The Protect Intersex Children Act would require states to ban certain genital surgeries on foster children under age six who have variations in sex characteristics, with limited exceptions only for surgeries addressing an immediate threat to life. The bill defines intersex conditions as natural variations in genitals, gonads, hormones, or chromosomes affecting an estimated 1.7 percent of babies born in the United States. States would need to adopt these restrictions as a condition of receiving federal foster care and adoption assistance grants under Social Security Act programs, with enforcement through professional licensing boards that would discipline physicians who violate the ban. The legislation would take effect starting one year after enactment, though states needing new legislation would have an additional grace period tied to their legislative calendar. The bill emphasizes that the restrictions apply only to cosmetic or unnecessary surgeries and do not prevent medically necessary treatments or surgeries for transgender patients performed with informed consent.