Chloe Cole Act Bans Gender-Affirming Care for Minors, Creates Long-Term Liability for Doctors

The “Chloe Cole Act” is a piece of legislation that aims to ban specific types of medical care for anyone under the age of 18, provided that care has any connection to interstate commerce—which, let’s be honest, covers pretty much everything these days. If the doctor or the patient crossed a state line, if the payment used an out-of-state bank, or if the drug used was manufactured outside the state, the prohibition kicks in (SEC. 3).

This bill defines "chemical or surgical mutilation" as using puberty blockers, sex hormones (like testosterone or estrogen), or performing surgeries to intentionally stop or change a child’s natural development to alter their sex or appearance (SEC. 2). The only exceptions are for verifiable intersex conditions (like ambiguous reproductive organs) or for treatment related to detransitioning—meaning reversing a previous procedure (SEC. 2).

The Ban Hammer and the Commerce Clause

Section 3 is the core of the prohibition. It uses the interstate commerce clause—that classic legal tool—to make it illegal for healthcare professionals to participate in these defined procedures for minors. Think about it: almost every prescription drug, every medical device, and every insurance payment plan crosses state lines. This effectively creates a federal ban on gender-affirming medical care for minors, even if a provider is operating entirely within their state. For busy parents and doctors, this means the medical options previously available for minors experiencing gender dysphoria are now off the table, regardless of a doctor’s recommendation or parental consent.

Strict Liability and the 43-Year Statute of Limitations

Section 4 is where the liability gets serious. The bill creates a “private right of action,” meaning anyone who received this prohibited care as a minor can sue the participating doctors, hospitals, or clinics. This right to sue is retroactive, applying even to procedures done before this law was enacted. If you win, you can collect damages covering the cost of fixing the harm (compensatory damages), pain and suffering (non-economic damages), and potentially punitive damages if the provider acted maliciously.

Here’s the kicker: For any procedure done after this law passes, providers face strict liability. That means if a provider participates in the prohibited care, the patient doesn’t have to prove negligence; simply proving the procedure happened is enough to hold the provider responsible for damages (SEC. 4). The burden of proof is flipped onto the provider, who must prove with “clear and convincing evidence” that the procedure fell under one of the few exceptions. This is a massive legal risk that could force doctors and hospitals to stop offering this care entirely, simply because the liability exposure is too high.

Adding to the long-term risk, the statute of limitations—the deadline for filing a lawsuit—is incredibly long. A person has until they are 43 years old (25 years after their 18th birthday) to file a claim. Alternatively, they get four years from the date they pay for detransition treatment, whichever is later (SEC. 6). This means a doctor could be held legally liable for a procedure they performed decades ago.

What About Detransition Care?

It’s important to note what the bill doesn’t prohibit. The definition of “chemical or surgical mutilation” specifically excludes “detransition treatment”—care designed to reverse the effects of a prior procedure or help someone cope with the results (SEC. 2). While this ensures that reversal care remains available, the overall chilling effect of the bill on medical practice might still make it difficult for people to find providers willing to touch any aspect of this care due to the massive liability risks outlined in Section 4.