; (2) the defendant used a means, channel, facility, or instrumentality of interstate or foreign commerce in furtherance of or in connection with the conduct described in that subsection; (3) any payment of any kind was made, directly or indirectly, in furtherance of or in connection with the conduct described in that subsection using any means, channel, facility, or instrumentality of interstate or foreign commerce or in or affecting interstate or foreign commerce; (4) the defendant transmitted in interstate or foreign commerce any communication relating to or in furtherance of the conduct described in that subsection— (A) using any means, channel, facility, or instrumentality of interstate or foreign commerce; or (B) in or affecting interstate or foreign commerce by any means or in any manner, including by computer, mail, wire, or electromagnetic transmission; (5) any instrument, item, substance, or other object that has traveled in interstate or foreign commerce was used to perform the conduct described in that subsection; (6) the conduct described in that subsection occurred in— (A) the special maritime and territorial jurisdiction of the United States; or (B) a territory or possession of the United States; or (7) the conduct described in that subsection otherwise occurred in or affected interstate or foreign commerce. (f) Rule of construction Nothing in this section shall be construed as prohibiting provision of the medical services described in subsection (a)(2)(A) to address legitimate health issues, such as any male or female reproductive cancers, apart from changing the body of an individual to correspond to a sex that differs from the individual's biological sex.