WASHINGTON (AP) — The U.S. Department of Health and Human Services has proposed a series of regulations that could effectively ban gender-affirming care for minors, extending existing restrictions on transgender Americans initiated during the Trump administration.
The proposed measures are seen as the most significant actions taken by the current administration to limit the availability of puberty blockers, hormone therapy, and surgical interventions for transgender children. Key components include eliminating federal Medicaid and Medicare funding for hospitals that provide such care and prohibiting federal funds from being used for these procedures.
Currently, over half of U.S. states have implemented laws that either restrict or completely ban gender-affirming care. However, this new announcement poses a risk to access in about 20 states where medical treatments remain legal and funded by Medicaid, which comprises both federal and state dollars.
Though the proposals were announced by Secretary Robert F. Kennedy Jr. and his administration, they are not finalized or legally binding. The federal government must undergo an extensive rulemaking process, which includes public comments and potential legal ramifications.
The proposed restrictions could force many health care providers to stop offering gender-affirming care to young patients, as numerous facilities have already halted these services in anticipation of federal actions.
With nearly all U.S. hospitals participating in Medicaid and Medicare programs—funding crucial for low-income Americans—losing access to these payments could severely affect healthcare services across the nation. The restrictions would also impact the Children's Health Insurance Program.
These actions clash with guidelines from major medical organizations, including the American Medical Association, which advocate against limitations on care for gender dysphoria. According to health professionals, the therapeutic process for youth who identify with a different gender from their assigned birth sex typically begins with evaluation and social transition, potentially leading to hormone treatments. Surgical interventions, however, remain rare for minors.
Despite ongoing legal battles in states like Arkansas and Montana regarding bans on gender-affirming care, critics including Rodrigo Heng-Lehtinen from The Trevor Project call these new changes a harmful and overly broad mandate from the federal government, stressing the importance of patient-doctor autonomy in health care decisions.
