Trump Administration Announces New Rules Targeting Care for Transgender Youth

Trump administration officials on Thursday announced new proposed regulations targeting gender-affirming care for youth, part of a larger push from the Department of Health and Human Services (HHS) to restrict such care.

One of the new proposed rules would ban hospitals that provide gender affirming care to youth under 18 from receiving Medicaid and Medicare funds. Another proposed rule would bar Medicaid from covering gender-affirming care for youth under 18 and the Children’s Health Insurance Program (CHIP) from covering such care for youth under 19.

HHS Secretary Robert F. Kennedy Jr., along with other officials, formally announced the proposed rules at an event on Thursday morning. In his remarks, Kennedy cast gender affirming care as “sex-rejecting” procedures that impose “lasting harm” on children.

“This is not medicine. It is malpractice,” Kennedy said. “We’re done with junk science driven by ideological pursuits, not the well-being of children.”

Gender-affirming care for youth, backed by major medical organizations to treat gender dysphoria, varies depending on the patient’s age and circumstances. For those entering adolescence, providers can prescribe puberty blockers, which temporarily halt hormones causing puberty and are also prescribed to cisgender youth who undergo early puberty. Research has shown that puberty blockers significantly reduce depression and risk of suicide in trans and non-binary youth and that gender-affirming care also reduces depression in transgender adults.

The Human Rights Campaign, the nation’s largest LGBTQ+ rights advocacy group, said in a statement Thursday that the proposed rules “aim to put best-practice, medically necessary health care for trans youth entirely out of reach in this country.”

The proposed actions “would put Donald Trump and RFK Jr. in those doctor’s offices, ripping health care decisions from the hands of families and putting it in the grips of the anti-LGBTQ+ fringe,” said Kelley Robinson, Human Rights Campaign’s president.

“Make no mistake: these rules aim to completely cut off medically necessary care from children no matter where in this country they live,” she added. “It’s the Trump administration dictating who gets their prescription filled and who has their next appointment canceled altogether.”

The proposed rules, which will be subject to a 60-day public comment period, could have sweeping effects in an already challenging landscape for youth gender-affirming care.

In June, the U.S. Supreme Court upheld Tennessee’s ban on gender-affirming care for youth, and about half of U.S. states now ban medication and surgery for transgender youth.. Catholic hospitals are also now barred from providing youth gender affirming care following a vote of the United States Conference of Catholic Bishops in November. The U.S. House also voted to pass legislation on Wednesday criminalizing doctors who provide gender affirming care to youth (the bill is not expected to pass the U.S. Senate).

Alexis McGill Johnson, president and CEO of Planned Parenthood Action Fund, called the proposed rules “shameful.” Planned Parenthood provides gender-affirming care along with other reproductive health services. (The Trump administration and Republicans in Congress included cuts to Medicaid funding for Planned Parenthood and local affiliates that provide abortion services in the tax-and-spending bill approved in July. Earlier this month, a federal judge in Boston blocked the administration from enforcing such a provision in 22 states.)

“Planned Parenthood health centers across the country are proud to serve patients of all gender identities and expressions,” she said in a statement. “At Planned Parenthood, we believe all people deserve access to the evidence-based health care and education they need to make informed care decisions and live safe, healthy, and fulfilling lives.”

During Thursday’s event, Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services (CMS), noted that more than half of children in the United States are covered by Medicaid and CHIP.

Kennedy also announced that the FDA was sending warning letters to manufacturers of chest binders that he said were marketing the devices to youth under 18. He added that the Trump administration would seek to reverse Biden-era rules that included protections against discrimination from gender dysphoria under the Rehabilitation Act of 1973.

The proposed regulations follow an executive order President Donald Trump issued in January, castigating youth gender affirming care as “chemical and surgical mutilation.” (Most transgender youth do not undergo gender affirming surgery). A subsequent 400-page review of the available research on gender-affirming care for youth that HHS released in May denounced such care while acknowledging “sparse” evidence of it causing harm.

Chloe Cole, an activist who detransitioned after undergoing gender-affirming care as a teenager, spoke in favor of the proposed changes at Thursday’s event. She said detransitioners “largely are ignored” by the medical system.

“I detransitioned, and I chose to face the world and sound the alarm on what is happening to my generation, both in the hopes that this would set forth the movements of young people who chose to break free from ideology, and also that one day, no child would ever have to speak up about this ever again,” she said. “And what this movement has achieved in such a small amount of time is far greater than I have ever dreamed of.”

Cole is among the detransition activists whom Republican lawmakers have enlisted to support their campaign for gender-affirming care bans. Logan Casey, director of policy research at the Movement Advancement Project, which tracks LGBTQ+ policy, told The 19th in an interview for a recent series of stories on detransitioners that the broader issue in selectively elevating detransitioners’ experiences “the idea of banning health care entirely out of the experiences of an extraordinarily small group of folks.”

Sen. Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee, said in a statement Thursday that Trump and Republicans “are attempting to demonize and ultimately erase trans Americans.”

“Trump’s latest effort to bully hospitals into carrying out his extremist agenda is a cruel and thoughtless step that contradicts medical evidence and will jeopardize health care for many communities around the country,” he said. “Our trans neighbors, family members and friends deserve better.”