The Trump administration unveiled new actions aimed at eliminating transition-related medical care for minors across the US on Thursday, referring to such treatments as “sex-rejecting procedures”, a term used by the Department of Health and Human Services (HHS).
As part of the effort, the Centers for Medicare and Medicaid Services will initiate a rule-making process that would prevent hospitals from offering puberty blockers, hormone treatments, or surgical procedures to minors if they wish to participate in Medicare or Medicaid.
The proposal would also prohibit Medicaid funds from being used to cover this type of care. Medicaid and the Children’s Health Insurance Program (Chip) together cover nearly half of all American children.
“Under my leadership, and answering President Trump’s call to action, the federal government will do everything in its power to stop unsafe, irreversible practices that put our children at risk,” Robert F Kennedy Jr, the US health secretary, said in a statement.
“This administration will protect America’s most vulnerable. Our children deserve better – and we are delivering on that promise.”
HHS also announced that the Food and Drug Administration (FDA) will send warnings to 12 companies that manufacture or sell breast binders intended for minors to treat gender dysphoria. The department alleges these companies are engaging in illegal marketing practices. Gender dysphoria refers to the distress caused by a mismatch between a person’s gender identity and their sex assigned at birth.
“The American Medical Association and the American Academy of Pediatrics peddled the lie that chemical and surgical sex-rejecting procedures could be good for children who suffer from gender dysphoria,” Kennedy said at a Thursday press conference. “This is not medicine. It is malpractice.”
It was revealed on Wednesday that the Trump administration terminated several multimillion-dollar grants to the American Academy of Pediatrics (AAP), citing concerns about “identity-based” language. The cuts followed the AAP publicly criticizing Kennedy’s overhaul of federal vaccine policy.
HHS is also taking steps to reverse a policy established during the Biden administration that classified gender dysphoria as a disability under federal law. A newly proposed update to Section 504 of the Rehabilitation Act of 1973 would specify that “disability” and “individual with a disability” do not include gender dysphoria unless it stems from a physical impairment.
These moves have already been met with heavy criticism from health experts, lawmakers, and LGBTQ+ rights organizations.
“Gender-affirming care is lifesaving care,” said Dr Jamila Perritt, an OB/GYN and the CEO of Physicians for Reproductive Health. “Today’s proposed rules are a deliberate and targeted attack on transgender youth, their families, and the clinicians committed to providing patients the care they need … This is a lose-lose situation where lives are inevitably on the line.”
Rodrigo Heng-Lehtinen, the senior vice-president of public engagement campaigns at the Trevor Project, said: “Everyone in this country should have access to the care they need to stay healthy, including transgender and nonbinary young people. Personal medical decisions ought to be made between patients, their doctors and their families – not through a one-size-fits-all mandate from the federal government.”
New York’s attorney general, Letitia James, also released a statement: “This president would rather target young people than lower costs or expand access to health care. It is reprehensible that our federal government is intent on hurting and isolating the adolescents it is supposed to protect. I will use every tool at my disposal to fight this proposal and protect transgender Americans and their families.”
These proposals represent the latest in a series of actions by the Trump administration aimed at limiting access to certain forms of transgender healthcare for both children and adults.
During the opening weeks of his second term, Donald Trump signed several executive orders focused on transgender issues, including one asserting that only two sexes exist and another that barred federal funds from going to hospitals that provide transition-related care to minors.
HHS released a review in May stating that the evidence supporting the effects of gender-affirming care for minors “is very low”, a conclusion that diverges from the position of most major US medical organizations, which support access to such care and have criticized efforts to restrict it.
On Wednesday night, the House passed a bill introduced by Marjorie Taylor Greene, a Republican, to criminalize parents and providers for providing gender-affirming care to children under the age of 18.
