Technical and procedural updates only. The two versions of H.R. 3492 are identical in their legislative text; v4 reflects the bill's referral to the Senate after passing the House. No substantive policy changes were made between v3 and v4.
Protect Children’s Innocence Act
- Sponsor
- Rep. Greene, Marjorie Taylor [R-GA-14]
- Committees
- Judiciary Committee (primary)
- Last action
- Dec 18, 2025
Bottom line
This bill establishes new federal crimes for a wide range of gender-affirming medical procedures and hormone therapies for minors, with narrow exceptions for specific physical health conditions.
What it actually does
This bill amends existing federal law (18 U.S.C. 116) to criminalize performing or attempting to perform "genital or bodily mutilation" or "chemical castration" on a minor. It broadly defines these terms to include various gender-affirming surgeries and hormone therapies, while also expanding prohibitions related to female genital mutilation. The bill outlines specific medical exceptions, primarily for intersex conditions or physical health necessities, explicitly excluding mental, behavioral, or emotional distress as a justification for these procedures.
Proponents argue
Supporters argue the bill protects minors from irreversible medical procedures and interventions that they are too young to consent to, asserting that these procedures can cause long-term harm. They contend it safeguards children's physical and psychological well-being by preventing what they view as experimental or unnecessary interventions that alter biological sex.
Opponents contend
Opponents argue the bill interferes with medical decisions made by families and healthcare providers, potentially denying necessary, evidence-based care for transgender and intersex youth. They contend it could lead to worse mental health outcomes for minors experiencing gender dysphoria and infringes on parental rights and medical autonomy by criminalizing accepted medical practices.
The bill is relatively short and clearly structured, making it accessible for an informed reader to understand its core provisions within a reasonable timeframe.
Section 2(a), amending 18 U.S.C. 116(a) and (b)
Criminalization of Genital/Bodily Mutilation and Chemical Castration of Minors
This provision makes it a federal crime, punishable by up to 10 years imprisonment and/or a fine, for anyone to knowingly perform or attempt to perform "genital or bodily mutilation" or "chemical castration" on a minor. It significantly expands the scope of the existing law beyond female genital mutilation to include a broad range of gender-affirming medical interventions.
Supporters argue
Supporters argue this protects minors from irreversible medical interventions that they may later regret, emphasizing that children are not mature enough to make such life-altering decisions. They contend it safeguards children from procedures that are not medically necessary for their biological sex.
Critics contend
Opponents argue this provision criminalizes medically accepted care for gender dysphoria, infringing on the rights of parents and medical professionals to make healthcare decisions. They contend it could force minors to delay care, leading to increased psychological distress and negative health outcomes.
Tradeoffs
The bill balances the perceived need to protect minors from irreversible procedures against the autonomy of parents and medical professionals to provide gender-affirming care, and the potential for negative mental health impacts on minors denied such care.
Section 2(a), amending 18 U.S.C. 116(c)
Expansion of Female Genital Mutilation Offenses
This provision explicitly criminalizes facilitating or consenting to female genital mutilation (FGM) of a minor, or transporting a minor for the purpose of FGM. This reinforces and potentially broadens existing prohibitions against FGM, aligning with international human rights standards.
Section 2(a), amending 18 U.S.C. 116(d)
Interstate Commerce and Federal Jurisdiction
This section defines the circumstances under which the federal government has jurisdiction to prosecute offenses under the Act. These include travel in interstate or foreign commerce, use of interstate commerce instrumentalities, payments affecting interstate commerce, interstate communications, use of items that traveled in interstate commerce, conduct in federal jurisdiction, or conduct otherwise affecting interstate commerce.
Section 2(a), amending 18 U.S.C. 116(g)
Medical and Intersex Exceptions
This section outlines specific exceptions where the prohibitions do not apply. These include procedures "necessary to the health of the minor" performed by a licensed medical practitioner (explicitly excluding mental/behavioral distress), FGM for medical purposes during labor/birth, and procedures for individuals with intersex conditions (e.g., ovarian/testicular tissue, abnormal sex chromosomes/hormones), those experiencing complications from a previous procedure, or those in imminent danger of major bodily function impairment. It also exempts treatment for precocious puberty to normalize puberty.
Section 2(a), amending 18 U.S.C. 116(h)
Key Definitions (Genital/Bodily Mutilation, Chemical Castration, Biological Sex, Minor, Male, Female)
This section provides extensive definitions for key terms. "Genital or bodily mutilation" includes FGM and a long list of surgeries for the purpose of changing the body to correspond to a sex differing from biological sex (e.g., castration, hysterectomy, mastectomy, facial feminization/masculinization). "Chemical castration" includes puberty blockers, testosterone for biological females, and estrogen for biological males. "Biological sex" is defined as classification at birth. "Minor" is under 18. "Male" and "Female" are defined by reproductive systems.
This sub-provision explicitly states that "health of a minor" for the purpose of medical exceptions does not include "mental, behavioral, or emotional distress" or "a mental, behavioral, or emotional disorder."
Section 2(a), amending 18 U.S.C. 116(g)(1)(B)
Why it matters:This is a standard legislative technique to precisely define terms and limit the scope of exceptions. However, given the significant role of mental health in gender dysphoria treatment, its placement here is highly consequential.
Case for: Proponents argue this ensures the bill's focus remains on preventing purely elective or non-physically necessary procedures, preventing mental health concerns from being used as a justification for irreversible physical interventions.
Case against: Opponents argue this clause effectively bans gender-affirming care for minors, as gender dysphoria is a recognized mental health condition, and medical interventions are often deemed necessary by professional organizations to alleviate severe mental distress and improve psychological well-being.
Estimated impact: This clause fundamentally narrows the medical exceptions, making it impossible to justify gender-affirming medical care for minors based on mental health needs, which is a primary reason such care is sought.