; or (ii) subcutaneous mastectomy, voice surgery, liposuction, lipofilling, pectoral implants or various aesthetic procedures for biologically female patients; and (B) does not include any procedure undertaken because the individual suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the individual in imminent danger of death or impairment of major bodily function unless surgery is performed, unless the procedure is for the purpose of a gender transition. (9) Puberty-Blocking drugs The term puberty-blocking drugs means, when used to delay or suppress pubertal development in children for the purpose of assisting an individual with a gender transition— (A) Gonadotropin-releasing hormone (GnRH) analogues or other synthetic drugs used in biological males to stop luteinizing hormone secretion and therefore testosterone secretion; and (B) synthetic drugs used in biological females that stop the production of estrogen and progesterone. (10) Sex; birth sex; biological sex The terms sex , birth sex, and biological sex refer to the biological indication of male and female in the context of reproductive potential or capacity, such as sex chromosomes, naturally occurring sex hormones, gonads, and non-ambiguous internal and external genitalia present at birth, without regard to an individual’s psychological, chosen, or subjective experience of gender.