The U.S. Department of Health and Human Services on Thursday announced a broad set of proposed regulatory actions that would sharply restrict, and in effect ban, gender-affirming care for minors, marking the Trump administration’s most aggressive federal move yet targeting transgender health care.
According to a report from The Advocate, the proposals would cut off Medicaid and Medicare funding to hospitals and providers that offer puberty blockers, hormone therapy or surgical interventions to transgender patients under 18. They would also prohibit the use of federal Medicaid dollars to pay for such care. Because nearly all U.S. hospitals rely on Medicare and Medicaid reimbursement, the changes could have sweeping consequences for health systems nationwide.
Health Secretary Robert F. Kennedy Jr., speaking at a news conference, denounced gender-affirming medical care for children. “This is not medicine, it is malpractice,” Kennedy said. “Sex-rejecting procedures rob children of their futures.” He also announced that the HHS Office of Civil Rights would move to exclude gender dysphoria from the definition of a disability, a change that could limit civil rights protections.
In a related action, the Food and Drug Administration issued warning letters to about a dozen companies that market chest binders and similar products commonly used by people with gender dysphoria. The letters state that such products may only be legally marketed for FDA-approved medical purposes, such as post-mastectomy recovery, potentially curtailing their availability for transgender and nonbinary consumers.
While more than half of U.S. states already ban or restrict gender-affirming care for minors, Thursday’s announcements would threaten access in nearly two dozen states where such care remains legal and, in some cases, covered by Medicaid. Federal officials also said the funding restrictions would apply to the State Children’s Health Insurance Program, which covers some low-income people under 19.
The proposals are not yet final. Federal agencies must go through a formal rulemaking process, including public comment periods, before any regulations take effect. Legal challenges are widely expected. Still, advocates say the announcements are likely to further discourage providers from offering care, a trend already underway as some hospitals have paused services in anticipation of federal action.
Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, described transgender treatments as “a Band-Aid on a much deeper pathology,” and suggested children with gender dysphoria are “confused, lost and need help.”
The regulatory push comes amid broader congressional action. On Wednesday, the U.S. House passed a bill that would expose health care providers to criminal penalties for offering gender-affirming care to minors. Another House bill under consideration would bar Medicaid coverage for such care nationwide.