A divided House on Wednesday approved legislation that would criminalize gender transition treatments for minors, including surgery and supplying hormones, and would subject providers to up to 10 years in federal prison.
The bill, which civil rights groups said counted as one of the most extreme anti-trans pieces of legislation ever considered by Congress, was approved almost entirely along party lines on a vote of 216 to 211.
It has little chance of being considered by the Senate, where it would need the support of a bipartisan coalition to advance. But its debate and passage in the House reflected the priorities of the ultraconservative Republican majority and President Trump, who has demonized and targeted L.G.B.T.Q. people during his tenure.
It was pushed through the House by Representative Marjorie Taylor Greene, the right-wing Republican from Georgia, who earlier this month insisted that Speaker Mike Johnson bring her bill to the floor in exchange for her support for the defense policy measure she was otherwise threatening to sink.
Ms. Greene said that the legislation delivered on one of Mr. Trump’s key campaign promises and that Congress needed to act to codify his executive order ending gender-affirming medical treatments.
“Most Americans agree that kids just need to grow up before they do anything radical, like a mastectomy on a 15-year-old girl,” she said on Wednesday on the House floor, pointing at a poster board of a child who had undergone such a surgery.
Ms. Greene, who abruptly announced last month that she was leaving Congress a year before the end of her term, has recently won strange new respect from some Democrats for breaking with the president on a variety of issues. Her hard-line position opposing transgender rights on one of her final days in Congress was a return to her older, more familiar political persona.
“If a child believes they’re a unicorn, do adults take their word for it as well?” Ms. Greene said, adding that in electing Mr. Trump in 2024, the American people voted to end gender transition treatments.
Representative Barry Moore, Republican of Alabama, said Democrats had misleadingly framed gender-affirming procedures as being necessary when in fact what they were doing was indoctrinating children.
“It is not lifesaving care,” he said. “It is child abuse.”
Democrats, in response, said supporters of the legislation were targeting a tiny and vulnerable population of trans youth and, in doing so, seeking to replace medicine with ideology. They said the legislation trampled on parental rights by threatening them with prison time and allowed politicians to make deeply personal decisions for families.
“Does anyone believe that the Freedom Caucus and President Trump love America’s children more than their parents do?” said Representative Jamie Raskin, Democrat of Maryland.
Representative Mark Takano, Democrat of California, said the surgeries on minors that Ms. Greene described were extremely rare. What the bill would really do, he said, is ban “safe and effective medications for an entire group of people.” Mr. Takano said that the bill would not make children safe and that it would “interfere with parental choice and open private medical data up to investigation.”
The House also teed up a vote for later this week on a second anti-trans bill, also backed by Ms. Greene, that would ban Medicaid coverage of gender-affirming care for trans youth.
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Before the vote on Wednesday, Representative Sarah McBride, Democrat of Delaware and the first openly transgender lawmaker to serve in Congress, said that Republicans were “obsessed” with transgender people and were focusing on a “misunderstood and vulnerable 1 percent of the population” instead of doing anything to protect Americans’ health care.
“They think more about trans people than trans people think about trans people,” she said, speaking to reporters on the steps of the Capitol. “They are consumed with this and they are extreme on it.”
Before the vote, Ms. McBride, a center-leaning lawmaker who typically tries to focus on economic issues and has gone out of her way not to dwell on her identity, delivered the most personal remarks on the topic since her election.
“I get that it’s hard to understand what it feels like to be trans,” she said. “I get that it’s hard to understand this care and the need for it.” But, she added, the legislation would put parents and providers at risk of going to jail for affirming their transgender child and following medical best practices.
She continued: “I didn’t have the courage to come out until I was 21, but it’s a fact I have known about myself for my entire life. That means 21 years of pain, 21 years of unwavering homesickness. I never had a childhood without pain.”
Ms. McBride was joined on the steps by Representatives Alexandria Ocasio-Cortez of New York and Julie Johnson of Texas, an effort to show how centrist and progressive Democrats were united on the issue.
The American Medical Association, the American Psychological Association and the American Academy of Pediatrics all support gender-affirming care and outside civil rights organizations denounced the legislation and urged members to oppose it.
“This extreme bill puts the threat of prosecution between hundreds of thousands of families and their doctors and would put doctors behind bars for exercising their best medical judgment,” said Mike Zamore, the national director of policy and government affairs at the American Civil Liberties Union.
State laws banning or restricting minors’ access to gender affirming care have proliferated in the past few years. In 2021, Arkansas became the first state to pass a law prohibiting gender-transition treatments for minors. Since then, laws banning or restricting those treatments have proliferated in Republican-led states.
Of 28 states where Republicans control the legislature, 24 now restrict doctors from providing puberty blockers, hormone therapies or surgery to transgender minors. Two more, New Hampshire and Arizona, ban surgeries.
In June, the Supreme Court voted 6 to 3 to uphold a Tennessee law that prohibits adolescents from using hormones and puberty blockers for gender transition. That statute includes civil penalties, such as fines for doctors who violate the ban, in addition to misdemeanor criminal charges. Laws in six states and Puerto Rico include a felony charge.
It was not the first time this year the House has highlighted trans issues, a topic that Republicans believe helped Mr. Trump win the White House in 2024. In January, the House approved legislation that aimed to bar transgender women and girls from participating in school athletic programs designated for female students.
On Wednesday, Republicans used their floor time to accuse Democrats of abusing children.
“There is no such thing as a trans kid,” Representative Nancy Mace, Republican of South Carolina, said. She called it a “mind virus perpetuated by the far left to groom kids.”
Mr. Trump has also made an assault on transgender rights an important plank of his agenda. His executive order ending gender-affirming medical treatment for children and teenagers was one of the first he signed after taking office in January. Mr. Trump’s directive set as official policy that the federal government would not “fund, sponsor, promote, assist or support the so-called ‘transition’ of a child from one sex to another.”
Ann E. Marimow contributed reporting
Annie Karni is a congressional correspondent for The Times.
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