Just ahead of her resignation in January, Rep. Marjorie Taylor Greene cut a deal to ensure that her signature anti-trans bill would get a vote on the House floor. 

The American Civil Liberties Union says it is the most extreme anti-trans legislation ever considered by Congress: It would put doctors in jail for up to 10 years if they provide gender-affirming care to minors, including prescribing hormone replacement therapy to adolescents or puberty blockers to young kids. The bill also aims to halt gender-affirming surgeries on minors, which is rare. 

“This would make it a Class C felony to trans a child under 18,” Greene, a Georgia Republican, said on X. In that post, she describes her bill as “one of President Trump’s key campaign promises” — gutting gender-affirming care — a presidential shout-out despite the litany of public grievances that led to their estrangement. 

The far-reaching legislation is leaving medical professionals fearful, even though it’s not expected to become law. A vote on the House floor, where the bill needs a simple majority to pass, is scheduled for Wednesday. The measure will then go to the Senate, where it is unlikely to advance, since at least seven Democrats would need to sign on. 

“One of the problems with these sorts of bills is that medical communities, medical organizations, tend to over-enforce them,” said Kenneth Haller, a professor and St. Louis pediatrician, at a press call organized by the Human Rights Campaign on Tuesday. He pointed to the chilling effect anti-abortion bills had on reproductive care as an example: “These bills are so sweeping that they’re afraid that anybody could do anything to drag an obstetrician or a hospital into court or put them in jail,” he said. 

Greene’s bill also threatens families of trans youth. If passed, it would subject anyone who “facilitates or consents to female genital mutilation of a minor” or who transports a minor for that purpose to the same 10-year sentence, or a fine. Given that nearly the entire South has banned gender-affirming care for youth, many families are making long drives to find appointments. As of July 2024, the Campaign for Southern Equality estimated that it takes a trans kid living in Atlanta — the biggest city near Greene’s Georgia district — almost seven hours’ drive to reach a gender clinic. 

“Congress has to reject these bills. They are so dangerous. They are insulting to families like mine,” said Rachel Gonzales, mother to a trans 15-year-old, on the Human Rights Campaign press call. Her family recently left the United States due to anti-trans policies, she said. 

“There are so many parents like me who are just trying to stay one step ahead. … It’s been really, really difficult for my family to relocate,” Gonzales said. 

The legislation also seeks to revise the federal statute outlawing female genital mutilation to include gender-affirming care for minors. Advocates who fight against genital mutilation previously told The 19th that this kind of false conflation is hurting their efforts to protect kids from genital cutting. 

Republicans control the House by a slim margin, and members of their party — particularly women — have expressed dissatisfaction with Speaker Mike Johnson. 

During the final week that Congress is in session before the holidays, lawmakers advanced Greene’s sweeping legislation alongside another bill seeking to restrict trans health care. If passed, Rep. Dan Crenshaw’s bill would prevent federal Medicaid dollars from being used to fund gender-affirming care for minors. Crenshaw, a Texas Republican, previously led an effort in the House to add a ban on Medicaid funds for gender-affirming care into the GOP reconciliation bill; his effort ultimately failed. 

Eleven states already explicitly exclude transgender health care coverage for patients of all ages in their Medicaid policy, according to the Movement Advancement Project, which tracks LGBTQ+ policy. Three other states exclude Medicaid coverage only for minors. In 26 states and Washington, D.C., state Medicaid covers trans health care needs. 

Both bills were brought to the House Rules Committee on Tuesday, where they were voted forward. A full floor vote on Crenshaw’s bill is also expected this week. 

Greene has repeatedly introduced her bill since 2021, the same year she entered Congress, and watched it fail to advance. Now, in exchange for her support on the National Defense Authorization Act, the bill will reach the House floor for the first time. LGBTQ+ advocates are deeply concerned about how the legislation would impact families of trans youth — many of whom have already reached a breaking point after one year of Trump. 

Access to gender-affirming care has been linked to lower rates of depression and suicidality for young trans and nonbinary people, as well as for trans adults. Rodrigo Heng-Lehtinen, senior vice president of public engagement campaigns with the Trevor Project, an LGBTQ+ youth crisis organization, said on Tuesday that gender-affirming care bans have consequences for youth mental health. 

“Our counselors regularly hear from trans and nonbinary youth who express fear and anxiety and deep concern over the anti-transgender politics they’re hearing about in the news,” he said during the Human Rights Campaign press call. “So many young people have expressed that this care made their lives better and allowed them to lead healthy, happy, successful lives.”

Greene’s bill still permits the nonconsensual genital cutting of intersex infants, or people born with variations in their reproductive anatomy. Surgeries performed on intersex infants, including vaginoplasty and clitoral reductions, cause lifelong complications and are often kept secret from the children, who have no ability to consent. For years, state laws banning gender-affirming care around the country have explicitly allowed this practice to continue.

“Intersex infants and young kids who are being subjected to these nonconsensual surgeries are suffering the exact harm that is being falsely claimed about gender-affirming care, and meanwhile, no one in the administration cares to do anything about it,” Sylvan Fraser Anthony, legal and policy director for interACT, a nonprofit advocating for intersex rights, previously told The 19th.

Taken together, both bills represent a dramatic escalation of anti-trans legislation in Congress at a time when the Trump administration is expected to crack down even further on gender-affirming care for trans people of all ages.

On the steps of the Capitol on Wednesday, Rep. Sarah McBride — the first transgender member of Congress — rebuked Republicans for advancing anti-trans bills while letting Affordable Care Act tax credits expire; which is expected to raise health care costs for millions of Americans. 

“They would rather have us focus in and debate a misunderstood and vulnerable one percent of the population, instead of focusing in on the fact that they are raiding everyone’s health care,” the Delaware Democrat said. “They are obsessed with trans people … they are consumed with this.”