H.R. 6876: Protecting Children from Foreign Mutilation Act

HR6876, the Protecting Children from Foreign Mutilation Act, would impose U.S. immigration sanctions on three categories of foreign persons: members of the World Professional Association for Transgender Health, licensed physicians who perform, prescribe, or facilitate covered treatments for U.S. persons, and owners or operators of clinics, hospitals, pharmacies, or other medical institutions that do the same. The bill defines a "United States person" narrowly here as a U.S. citizen, national, or lawful permanent resident who has not attained 18 years of age. That means the sanctions framework is aimed at care involving minors, not adults.

The penalties are sweeping. A foreign person covered by the bill would be inadmissible to the United States, ineligible for a visa or other entry document, and ineligible for admission, parole, or any other benefit under the Immigration and Nationality Act. Any existing visa or entry documentation would be immediately and automatically revoked. The Secretary of State would also have to create procedures allowing people to submit information about foreign persons who may qualify for sanctions, and Congress would have to receive a report no later than 180 days after enactment describing actions taken, the number of people sanctioned, and recommendations for additional deterrence measures.

The bill uses an expansive definition of "chemical or surgical mutilation." It specifically includes puberty blockers such as GnRH agonists, sex hormones including androgen blockers, estrogen, progesterone, and testosterone, and surgeries that transform appearance or alter or remove sexual organs so a person's body no longer corresponds to the person's sex. It defines sex as an immutable biological classification determined at the moment of conception as either male or female. At the same time, the bill carves out several exclusions: treatment for specific disorders of sexual development, listed as 46 XX with virilization, 46 XY with undervirilization, or the presence of both ovarian and testicular tissue; treatment of infection, injury, disease, or disorder caused by a prior intervention; responses to traumatic bodily injuries, congenital structural anomalies of major organs or systems, or acute illnesses with a high probability of mortality; and detransition treatment.

There are limited escape valves. Sanctions would not apply when admission is required by the June 26, 1947 UN Headquarters Agreement or other international obligations. A physician can seek a waiver if the physician no longer works for the entity performing the acts and has provided information to the Secretary of State identifying another sanctionable person or has reported a legal or regulatory violation to a federal official. The President may also waive sanctions when doing so is in the national security interests of the United States. If any part of the law is struck down in court, the rest would remain in effect because the bill includes a severability clause.