The Trump administration is moving to sharply curb gender-affirming medical care for transgender minors. On Thursday, the Centers for Medicare and Medicaid Services proposed two rules aimed at restricting such care, which can include puberty blockers, hormones, and surgeries. One proposal would bar any hospital or clinic that provides gender-affirming care to people under 19 from participating in Medicare and Medicaid. That could force providers to halt services or risk losing critical federal funding, health care attorney Hannah Oliason tells STAT News. A second rule would prohibit Medicaid and Children's Health Insurance Program dollars from paying for gender-affirming care for minors.
The proposals arrive a day after House Republicans passed a bill to outlaw gender-affirming care for transgender minors nationwide, a symbolic measure unlikely to clear the Senate. The CMS rules, by contrast, do not need congressional approval. The proposals, echoing provisions struck from President Trump's tax bill, cite a recent report from the Department of Health and Human Services, which labels all gender-affirming treatments as "experimental." In announcing the policy, Health Secretary Robert F. Kennedy Jr. said it was "junk science driven by ideological pursuits," per Axios.
The Human Rights Campaign said the proposals, which carry exceptions for minors with "medically verifiable" sexual development disorder, "aim to put best-practice, medically necessary health care for trans youth nearly entirely out of reach." Attorneys and advocacy groups are preparing legal challenges, likely to argue the rules are unlawful, discriminatory, or "arbitrary and capricious" under administrative law. Public comment will be accepted for 60 days from Friday, though STAT News reports some health systems may pause gender-affirming programs before that time is up to protect their federal funding. Patient families are already contesting service cutbacks in certain areas, citing political pressure.
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