The Trump-Vance administration is pushing to end all gender-affirming care for transgender youth, according to a new proposal from the Department of Health and Human Services.
Texts obtained by NPR show the proposed healthcare policy changes would prohibit federal Medicaid reimbursement for medical care provided to trans patients under 18, and would also prohibit reimbursement through the Children’s Health Insurance Program for patients under 19.
Another proposal found by NPR shows the administration is considering blocking all Medicaid and Medicare funding for any services at hospitals that provide pediatric gender-affirming care.
The proposals are set to be released in early November, according to NPR’s source from the Centers for Medicare and Medicaid Services, who spoke on the condition of anonymity for fear of retaliation.
Nearly all medical associations in the U.S. support gender-affirming care for trans youth and have emphasized its importance for the mental health of trans young people.
These actions are consistent with the goals of the Trump-Vance administration. Days after being sworn into office, Trump signed an executive order stating that the U.S. “will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another.” The administration also ended a federal suicide prevention lifeline specifically for transgender youth and canceled hundreds of millions of dollars in scientific research funding related to LGBTQ people.
The anti-trans rhetoric the administration is pushing has become a major focus of its operations.
Officials have even blamed part of the government shutdown on Democrats’ support for gender-affirming care — or, as the Department of Agriculture’s website refers to it, “gender mutilation procedures.”
There are currently 27 states that ban gender-affirming care for trans youth, according to data collected by the Human Rights Campaign. This widespread push to police trans healthcare comes despite the relatively small number of trans-identifying youth, only about 724,000 individuals, or 3.3 percent of the U.S. population, according to the Willams Institute.
Many hospitals receive a large portion of their funding from Medicare, which would ultimately force them to stop providing this care in order to continue receiving federal dollars. That, Katie Keith, director of the Center for Health Policy and Law at Georgetown University, explained to NPR, would make it nearly impossible to access gender-affirming care — even at private hospitals and clinics.
“These rules would be a significant escalation in the Trump administration’s attack on access to transgender health care,” Keith said.
Ellen Kahn, senior vice president of equality programs at HRC, spoke out against the proposed policy changes, saying the decision to implement them would only hurt American families.
“This latest attempt to strip best-practice health care from trans young people would place parents and doctors in an impossible position in service of the far-right’s culture war on transgender people,” Kahn said in a statement. “Any proposed rule that would strip federal dollars from providers who dare to defy the administration’s political agenda by caring for trans youth would help no one, hurt countless families, and send a dangerous message that only the president himself — not doctors, not parents, not even you — can decide what health care you can access.”