This bill aims to prohibit healthcare professionals, hospitals, and clinics from participating in what it defines as "chemical or surgical mutilation" of children, meaning individuals under 18 years of age. This definition includes the use of puberty blockers, sex hormones, or surgical procedures intended to intentionally halt natural development or change a child's body to no longer correspond to their immutable biological sex. However, the bill explicitly excludes medically necessary procedures for verifiable disorders of sexual development, treatment of existing infections or injuries, and "detransition treatment" designed to reverse or cope with prior interventions.

The prohibition applies when there is a connection to interstate commerce, such as through travel, payments, or the use of instruments that have crossed state lines. Any healthcare professional, hospital, or clinic participating in such acts must demonstrate by clear and convincing evidence that an exception applies. The bill also clarifies that it does not prohibit counseling, referrals, or discussions of treatment options, provided these actions do not constitute participation in the defined mutilation.

A key provision establishes a private right of action, allowing individuals who underwent these procedures as children, or their parents, to file civil lawsuits for damages. This right applies to procedures performed both before and after the bill's enactment. Available damages include compensatory damages for reversing or ameliorating effects, non-economic damages for emotional distress, and punitive damages for malicious or reckless conduct.

For acts occurring after the bill's enactment, strict liability applies if participation in chemical or surgical mutilation is proven by clear and convincing evidence. If an exception is claimed, the healthcare provider bears the burden of proving its applicability by clear and convincing evidence. The statute of limitations for these actions is 25 years from the individual's 18th birthday or 4 years from the time the cost of detransition treatment is incurred, whichever date is later.