; or (B) estrogen given to biological males at doses that are profoundly larger or more potent than would naturally occur in healthy biological males. (3) Gender The term gender means the psychological, behavioral, social, and cultural aspects of being male or female. (4) Gender transition The term gender transition means the process in which a person goes from identifying with and living as a gender that corresponds to his or her biological sex to identifying with and living as a gender different from his or her biological sex, and may involve social, legal, or physical changes. (5) Gender transition procedure (A) In general The term gender transition procedure means any medical or surgical service, including physician’s services, inpatient and outpatient hospital services, or prescribed drugs related to gender transition, that seek to alter or remove physical or anatomical characteristics or features that are typical for an individual’s biological sex, or to instill or create physiological or anatomical characteristics that resemble a sex different from an individual’s birth sex, including, without limitation, medical services that provide puberty-blocking drugs, cross-sex hormones, or other mechanisms to promote the development of feminizing or masculinizing features (in the opposite sex), or genital gender transition surgery or nongenital gender transition surgery performed for the purpose of assisting an individual with a gender transition. (B) Exceptions The term gender transition procedure does not include— (i) services to those born with a medically-verifiable disorder of sex development, including a person with external biological sex characteristics that are irresolvably ambiguous, such as those born with 46 XX chromosomes with virilization, 46 XY chromosomes with undervirilization, or having both ovarian and testicular tissue