House sets votes on gender care penalties

Axios – Wednesday, December 17, 2025
By Maya Goldman

The House of Representatives will vote this week on two bills to restrict transgender youths’ access to gender-affirming care, including legislation led by Rep. Marjorie Taylor Greene (R-Ga.) that would criminalize providing certain procedures or medications.

The big picture: Even if the bills pass the House, they likely will die in the Senate. But the votes will serve as a barometer of how far Republican lawmakers are willing to go to strip access to gender-affirming care and showcase the issue during the midterms.

Gender-affirming medical care for kids is considered safe and appropriate by major medical organizations, including the American Medical Association.

State of play: Greene’s bill, up for a vote Wednesday, would make it a felony to provide or facilitate transition-related care for minors via an expanded definition of what counts as “genital and bodily mutilation and chemical castration.”

Violators could face fines and up to 10 years in prison.

Greene, who’s resigning in January, said on X that House leadership agreed to bring the legislation to the floor in exchange for her vote to pass the annual defense authorization bill. She’s introduced this bill in the past but it’s never before received a floor vote.

What they’re saying: The American Civil Liberties Union describes the bill as “the most extreme anti-trans legislation ever considered by Congress.”

“The fundamental equality of transgender people and our families is at stake now, but the implications of criminalizing health care could be far-reaching for everyone,” Mike Zamore, the ACLU’s national director of policy and government affairs, said in a statement.

More than 160 advocacy groups focused on health care and LGBTQ+ rights wrote to House leadership last week urging them to oppose the legislation.

“This bill does not protect children. Instead, it polices identities and criminalizes the practice of safe pediatric medicine,” their letter says.

Another bill up for a vote in the House this week would prohibit Medicaid funding for gender-affirming care — including puberty blockers, hormone therapy and surgeries for transgender kids.

Other minors with medical needs would still get coverage for those procedures under the bill, which is sponsored by Rep. Dan Crenshaw (R-Texas).

The House previously passed a Medicaid gender-affirming care ban in the GOP tax-and-spending package, although the language wasn’t included in the final version.

What we’re watching: The Trump administration is eyeing a proposal to cut off hospitals’ Medicare and Medicaid payments if they perform gender-affirming medical procedures for transgender youth.

The proposal is currently under White House review.

Hospitals are highly reliant on Medicare and Medicaid. Losing access to that coverage could cripple facilities.

Reality check: Drugs like puberty blockers are temporary and reversible, and are also used for non-trans youth who experience early-onset puberty. Surgeries for transgender children are rare.

The overwhelming majority of kids who receive gender-affirming care report high levels of satisfaction and low levels of regret.

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