As the last vote of the day on Wednesday evening, the U.S. House passed a bill that would make doctors and parents criminals for providing gender-affirming medical care to transgender minors, marking the first time Congress has approved a national ban on such treatment and escalating a years-long Republican campaign to regulate transgender lives through federal law. It now goes to the Senate, where it is unlikely to pass.
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The legislation, introduced by Republican Rep. Marjorie Taylor Greene of Georgia and titled the Protect Children’s Innocence Act, would impose felony penalties of up to 10 years in prison on physicians who provide puberty blockers, hormone therapy, or surgical care to patients under 18. The bill would also expose parents and others who consent to or help minors access that care to criminal liability.
The bill passed with 216 members voting for it and 211 against it. Three Democrats, Texas Reps. Henry Cuellar and Vicente Gonzalez, and North Carolina Rep. Don Davis joined all but four Republicans in supporting the bill’s passage. President Donald Trump recently pardoned Cuellar after the congressman was indicted on a dozen charges of bribery, money laundering, and conspiracy. Democrats Reps. Eric Swalwell of California, Lucy McBath of Georgia, and Joe Courtney of Connecticut did not vote. Swalwell is running for governor of California.
Republican Reps. Gabe Evans of Colorado, Brian Fitzpatrick of Pennsylvania, Mike Kennedy of Utah, and Mike Lawler of New York voted against the measure.
Related: House GOP advances Marjorie Taylor Greene’s transphobic bill banning gender-affirming care for trans youth
Every major medical association in the U.S., including the American Medical Association and the American Academy of Pediatrics, supports providing this evidence-based and safe care to young people when supervised by a qualified health care provider.
The vote represents a watershed moment in the national fight over transgender rights, transforming what has largely been a state-level effort to ban gender-affirming care for minors into a federal mandate with sweeping implications for medical practice, family autonomy, and constitutional law. Democrats in the Senate are expected to reject the measure and attempt to block or delay its passage.
Before the House voted on the bill, Vermont U.S. Rep. Becca Balint, a Democrat, offered the motion to recommit — the minority party’s final opportunity to amend or send the bill back to committee before a vote on final passage. The motion failed, allowing the House to proceed to final passage of the legislation.
After the bill passed, out California U.S. Rep. Mark Takano, chair of the Congressional Equality Caucus, criticized the result in a statement.
“This bill is the most extreme anti-transgender legislation to ever pass through the House of Representatives and a direct attack on the rights of parents to work with their children and their doctors to provide them with the medical care they need. If this bill becomes law, doctors, pharmacists, and — in some circumstances — the parents of young trans people, would face time in prison for choosing to prioritize their child’s health," Takano said. "This bill is beyond cruel and its passage will forever be a stain on the institution of the United States Congress."
Ahead of the vote, Greene publicly clashed with fellow Republicans over proposed changes to her bill, accusing House leadership and Rep. Chip Roy of Texas of weakening its scope. In a series of posts on X, Greene wrote that her original proposal relied on Congress’s authority under the Commerce Clause to criminalize all pediatric gender-affirming care nationwide, while Roy’s amendment would instead limit federal funding to facilities that provide such care.
“My bill fully criminalizes it if passed as a stand-alone bill,” Greene wrote, adding that allowing Roy’s amendment to advance would leave what she called “California trans child sanctuary state policies and laws” untouched. She warned that if the amendment passed, “Republicans will be fully responsible for NOT stopping the evil trans agenda on kids.”
Related: Behind Marjorie Taylor Greene's latest push to criminalize gender-affirming care
Greene pushed the bill as a fulfillment of what she described as a promise by Trump and congressional Republicans to “protect kids from the trans agenda.”
The House’s approval came during Greene’s final weeks in Congress. She announced last month that she will resign in early January, following escalating clashes with House Speaker Mike Johnson of Louisiana and growing distance from Trump and his allies.
Related: Citing Skrmetti, appeals court rejects challenge to Oklahoma ban on gender-affirming care for youth
Democrats and LGBTQ+ advocates warned that the legislation would have immediate and far-reaching consequences, regardless of whether it ultimately becomes law.
Those concerns were echoed during a press call Tuesday organized by the Human Rights Campaign ahead of the vote. Kelley Robinson, the organization’s president, pointed out the bill would criminalize care widely accepted within the medical community. “They want to put pediatricians and parents into a jail cell for caring for their kids,” Robinson said. “I have to ask again, what are we doing here?”
Robinson argued that the legislation reflected misplaced priorities as Congress approaches major health care deadlines. “There are plenty of things that the American people are begging for them to work on,” she said, warning that millions could lose insurance coverage without Republican action to extend tax subsidies. Instead, she said, lawmakers were ending the year “spending their time and energy voting on proposals that target a tiny vulnerable group of people in this country, transgender kids.”
Medical experts warned that the bill’s passage could chill care nationwide. Dr. Kenneth Haller, an emeritus professor of pediatrics at Saint Louis University School of Medicine, said similar state restrictions had already driven families out of Missouri. “Until recently, I have never had to tell parents that despite safe, effective, thoroughly researched treatments for a condition that is causing their child to suffer, the state has made these treatments illegal,” he said. “It is not science. It is just blind ideology.”
Related: Supreme Court rules states can ban gender-affirming care for youth in U.S. v. Skrmetti
Advocates for transgender youth emphasized that the harm is already being felt. Rodrigo Heng-Lehtinen, a senior vice president at the Trevor Project, said the organization’s crisis counselors regularly hear from young people distressed by political attacks on their health care. “This care has quite literally been lifesaving for so many young people,” he said, adding that the group’s most recent national survey found that 90 percent of LGBTQ+ youth said recent politics had negatively affected their mental health.
Parents described the legislation as life-altering. Rachel Gonzalez, a Texas parent of a transgender teenager, said her family relocated out of state after losing access to care.
“No politician should be in any doctor’s office or living room making private health care decisions,” she said. “No trans youth should ever be used as a political pawn.”
Takano added, "At a time where the federal government is already so hostile towards the transgender community, it is imperative that Senate Democrats hold the line to prevent this dangerous bill from reaching President Trump’s desk in order to protect the rights and safety of young trans people and their families.”
Editor's note: This story has been updated to include the names of the Democratic members of Congress who voted for the bill.
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