38) provides that the State shall have in effect
policies and procedures, and require that any covered entity
have in effect policies and procedures that protect and promote
the right of a parent, legal guardian, caregiver, foster
parent, prospective foster parent, or prospective adoptive
parent to be free from discrimination for affirming or
intending to affirm a child's sex and from any adverse State
action;
``(39) has in effect policies and procedures, and requires
any covered entity to have in effect policies and procedures,
ensuring that foster care or adoptive placement of a child
shall not be denied or delayed because a foster parent,
prospective foster parent, or prospective adoptive parent may
affirm a child's sex;
``(40) provides, and has in effect policies and procedures,
and requires any covered entity to have in effect policies and
procedures that--
``(A) protect and promote a child's right to be
free from sex-rejecting interventions, and without
express parental consent, protect a child from the use
of pronouns or titles that do not correspond to the
child's sex;
``(B) require ensuring that no child in foster care
under the supervision of the State is subjected to sex-
rejecting interventions;
``(C) require that no funds under this part shall
be used, for any child placed in the covered entity's
care, to provide, facilitate, fund, authorize, permit
for the child, or refer the child for, any sex-
rejecting intervention;
``(D) require that no foster family home, child-
care institution, or other placement setting receiving
funds under this part shall provide, facilitate, fund,
permit, aid, or refer sex-rejecting interventions for
any child placed in the foster family home, child-care
institution, or other placement setting;
``(E) require training for child protective
services workers, foster care caseworkers, supervisors,
foster parents, guardians ad litem, court-appointed
special advocates, minor's counsel, judges, and other
individuals providing services to children and
families, prospective foster parents, prospective
adoptive parents, and parents on--
``(i) the medical, psychological, and
developmental harms of sex-rejecting
interventions and the harms of using pronouns
or titles that do not correspond to the child's
sex;
``(ii) the right of a parent or legal
guardian to affirm a child's sex and the right
of a parent, legal guardian, caregiver, foster
parent, prospective foster parent, or
prospective adoptive parent to be free from
discrimination or adverse State action for
affirming or intending to affirm a child's sex;
``(iii) the principle that affirmation of a
child's sex by a parent, legal guardian,
caregiver, foster parent, prospective foster
parent, or prospective adoptive parent is not
child abuse, emotional abuse, neglect,
maltreatment, abandonment, contrary to the
child's best interests, contrary to a child's
health, safety or welfare, or indication of
parental unfitness or incapacity;
``(iv) the principle that affirmation of a
child's sex is consistent with the child's best
interests;
``(v) the prohibition on providing sex-
rejecting interventions to children in foster
care placements;
``(vi) the prohibition on the use of
pronouns or titles that do not correspond to
the child's sex without the parent's express
consent; and
``(vii) the prohibition on denying,
delaying or conditioning the placement of a
child in a foster or adoptive home placement
because a foster parent, prospective foster
parent, or prospective adoptive parent may
affirm the child's sex; and
``(F) procedures to prevent sex marker changes
(meaning the designation of the child's sex on any
official record, including records maintained under
this part or part B) to the child's records case that
differ from the child's sex, while the child is in
foster care;
``(41) has in effect procedures and requirements ensuring
that children who are 4 years of age or older in foster care
placements are housed in accordance with their sex, including--
``(A) requirements that a foster family home
provide either single occupancy or sex-separated multi-
occupancy sleeping quarters (other than sleeping
quarters shared only with a sibling), bathrooms,
showers, locker rooms, changing rooms, or any other
areas in which a child would be in a state of undress
when in use by the child;
``(B) requirements that a child-care institution
(including any group home, residential treatment
center, shelter, qualified residential treatment
program, settings for pregnant or parenting foster
youth described in section 472(k)(2)(B), setting for
sex trafficking victims described in section
472(k)(2)(D) or other congregate care setting) assign
the child to and provide either single occupancy or
sex-separated multi-occupancy sleeping quarters (other
than sleeping quarters shared only with a sibling),
bathrooms, showers, locker rooms, changing rooms, or
any other areas in which a child would be in a state of
undress, when in use by the child; and
``(C) requirements that licensing standards for
foster family homes, child-care institutions, and other
placement settings include compliance with
subparagraphs (A) and (B) as a condition of licensure
for any foster family home, child-care institution, or
other placement setting receiving funds under this
part; and
``(42) has in effect procedures and requirements ensuring
that no sex-rejecting interventions are initiated or continued
when the child is removed from the custody, care, or control of
the parent.''.
(b) Prevention and Family Services and Programs.--Section 471(e) of
the Social Security Act (42 U.S.C. 671(e)) is amended--
(1) in paragraph (4), by adding at the end the following
new subparagraph:
``(F) Limitations.--State expenditures for services
or programs that facilitate, promote, provide, fund, or
authorize sex-rejecting interventions shall not be
eligible for a Federal matching payment under section
474(a)(6)(A) and shall not be treated as meeting the
requirements of evidence-based or medically-proven
practices.'';
(2) in paragraph (5)(C)--
(A) in clause (i), by inserting ``and does not
include promoting, facilitating, or providing sex-
rejecting interventions, referring to or treating the
child in a manner that does not correspond to the
child's sex, or without express parental consent, using
pronouns or titles that do not correspond to the
child's sex'' after ``strategy for that practice''; and
(B) in clause (ii), by inserting ``, except for the
requirement that the practice may not include
promoting, facilitating, or providing sex-rejecting
interventions, referring to or treating the child in a
manner that does not correspond to the child's sex, or
without express parental consent, using pronouns or
titles that do not correspond to the child's sex''
after ``with regard to the practice''.
(c) Foster Care Maintenance Payments.--Section 472 of the Social
Security Act (42 U.S.C. 672) is amended--
(1) in subsection (a)(2)(A)--
(A) in clause (i), by striking ``or'' after the
semicolon;
(B) in clause (ii), by adding ``or'' after the
semicolon; and
(C) by inserting after clause (ii), the following
new clause:
``(iii) the limitations and requirements
provided in paragraphs (38) through (42) of
section 471(a);''; and
(2) in subsection (c)(1)(A)(ii)(I), by inserting ``and
capable of housing the child in compliance with the
requirements of section 471(a)(41)'' after ``prudent parent
standard''.
(d) Payments.--Section 474 of the Social Security Act (42 U.S.C.
674) is amended--
(1) in subsection (d)--
(A) in paragraph (1), in the matter preceding
subparagraph (A)--
(i) by inserting ``Reduction for Violation
of Plan Requirement; Private Right of Action.--
'' before ``If, during'';
(ii) by striking ``or (23) of section
471(a)'' and inserting ``, (23), (38), (39),
(40), (41), or (42) of section 471(a), or any
right, restriction, limitation, obligation, or
condition established under section 479C as
applicable to this part or part B,''; and
(iii) by striking ``such violation'' and
inserting ``violations of paragraphs (18) and
(23) of section 471(a), and not to exceed 30
days with respect to violations of paragraphs
(38) through (42) of section 471(a) or of any
right, restriction, limitation, obligation, or
condition established under section 479C as
applicable to this part or part B'';
(B) in paragraph (2)--
(i) by inserting ``(A)'' after ``(2)'';
(ii) by striking ``or (23) of section
471(a)'' and inserting ``, (23), (38), (39),
(40), (41), or (42) of section 471(a), or any
right, restriction, limitation, obligation, or
condition established under section 479C as
applicable to this part or part B,''; and
(iii) by adding at the end the following:
``(B) For purposes of this subsection, a failure to comply
substantially with paragraph (38), (39), (40), (41), or (42) of section
471(a), or with any right, restriction, limitation, obligation, or
condition established under section 479C as applicable to this part or
part B, shall be treated as a failure subject to the reductions and
remedies provided under this subsection.''; and
(C) by adding at the end the following new
paragraph:
``(5) Private right of action.--
``(A) In general.--By accepting funds under this
part, the State and any covered entity agree to be
bound by the following provisions of this paragraph.
``(B) Cause of action.--Any parent, legal guardian,
caregiver, foster parent, prospective foster parent,
prospective adoptive parent, or child who is aggrieved
by an adverse State action or, in the case of a parent,
legal guardian, caregiver, foster parent, prospective
foster parent, or prospective adoptive parent, a
violation of a right protected under section 479C(b),
that is alleged to have been taken by a covered entity
may bring an action seeking relief from a covered
entity in any United States district court regardless
of whether the specific operation, division, facility,
or program of the covered entity that engaged in such
adverse State action was itself funded, in whole or in
part, by an award or payment made under this part or
part B.
``(C) Liability of a covered entity for conduct of
others.--For purposes of subparagraph (B), a covered
entity described in subparagraph (A), (B), or (C) of
section 475(19) waives any defense based on the absence
of respondeat superior liability, and shall be
vicariously liable under this paragraph for any adverse
State action or any violation of the right protected
under section 479C(b) that is committed by any
employee, contractor, or agent of such covered entity,
without regard to whether such adverse State action or
violation--
``(i) resulted from an official policy or
custom of the covered entity;
``(ii) was known to any supervisory
official of the covered entity; or
``(iii) was within the scope of such
covered entity's employment, contract, or
agency.
``(D) Rebuttable presumption.--For purposes of any
action brought under this paragraph, there is a
rebuttable presumption that an adverse State action or
a violation of the right protected under section
479C(b) was because of the affirmation of a child's sex
if--
``(i) a case record, report, petition,
recommendation, or other agency or court
document includes the affirmation of the
child's sex as a basis for, contributing factor
in, or concern related to the adverse State
action; or
``(ii) a recommendation, order, or
agreement has been made that a child be removed
from a parent, legal guardian, or caregiver and
be placed in a foster family home, child-care
institution, or other placement setting that--
``(I) provides, permits, or
encourages the child to undergo any
sex-rejecting intervention; or
``(II) without parental consent,
uses pronouns or titles that do not
correspond to the child's sex.
``(E) Rebuttal.--A covered entity bears the burden
of rebutting the presumption described in subparagraph
(D) by clear and convincing evidence that the
affirmation of the child's sex was not a factor in the
adverse State action or violation of the rights
protected under section 479C(b).
``(F) Nonapplication of exhaustion of remedies.--
Exhaustion of any State or administrative remedies
shall not be required as a condition of bringing an
action described in subparagraph (B).
``(G) Relief.--
``(i) In general.--As a condition of
accepting funds under this part, each of the
remedies described in clause (ii) is available
to a prevailing parent, legal guardian,
caregiver, foster parent, prospective foster
parent, prospective adoptive parent, or child
in an action brought under this paragraph.
``(ii) Remedies.--The remedies described in
this clause are--
``(I) declaratory relief;
``(II) preliminary and permanent
injunctive relief, including an order
enjoining, vacating, or prohibiting the
enforcement of any adverse State action
or any violation of the right protected
under section 479C(b), notwithstanding
section 2283 of title 28, United States
Code, except where the covered entity
demonstrates by clear and convincing
evidence that such relief would create
an imminent risk of serious physical
harm to the child based on conduct
independent of the adverse State action
or violation;
``(III) compensatory damages; and
``(IV) damages for emotional
distress suffered by a parent, legal
guardian, caregiver, foster parent,
prospective foster parent, prospective
adoptive parent, or child.
``(H) Costs and attorney's fees.--In any action
brought under this paragraph, the court shall award the
prevailing parent, legal guardian, caregiver, foster
parent, prospective foster parent, prospective adoptive
parent, or child costs of litigation and attorney's
fees.
``(I) Abrogation of qualified immunity.--In any
action brought under this paragraph against an
employee, contractor, or agent of a covered entity
described in subparagraph (D) of section 475(19),
qualified immunity shall not be available as a defense.
To satisfy the requirement that the law be clearly
established at the time of the violation, it is
sufficient that the conduct constituted an adverse
State action or violated the right protected under
section 479C(b). The absence of an express policy,
procedure, or protocol by a covered entity described in
subparagraph (A), (B), or (C) of section 475(19) shall
not preclude a finding that the law was clearly
established or that the employee, contractor, or agent
of a covered entity described in subparagraph (D) of
section 475(19) knew or should have known that the
conduct was unlawful.
``(J) Waiver of sovereign immunity.--
``(i) State immunity.--A covered entity
described in subparagraph (A) of section
475(19), as a condition of accepting funds
under this part, shall waive immunity under the
Eleventh Amendment to the Constitution of the
United States from suit in Federal court for
any adverse State action or any violation of
the right protected under section 479C(b).
``(ii) Tribal immunity.--A covered entity
described in subparagraph (B) of section 475
(19), as a condition of accepting funds under
this part, shall waive immunity from suit in
Federal court for any adverse State action or
any violation of the right protected under
section 479C(b).
``(iii) Remedies available.--In any action
against a State or Indian tribe or tribal
organization for any adverse State action or
any violation of the right protected under
section 479C(b), remedies (including remedies
both at law and in equity) are available in a
suit against any public or private entity other
than a State or Indian tribe, or tribal
organization.
``(K) Statute of limitations.--
``(i) In general.--Except as provided in
clause (iii), an action under subparagraph (B)
shall commence no later than 4 years after the
date on which the cause of action accrues.
``(ii) Accrual.--For purposes of clause
(i), a cause of action accrues on the date a
parent, legal guardian, caregiver, foster
parent, prospective foster parent, prospective
adoptive parent, or child knew or reasonably
should have known of the violation giving rise
to the claim, or, in the case of an ongoing
violation, on the date the violation ceases.
``(iii) Tolling.--The limitations period
under clause (i) shall be tolled--
``(I) with respect to a claim
brought on behalf of a minor child,
until the later of--
``(aa) the date the child
attains the age of 18; or
``(bb) the date that is 4
years after the date the
violation occurred; and
``(II) during the pendency of any
State or Indian child welfare
proceeding arising from the same facts
as the Federal claim, and for the 2-
year period following the final
resolution of such proceeding.
``(L) Relationship to other laws.--
``(i) Non-preemption.--Nothing in this
paragraph shall be construed to preempt any
State law that provides greater protection than
the rights established under this paragraph.
``(ii) Other applicable laws.--The rights
established under this paragraph are in
addition to, and not in lieu of, any rights
available under the Constitution of the United
States, section 1979 of the Revised Statues
(commonly referred to as `section 1983') (42
U.S.C. 1983), the Yaeli Martinez Child
Protection Act, or any other Federal or State
law.
``(iii) Jurisdiction.--Federal courts shall
have original jurisdiction over any civil
action brought under subparagraph (B). No
action shall be dismissed, stayed or otherwise
abated on the basis of--
``(I) the pendency of a State court
proceeding;
``(II) any State court judgment or
order;
``(III) any doctrine of equitable
restraint, abstention, or comity,
including any doctrine under which a
court declines to exercise jurisdiction
because of the pendency or potential
pendency of a State judicial or
administrative proceeding; or
``(IV) the domestic relations
exception in Federal jurisdiction, if
the action seeks enforcement of a right
established under this section, and
does not seek the issuance of an
original divorce, alimony or child
custody decree in a domestic-relations
proceeding between private parties.
``(iv) Other relief.--The relief available
under this paragraph shall be in addition to
any relief permitted by the Secretary under
this part.''; and
(2) by adding at the end the following new subsection:
``(h) Prohibition on Sex-Rejecting Interventions.--Notwithstanding
any other provision of law, no payments shall be made to a State under
this part for any amounts expended for sex-rejecting interventions.''.
(e) Definitions.--Section 475 of the Social Security Act (42 U.S.C.
675) is amended--
(1) in paragraph (1)--
(A) by striking subparagraph (A) and inserting the
following:
``(A) A description of--
``(i) the type of home or institution in
which a child is to be placed, including a
discussion of the safety and appropriateness of
the placement, how that placement complies with
paragraphs (38) through (42) of section 471(a),
and how the placement prohibits, without the
express consent of the parent, the use of
pronouns or titles that do not correspond to
the child's sex; and
``(ii) how the agency which is responsible
for the child plans to carry out the voluntary
placement agreement entered into or judicial
determination made with respect to the child in
accordance with section 472(a)(2)(A).''; and
(B) in subparagraph (C)--
(i) in clause (vi), by striking ``and''
after the semicolon;
(ii) by redesignating clause (vii) as
clause (viii); and
(iii) by inserting after clause (vi), the
following new clause:
``(vii) the child's sex; and'';
(2) in paragraph (2), by striking ``, as determined by
applicable State law'';
(3) in paragraph (10)(A), by inserting ``and the
affirmation of the child as his or her sex'' after
``developmental growth of the child''; and
(4) by adding at the end the following new paragraphs:
``(14)(A) The term `adverse State action' means any covered
action taken by a covered entity if any of the following was a
motiving factor, and without regard to how the covered entity
characterizes the reason for the covered action:
``(i) Affirmation of, or intent to affirm, the
child's sex by the parent, legal guardian, caregiver,
foster parent, prospective foster parent, or
prospective adoptive parent.
``(ii) The child's request to be treated in a
manner inconsistent with the child's sex, or the
child's request for or attempt to obtain sex-rejecting
interventions.
``(iii) The child's expression of psychological
distress, including suicidal ideation or threat of
self-harm, related to affirmation of the child's sex by
the parent, legal guardian, or caregiver.
``(iv) That the child ran away, threatens to run
away, intends to run away from, or requests no contact
with, a parent, legal guardian, or caregiver because of
a circumstance described in clause (i), (ii), or (iii).
``(B) For purposes of subparagraph (A), a covered action
includes any of the following:
``(i) The removal or threat of removal of a child
from the home, or the removal or threat of removal of a
parent, legal guardian, or caregiver from the home,
including removal of the child or such parent, legal
guardian, or caregiver pursuant to any safety plan or
other protective-services action by a covered entity.
``(ii) Any assessment, investigation, or inquiry
conducted for the purpose of determining the existence
of child abuse, neglect, or parental unfitness or
incapacity.
``(iii) Any dependency, child welfare, or juvenile
court proceeding, including any investigation, removal
proceeding, proceeding to limit or condition the
exercise of parental rights, proceeding relating to
visitation, proceeding to terminate parental rights, or
other related child welfare or court proceeding.
``(iv) Denying, impeding, interfering with, or
unreasonably delaying--
``(I) the parent's, legal guardian's, or
caregiver's visitation, communication, or
meeting with the child;
``(II) the parent's, legal guardian's, or
caregiver's scheduled meeting, case conference,
or other planned communication with an employee
or agent of a covered entity regarding the
child; or
``(III) the return of the child to the
parent, legal guardian, or caregiver.
``(v) The making of any finding or substantiation
of child abuse, neglect, or parental unfitness or
incapacity.
``(vi) Any case plan, safety plan, service plan, or
reunification plan recommendation or requirement
imposed by a covered entity as a condition of
visitation, communication, or meeting with a child,
reunification, return of a child, or continued family
preservation.
``(vii) The involuntary termination of parental
rights to a child or to a sibling of a child.
``(viii) Placement on a State child abuse registry
or index.
``(ix) The delay or denial of foster care placement
or adoption.
``(15) The terms `affirmed as his or her sex', `affirm a
child's sex', `affirm the child's sex', `affirmation of a
child's sex', `affirmation of the child's sex', and `affirmed
the sibling's sex' mean referring to or raising the child, or
intending to refer to or raise the child, as his or her sex,
including refusing to consent to sex-rejecting interventions
for the child.
``(16) The term `disorder of sex development' means a
congenital condition involving atypical complement or structure
or development of sex chromosomes, gonads, internal genital
ducts, or external genitalia, including disorders of sex
hormone synthesis or action, but does not include psychological
or behavioral conditions, nor typical male or female sex
development with distress regarding sexed anatomy.
``(17) The term `sex' means an individual's immutable
biological sex, either--
``(A) male, whereby the individual naturally has,
had, will have, or would have, but for a disorder of
sex development or an intentional or unintentional
disruption, the reproductive system that produces,
transports, and utilizes the small gamete (sperm) for
fertilization; or
``(B) female, whereby the individual naturally has,
had, will have, or would have, but for a disorder of
sex development or an intentional or unintentional
disruption, the reproductive system that produces,
transports, and utilizes the large gamete (ova) for
fertilization.
``(18) The term `sex-rejecting interventions' means a
psychological, medical, or surgical intervention that is
intended to promote, endorse, or enable a child's rejection of
his or her sex, to promote, endorse, or enable a child to adopt
an appearance that does not correspond to his or her sex, or to
intentionally change the body of a child, including the child's
external appearance or biological functions, to no longer
correspond to his or her sex, including--
``(A) intentionally delaying, halting, or
disrupting the natural development of the child's body,
including the onset or progression of puberty, so that
it does not develop or halts developing to correspond
to the child's sex, including but not limited to the
use of puberty blocking drugs, such as gonadotropin
releasing hormone agonists or antagonists;
``(B) prescribing, administering, or dispensing to
the child androgen blockers or sex hormones such as
estrogen, progesterone, or testosterone;
``(C) prescribing or performing any surgical
procedure that attempts to transform the physical
appearance or that attempts to alter or remove the
tissues, cavities, bone, cartilage, or organs of a
child;
``(D) providing compression materials or garments
that are designed to constrict female breasts, or that
flatten or tuck a male's genitals, prosthetic breasts,
genitals, or hips, or any other materials that enable
the child to conceal his or her sex or to simulate the
physical characteristics of the opposite sex;
``(E) permitting or assigning a child who is 4
years of age or older to--
``(i) use sleeping quarters, bathrooms,
locker rooms, changing rooms, or other areas in
which a child may be in a state of undress that
are designated for individuals of the opposite
sex; or
``(ii) participate in sex-separated
activities designated for individuals of the
opposite sex.
Nothing in this paragraph shall be construed as precluding the
treatment of a disorder of sex development or the treatment of
any infection, injury, disease, or disorder that has been
caused or exacerbated by the performance of an intervention
described in subparagraph (A), (B), (C), or (D).
``(19) The term `covered entity' means any of the following
entities that has received funds under this part or part B
directly or as a subrecipient:
``(A) Any State and any State or local agency.
``(B) Any Indian tribe or tribal organization.
``(C) Any public or private agency or organization
that contracts with any entity listed in subparagraph
(A) or (B).
``(D) Any individual who is a contractor, employee,
or agent of any of the entities listed in subparagraphs
(A), (B), or (C).''.
SEC. 203. AMENDMENTS TO THE JOHN H. CHAFEE FOSTER CARE PROGRAM FOR
SUCCESSFUL TRANSITION TO ADULTHOOD.
Section 477 of the Social Security Act (42 U.S.C. 677) is amended--
(1) in subsection (b)--
(A) in paragraph (2), by adding at the end the
following new subparagraphs:
``(G) Ensure that the programs comply with, and
require covered entities receiving funds under this
section to comply with, the requirements of paragraphs
(38) through (42) of section 471(a) for any youth who
has not attained the age of 18 receiving services under
this section.
``(H) Ensure that any provider of transitional or
independent living services shall comply with the
housing requirements of paragraph (41) of section
471(a) with regard to any youth receiving such services
who has not attained the age of 18.''; and
(B) in paragraph (3), by adding at the end the
following new subparagraphs:
``(L) A certification by the chief executive
officer of the State that the State's programs under
this section comply with the requirements of paragraphs
(38) through (42) of section 471(a) with respect to
services provided to any youth who has not attained the
age of 18.
``(M) A certification by the chief executive
officer of the State that the State will ensure that
any youth who has not attained the age of 18 and who is
receiving independent living services funded under this
section shall be housed in accordance with the
requirements of paragraph (41) of section 471(a).'';
and
(2) by adding at the end the following new subsection:
``(k) Limitations.--No amount paid to a State and no amount
received by a covered entity with such funds may be used to provide,
facilitate, fund, authorize, or permit for a youth, or refer a youth
for, any sex-rejecting intervention for any youth who has not attained
the age of 18 and who is receiving services funded under this
section.''.
SEC. 204. RULES OF CONSTRUCTION; APPLICATION TO FUNDING RESTRICTIONS
UNDER PARTS B AND E OF TITLE IV OF THE SOCIAL SECURITY
ACT.
Part E of title IV of the Social Security Act (42 U.S.C. 670 et
seq.) is amended by adding at the end the following new section:
``SEC. 479C. RULES OF CONSTRUCTION; APPLICATION TO FUNDING RESTRICTIONS
UNDER PARTS B AND E.
``(a) Affirming a Child's Sex Is Not Abuse.--In administering,
enforcing, or awarding funds under this part or part B, including under
section 477, the Secretary shall not treat, and shall ensure that no
recipient or subrecipient uses funds awarded under such provisions to
treat, affirmation of a child's sex by a parent, legal guardian,
caregiver, foster parent, prospective foster parent, or prospective
adoptive parent as child abuse, emotional abuse, neglect, maltreatment,
abandonment, contrary to the child's best interests, contrary to a
child's health, safety, or welfare, or as an indication of parental
unfitness or incapacity.
``(b) Condition on Receipt of Funds; Rights Protected.--As a
condition of receiving funds, including any grants, subgrants, or other
allocations, under this part or part B, including under section 477, a
covered entity shall protect the following rights and shall not
discriminate or take an adverse State action against an individual
because such individual exercises, has exercised, or intends to
exercise any such right:
``(1) A parent or legal guardian has the right to affirm a
child's sex, including the right for the child not to be
subjected by any covered entity, even if the child is in the
legal or physical custody of the covered entity, to--
``(A) the provision, facilitation, funding,
authorization, or permission of any sex-rejecting
intervention for the child;
``(B) the use of pronouns or titles that do not
correspond to the child's sex, without the express
written consent of such parent or legal guardian; or
``(C) if the child is 4 years of age or older,
being permitted or assigned the use of sleeping
quarters (other than sleeping quarters shared only with
a sibling), bathrooms, showers, locker rooms, changing
rooms, or any other area in which the child would be in
a state of undress, with individuals of the opposite
sex.
``(2) A parent or legal guardian has the right not to be
required to consent to the child being subjected to any of the
actions described in subparagraph (A), (B), or (C) of paragraph
(1) as a condition of custody or return of the child, or
visitation, communication, or reunification with the child.
``(3) A parent, legal guardian, caregiver, foster parent,
prospective foster parent, or prospective adoptive parent has a
right to be free from discrimination or adverse State action
for affirming or intending to affirm a child's sex.
``(4) A child has the right not to be subjected by any
covered entity, even if the child is in the legal or physical
custody of the covered entity, to any sex-rejecting
intervention.
``(c) Scope of Application.--For purposes of the restrictions on
the use of awards under this part or part B, including under section
477, if any covered entity receives funds under either such part or
section, directly or as a recipient of a subgrant, contract, or other
allocation, the requirements and prohibitions of such restrictions
shall apply to all of the operations, divisions, facilities, and
programs of that covered entity, regardless of whether the specific
operation, division, facility, or program that engages in the conduct
described in such restrictions itself received such funds.''.
SEC. 205. AMENDMENT TO SECTION 478 OF THE SOCIAL SECURITY ACT.
Section 478 of the Social Security Act (42 U.S.C. 678) is amended--
(1) by striking ``Nothing in this part'' and inserting the
following:
``(a) In General.--Nothing in this part''; and
(2) by adding at the end the following:
``(b) Compliance With Yaeli Martinez Child Protection Act.--
Notwithstanding subsection (a), as a condition of receiving payments
under this part, a State shall ensure that determinations concerning
the health, safety, and best interests of a child comply with the
requirements of, and the amendments made by, the Yaeli Martinez Child
Protection Act.''.
TITLE III--AMENDMENTS TO THE FULL FAITH AND CREDIT FOR CHILD CUSTODY
DETERMINATIONS
SEC. 301. FULL FAITH AND CREDIT FOR CHILD CUSTODY DETERMINATIONS.
Section 1738A of title 28, United States Code, is amended--
(1) in subsection (a), by striking ``subsections (f), (g),
and (h)'' and inserting ``subsections (g) through (j)'';
(2) in subsection (b)--
(A) by redesignating paragraphs (8) and (9) as
paragraphs (17) and (18), respectively;
(B) by redesignating paragraphs (5), (6), and (7)
as paragraphs (11), (12), and (13), respectively;
(C) by redesignating paragraph (4) as paragraph
(9);
(D) by redesignating paragraphs (1), (2), and (3)
as paragraphs (3), (4), and (5), respectively;
(E) by inserting before paragraph (3), as so
redesignated, the following:
``(1) `abuse', `neglect', `mistreatment', `abandonment',
`endangerment', `parental unfitness or incapacity', and `any
other similar claim relating to the health, safety, or welfare
of the child, however characterized under the law of the State
asserting jurisdiction' shall not be construed to include
affirming a child's sex;
``(2) `affirming a child's sex'--
``(A) means referring to and raising a child, or
intending to refer to or raise a child, in accordance
with his or her sex, including refusing to consent to
sex-rejecting interventions for the child; and
``(B) shall not be construed as contrary to the
best interest of the child or contrary to the child's
safety, health, well-being, or welfare;'';
(F) by inserting after paragraph (5), as so
redesignated, the following:
``(6) `disorder of sex development'--
``(A) means a congenital condition involving
atypical chromosome complement or structure or atypical
development of sex chromosomes, gonads, internal
genital ducts, or external genitalia, including
disorders of sex hormone synthesis or action; and
``(B) does not include psychological or behavioral
conditions or typical male or female sex development
with distress regarding sexed anatomy;
``(7) `female' means an individual who naturally has, had,
will have, or would have but for a disorder of sex development
or intentional or unintentional disruption, the reproductive
system that produces, transports, and utilizes the large gamete
(commonly known as `ova') for fertilization;
``(8) `foreign State' means a State that is not the home
State;'';
(G) by inserting after paragraph (9), as so
redesignated, the following:
``(10) `male' means an individual who naturally has, had,
will have, or would have but for a disorder of sex development
or intentional or unintentional disruption, the reproductive
system that produces, transports, and utilizes the small gamete
(commonly known as `sperm') for fertilization;'';
(H) by inserting after paragraph (13), as so
redesignated, the following:
``(14) `sex' means a child's immutable biological sex,
either male or female;
``(15) `sex-rejecting intervention'--
``(A) means a psychological, medical, or surgical
intervention that is intended to promote, endorse, or
enable a child's rejection of his or her sex, to
promote, endorse, or enable a child to adopt an
appearance that does not align with his or her sex, or
to intentionally change the body of a child, including
the child's external appearance or biological
functions, to no longer correspond to his or her sex,
including--
``(i) intentionally delaying, halting, or
disrupting the natural development of the
child's body, including the onset or
progression of puberty, so that it does not
develop or halts developing to correspond to
the child's sex, including the use of puberty
blocking drugs, such as gonadotropin releasing
hormone agonists;
``(ii) prescribing, administering, or
dispensing to the child androgen blockers or
sex hormones such as estrogen, progesterone, or
testosterone;
``(iii) prescribing or performing any
surgical procedure that attempts to transform
the physical appearance or that attempts to
alter or remove the tissues, cavities, bone,
cartilage, or organs of a child;
``(iv) using pronouns or titles that do not
align with the child's sex;
``(v) providing compression materials or
garments that are designed to constrict female
breasts or that flatten or tuck a male's
genitals, prosthetic breasts, genitals, or
hips, or any other materials that enable a
child to conceal his or her sex or to simulate
the physical characteristics of the opposite
sex; and
``(vi) permitting or assigning a child who
is not less than 4 years of age to--
``(I) use sleeping quarters,
bathrooms, locker rooms, changing
rooms, or other areas in which a child
may be in a state of undress that are
designated for individuals of the
opposite sex; or
``(II) participate in sex-separated
activities designated for individuals
of the opposite sex;
``(B) shall not be construed to include the
treatment of a disorder of sex development; and
``(C) shall not be construed to include emergency
medical care for a child, unless the medical care is
for the treatment of any infection, injury, disease, or
disorder that has been caused or exacerbated by the
performance of an intervention described in
subparagraph (A);
``(16) `sex-rejecting intervention kidnapping law' means a
State law that permits a foreign State to take temporary or
permanent jurisdiction over a child custody or visitation
determination because a contestant or a child is seeking a sex-
rejecting intervention or a custodial parent is affirming the
child's sex;'';
(3) in subsection (c)(2)--
(A) in subparagraph (A), by inserting ``with the
permission of each custodial parent'' after ``had been
the child's home State'';
(B) in subparagraph (B), by striking ``training''
and inserting ``education''; and
(C) in subparagraph (E), by striking ``subsection
(d)'' and inserting ``subsections (d) and (e)'';
(4) by redesignating subsection (g) as subsection (j) and
transferring such subsection, as so redesignated, so as to
appear after subsection (h);
(5) by redesignating subsections (d), (e), and (f) as
subsections (e), (f), and (g), respectively;
(6) by inserting before subsection (e), as so redesignated,
the following:
``(d)(1) Notwithstanding any other provision of this section, a
court of a State shall not exercise jurisdiction to make a custody or
visitation determination if--
``(A)(i) the assumption of jurisdiction is based on a
contestant or a child seeking a sex-rejecting intervention for
the child; and
``(ii) sex-rejecting interventions are available in such
State; or
``(B) the assumption of jurisdiction is based on a claim
that a child has been subjected to or threatened with abuse,
neglect, mistreatment, abandonment, endangerment, parental
unfitness or incapacity, or any other similar claim relating to
the health, safety, or welfare of the child, however
characterized under the law of the State asserting
jurisdiction, if such claim is based on a contestant or a child
seeking a sex-rejecting intervention for the child available in
the State.
``(2) For purposes of subparagraph (B) of paragraph (1)--
``(A) notwithstanding the laws of the home State or the
applicable foreign State--
``(i) abuse, neglect, mistreatment, abandonment,
endangerment, parental unfitness or incapacity, or any
other similar claim relating to the health, safety, or
welfare of the child, however characterized under the
law of the State asserting jurisdiction, shall not
include the refusal of a child's parent or legal
guardian to consent to or provide a sex-rejecting
intervention; and
``(ii) the refusal of a child's parent or legal
guardian to consent to a sex-rejecting intervention
shall not be construed as creating an unsafe
environment for a child; and
``(B) a court shall not determine that a court of another
State is a more appropriate forum for custody or visitation
determinations if a contestant or a child is seeking sex
rejecting interventions and those sex rejecting interventions
are not available in the State of the court making the
jurisdictional determination.
``(3) A custody or visitation determination made in violation of
subparagraph (A) or (B) of paragraph (1) is not entitled to full faith
and credit, enforcement, or recognition under this section by any court
and shall not be given effect as a custody or visitation determination
for purposes of subsections (a), (e), and (g) through (j). Any State
law that purports to authorize the exercise of jurisdiction over a
custody or visitation determination on a basis prohibited by
subparagraph (A) or (B) of paragraph (1) is preempted and without
effect.'';
(7) in subsection (e), as so redesignated, by striking
``the requirement of subsection (c)(1)'' and inserting ``the
requirements of subsections (c) and (d)'';
(8) in paragraph (1) of subsection (g), as so redesignated,
by inserting ``, unless a claim to such jurisdiction arises out
of, or is related to, such State's sex-rejecting intervention
kidnapping laws'' after ``determination''; and
(9) by inserting after subsection (h) the following:
``(i) No court of a State with a prohibition against a sex-
rejecting intervention for children shall decline to exercise
jurisdiction or be determined to have declined jurisdiction to
determine a modification of custody or visitation under subsection (g)
or (h) if the child has been provided or is seeking a sex-rejecting
intervention in another State.''.
<all>