The Trump administration has proposed new rules that would strip most federal health funding from hospitals that provide gender-affirming medical procedures to minors. The Department of Health and Human Services (HHS) announced measures that would make such care a violation of conditions for participation in Medicare and Medicaid, and would bar Medicaid and the Children’s Health Insurance Program from covering these services for people under 18, as part of efforts to carry out a recent executive order by President Donald Trump.
On Thursday, the Trump administration unveiled a package of proposed regulations aimed at sharply curtailing federal support for gender-affirming care for minors.
According to a Daily Wire report and HHS press materials, the Department of Health and Human Services posted draft rules that would bar hospitals providing what the agency calls "sex-rejecting procedures" to children from participating in Medicare and Medicaid programs. The Centers for Medicare & Medicaid Services plan to propose conditioning hospitals’ participation in those programs on not performing such interventions on patients under 18, a move that would affect nearly all U.S. hospitals, which rely on those federal reimbursements.
The proposals would also prohibit federal funding under Medicaid and the Children’s Health Insurance Program from being used for gender-affirming procedures for minors. The Daily Wire, citing an HHS official on a background call, reported that "collectively, these actions will ensure that the federal government in no way funds directly gender-transition procedures on minors and also does not fund facilities that perform these procedures on minors." An HHS background document said the initiative is designed to ensure that the U.S. government "will not be in business with organizations that intentionally or unintentionally inflict permanent harm on children."
The regulatory actions follow an internal HHS review of gender-related medical interventions for young people. In language quoted by the Daily Wire and echoed in HHS communications, the department described "sex-rejecting procedures on children — which include puberty blockers, cross-sex hormones, and surgical operations" as causing "irreversible damage, including infertility, impaired sexual function, diminished bone density, altered brain development, and other irreversible physiological effects." Major medical organizations, including the American Academy of Pediatrics and the American Medical Association, have publicly disputed that characterization and continue to support gender-affirming care for minors as appropriate in certain cases.
HHS Secretary Robert F. Kennedy Jr. signed a declaration stating that medical professionals who perform these procedures on minors are out of compliance with professionally recognized standards of health care, according to the Daily Wire summary of the document. In line with that declaration, Assistant Secretary for the HHS Public Health Service, Admiral Brian Christine, issued a public health message asserting that current evidence does not support the use of these interventions on children. Separately, the HHS Office for Civil Rights announced a proposed rule stating that policies preventing or limiting what the department terms "sex-rejecting procedures" would not be treated as violations of federal nondiscrimination laws.
In a related step, the Food and Drug Administration issued warning letters to 12 manufacturers of chest binders and similar products, accusing them of illegally marketing those devices to minors for the treatment of gender dysphoria. The letters direct the companies to bring their marketing practices into compliance with approved medical uses, such as post-mastectomy recovery, according to the Daily Wire and other news reports.
HHS has said these actions are being taken to implement President Trump’s executive order directing federal agencies to end support and funding for gender-affirming procedures on children, part of a broader set of measures from the administration targeting gender-related medical care and definitions of sex in federal policy.
Supporters of the proposals argue they are necessary to protect young people from what they describe as harmful and irreversible interventions. Stanley Goldfarb, chair of the advocacy group Do No Harm, praised the move in comments reported by the Daily Wire: "President Trump and HHS are taking another critical step to protect children from harmful gender ideology. The proposed rule – banning hospitals from performing sex change interventions on minors as a condition for Medicare and Medicaid participation – is common sense, evidence-based, and morally imperative. Many so-called gender clinics have already begun to close as the truth about the risks and long-term harms about these drugs and surgeries on minors have been exposed."
Medical associations, LGBTQ+ advocates and several Democratic officials have condemned the emerging policy package as discriminatory and inconsistent with established standards of care, and have signaled that legal challenges are likely once the rules are finalized.
The HHS proposals must go through a public notice-and-comment process before they can take effect. Officials have indicated there will be a 60-day comment period on the draft regulations prior to implementation.
