The Trump administration recently announced a sweeping set of proposals that would dramatically restrict access to gender-affirming health care for transgender youth nationwide, including in states where such care remains legal. The measures, unveiled December 18 by Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz, would make it nearly impossible for most hospitals to continue providing this care to minors.
At the center of the announcement are two proposed federal rules from the Department of Health and Human Services. One would block Medicaid and Children’s Health Insurance Program funding from covering gender-affirming care for transgender patients under 18, including puberty blockers and hormone therapy. The second would bar any hospital that provides gender-affirming care to minors from participating in Medicare or Medicaid. Because most hospitals rely heavily on those programs, critics say that would push hospitals to drop care rather than risk losing federal funding.
Kennedy framed the proposals as a matter of child safety, asserting that gender-affirming care for minors “does not meet professionally recognized standards of health care.” Oz echoed that argument, calling the treatments unproven and saying federal health programs should not support what he described as “experimental interventions.”
Federal officials also announced new action from the Food and Drug Administration, which will issue warning letters to 12 manufacturers and retailers of chest binders. FDA Commissioner Marty Makary said the agency believes some products are being illegally marketed to children for the treatment of gender dysphoria. “Illegal marketing of these products for children is alarming,” Makary said, warning that enforcement actions could include seizures or injunctions.
Medical organizations and LGBTQ+ advocates responded quickly. The American Academy of Pediatrics rejected the administration’s claims, saying the proposals misrepresent medical consensus and ignore the realities facing patients and families. “These policies and proposals misconstrue the current medical consensus,” AAP President Dr. Susan J. Kressly said, emphasizing that care decisions should remain between families and their physicians.
The Human Rights Campaign also condemned the proposals. President Kelley Robinson warned that the measures would override families’ medical decisions and cut off care for transgender youth regardless of where they live. “These rules aim to completely cut off medically necessary care from children no matter where in this country they live,” Robinson said, stressing that the announcements are proposals, not law.
The proposals arrive amid an already restrictive landscape, with gender-affirming care for minors banned in more than two dozen states. Legal challenges are expected if the rules move forward. The American Civil Liberties Union has announced plans to sue, and attorneys general in several states have said they will fight the measures in court. For families with transgender children, the announcement adds uncertainty as federal officials reshape access to care through regulation rather than legislation.