No Harm Act Bans Federal Funds for Gender-Affirming Care for Minors, Imposes Triple Damages on Providers

The “No Harm Act” is a sweeping piece of legislation that puts a hard stop on using federal money for any medical procedure that alters sex characteristics for people under 18. This isn't just about Medicaid; it’s a total ban on federal funds being used to pay for, promote, or even sponsor what the bill calls “sex-trait altering treatment” for minors, which includes puberty blockers, hormone therapy, and various surgeries (Sec. 2, Sec. 11).

The Federal Funding Freeze

If you’re a taxpayer, this bill gives you a direct way to hold the government accountable—or at least the ability to sue it. Any person can file a civil lawsuit against a federal agency if they suspect federal money was improperly used to fund these treatments for a minor, seeking monetary damages or a court order to stop it (Sec. 2, Sec. 3). Even bigger, any medical facility, like a hospital or clinic, that provides these specific treatments to minors risks losing all federal funding, which is a massive financial blow that could shut down entire programs or institutions (Sec. 5).

The State-Level Squeeze: Medicaid and Parental Rights

This bill uses the federal purse strings to force states to adopt specific policies. States will lose significant federal money—including funds from Medicaid (Title XIX) and child welfare programs—if they allow these treatments for minors without getting consent from both parents (Sec. 6). Even more critically, a state will be penalized if it separates a minor from their parents solely because the parents refused to consent to the sex-trait altering treatment. This means the federal government is stepping directly into state child welfare decisions, linking family separation policies to the continued flow of critical healthcare dollars.

New Liability for Past and Future Care

This section is a game-changer for healthcare providers. For any doctor, clinic, or hospital that has previously provided these treatments to someone who was a minor at the time, the risk of a lawsuit just went way up. The bill creates a new federal cause of action allowing anyone who received these treatments as a minor to sue their provider for up to 30 years after they turn 18 (Sec. 8). If the former patient wins, the court must award them treble damages—three times the amount of compensation for harm—plus attorney’s fees. This highly punitive liability standard could cause providers to immediately stop offering this type of care to minors, even if parents consent, due to the decades-long risk of massive financial penalties.

Conscience and Consent: The Fine Print for Doctors

The bill also establishes broad “Right of Conscience” protections, meaning healthcare providers (including doctors, nurses, pharmacists, and even health insurance companies) cannot be punished, fired, or discriminated against for refusing to participate in, refer for, or pay for these treatments (Sec. 9). Furthermore, the bill sets strict informed consent rules: even when parents agree, providers must schedule a meeting with the parents and provide a detailed, written list of all side effects, including permanent impacts on fertility and sexual function, at least 72 hours before the treatment (Sec. 7).

Impact on Schools and Legal Definitions

Federal funding for elementary and secondary schools is also tied to compliance. School personnel cannot support or facilitate these treatments for students without written parental consent (Sec. 10). Finally, the bill defines "Sex" biologically (chromosomes and anatomy at birth) versus "Gender" (psychological/social identity) and explicitly amends federal law regarding female genital mutilation (FGM) to state that gender-affirming care for minors cannot be considered medically necessary for the purposes of that statute (Sec. 4). This move effectively reclassifies gender-affirming care for minors in a specific legal context, signaling a significant shift in how the federal government views these procedures.