Trump Administration Moves to Restrict Gender-Affirming Care for Transgender Youth
WASHINGTON - The Trump administration on Thursday unveiled sweeping federal proposals that would significantly restrict access to gender-affirming medical care for minors, threatening to cut off Medicare, Medicaid, and CHIP funding for providers who offer such treatments.
Health and Human Services Secretary Robert F. Kennedy Jr. announced the proposed rules during a press conference in Washington, saying the measures are intended to safeguard children from undergoing “irreversible” procedures. The changes, the most consequential yet from the administration on transgender policy, aim to declare such care ineligible for federal reimbursement and redefine protections for individuals with gender dysphoria.
“This is not medicine, it is malpractice,” Kennedy said Thursday. “Sex-rejecting procedures rob children of their futures.”
The proposed regulations would bar hospitals offering gender-affirming care to minors from participating in Medicaid and Medicare, placing substantial federal funding at risk. The rules would also prohibit the use of federal dollars in those programs, including the Children’s Health Insurance Program (CHIP), to finance puberty blockers, hormone treatments, or surgeries for individuals under 18.
The policy would impact transgender youth in states where such care remains legal and currently receives Medicaid funding. According to the Department of Health and Human Services (HHS), nearly all hospitals in the United States participate in federally funded health programs. A federal notice posted Thursday confirmed that the same funding restrictions would apply to CHIP, which covers children under 19.
Thursday’s announcement marks a continuation of the Trump administration’s broader effort to restrict gender-affirming healthcare and federal support for transgender individuals. On his first day in office, President Donald Trump signed an executive order defining only two “immutable sexes,” male and female, as recognized by the federal government.
The proposals are not final and must undergo a standard federal rulemaking process, which includes a public comment period before any implementation. Legal challenges are expected, and the policies may face stiff resistance during review. However, the announcement has already led to tangible repercussions, with some hospitals reportedly reconsidering or halting the provision of gender-related care for minors out of concern for losing federal support.
Kennedy also indicated that the HHS Office of Civil Rights would propose a rule to exclude gender dysphoria from federal definitions of disability.
In a related move, the Food and Drug Administration issued warning letters to a dozen companies marketing products such as chest-binding garments used by individuals with gender dysphoria. Targets include GenderBender LLC of Carson, California, and TomboyX of Seattle. The FDA stated that such devices cannot be legally advertised unless approved for medical uses, like recovery from mastectomy.
Dr. Mehmet Oz, Administrator of the Centers for Medicare and Medicaid Services, appeared alongside Kennedy at the press briefing. Oz described transgender medical treatments as “a Band-Aid on a much deeper pathology” and said that children with gender dysphoria are “confused, lost and need help.”
Chloe Cole, a conservative activist known for her reversal of gender transition, also spoke at the event. “Our cries for help have finally been heard,” she told reporters.
Meanwhile, legislative activity on Capitol Hill has mirrored the administration’s approach. A bill that would criminalize gender-affirming care for minors passed the U.S. House of Representatives on Wednesday and now moves to the Senate. On Thursday, lawmakers debated additional legislation to ban Medicaid coverage of gender-related care for children.
Advocates for transgender youth condemned the announcements, warning of grave consequences for young people seeking medical support.
“In an effort to strongarm hospitals into participating in the administration’s anti-LGBTQ agenda, the Trump Administration is forcing health care systems to choose between providing lifesaving care for LGBTQ+ young people and accepting crucial federal funding,” said Dr. Jamila Perritt, a Washington-based OB/GYN and president of Physicians for Reproductive Health. “This is a lose-lose situation where lives are inevitably on the line.”
Rodrigo Heng-Lehtinen, senior vice president at The Trevor Project, also condemned the policy direction. “The multitude of efforts we are seeing from federal legislators to strip transgender and nonbinary youth of the health care they need is deeply troubling,” he said, calling the new rules “a one-size-fits-all mandate from the federal government” on decisions that should remain between doctor and patient.
The American Medical Association and other major medical groups have opposed state-level restrictions on gender-affirming care and continue to recommend access to such treatments for youth diagnosed with gender dysphoria.
Polling data cited by the administration, however, indicates that many Americans share the administration’s concerns. An Associated Press-NORC Center for Public Affairs Research survey conducted earlier this year found that about half of U.S. adults approved of how President Trump was handling transgender issues.
Gender-affirming care for minors may include a variety of steps, beginning with social transition measures such as adopting new names, pronouns, or hairstyles. Some youth may later receive puberty-blocking medication to delay changes associated with their assigned sex at birth, followed in some cases by estrogen or testosterone therapy. Surgical treatments remain rare for minors.
As of Thursday, at least 27 U.S. states have enacted laws banning or restricting gender-affirming care. Slightly under half of state Medicaid programs currently fund such treatments. A recent Supreme Court decision upholding Tennessee’s ban on gender-affirming care for minors suggests that similar state laws will likely remain in effect.
Although the federal proposals announced Thursday are still subject to the regulatory process, health providers, legal experts, and advocacy groups are bracing for what may be a protracted battle over the future of care for transgender youth in the United States.