The U.S. Department of Health and Human Services on Thursday announced a series of regulatory measures intended to eliminate gender-affirming medical care for minors.
The proposals announced Thursday represent the most far-reaching steps this administration has taken to restrict the use of puberty blockers, hormone therapy and surgeries for transgender children. And they include cutting federal Medicaid and Medicare funding for hospitals that provide gender-affirming care to children and prohibiting the use of federal Medicaid funds to finance such procedures.
“It’s not medicine, it’s medical negligence,” Health Secretary Robert F. Kennedy Jr. said of gender-affirming procedures in children: “Gender-rejection procedures rob children of their future.”
Additionally, the Food and Drug Administration (FDA) has sent warning letters to a dozen companies that market chest support vests and other equipment used in gender affirmation processes.
Manufacturers include GenderBender LLC, of Carson, Calif., and TomboyX, of Seattle. The FDA letters indicate that chest binders can only be legally marketed for FDA-approved medical uses, such as recovery from a mastectomy, the Associated Press reports.
The proposed rules would threaten gender-affirming care for young people in states where it remains legal.
Medicaid programs currently cover gender-affirming care in just under half of the states. At least 27 states have passed laws restricting or banning this care. The Supreme Court’s recent decision upholding Tennessee’s ban opens the door for most other state laws to remain in effect.
Thursday’s announcements undermine access in nearly two dozen states, where drug treatments and surgical procedures remain legal and funded by federal and state Medicaid funds.
The proposals announced by Kennedy and his team are neither final nor legally binding, recalls AP.
The federal government must go through a lengthy rulemaking process, including public comment and document review periods, before restrictions become permanent. They also risk facing legal challenges.
However, the proposed rules will likely further limit gender-affirming care for children, and many hospitals have already ended such care.
Nearly all U.S. hospitals participate in the Medicare and Medicaid programs, the federal government’s largest health plans that cover seniors, people with disabilities, and low-income people. Losing access to these payments would put most U.S. hospitals and medical providers at risk.
The same funding restrictions would apply to a smaller health program, the National Children’s Health Insurance Program, intended for care of children under age 19, according to an Administration memo.
The measures contradict advice from medical organizations and trans advocates.
Dr. Mehmet Oz, director of the Centers for Medicare and Medicaid Services, on Thursday called treatments for transgender people “a Band-Aid on a much deeper pathology” and suggested that trans minors are “confused, lost and need help.”
This approach contradicts recommendations from most major U.S. medical organizations, including the American Medical Association, which has urged states not to limit care for gender dysphoria, the AP reports.
The ads join a series of moves by U.S. President Donald Trump, his administration and congressional Republicans to attack the rights of trans people across the country.
On his first day in office, Trump signed an executive order declaring that the federal government would recognize only two genders: male and female. He also signed orders to reduce federal support for gender transitions for people under the age of 19 and to ban trans athletes from participating in girls’ and women’s sports.
Additionally, a bill that would expose trans health care providers to prison time if they serve people under 18 passed the U.S. House of Representatives on Wednesday and will move to the Senate. Another bill considered Thursday in the House seeks to ban Medicaid coverage for gender-affirming care for children.
In the United States, young people who identify as a gender different from the one assigned at birth are first assessed by a team of professionals. Some may attempt a social transition, which involves changing their hairstyle or pronouns. Others may subsequently be given hormone-blocking medications that delay puberty, followed by testosterone or estrogen to achieve the desired physical changes.
Surgery is rare in minors.
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