HHS moves to slash funding and access to care for transgender minors

The proposals announced Thursday would bar hospitals that receive federal funding from providing transition-related care to minors.

The Trump administration announced Thursday that it would begin to take steps aimed at ending transition-related care — or what the Department of Health and Human Services has termed “sex-rejecting procedures” — for minors nationwide.

“These actions will ensure that the federal government in no way funds directly gender transition procedures on minors and also does not fund facilities that perform these procedures,” a department official said in a call with reporters Thursday.

Health and Human Services Secretary Robert F. Kennedy Jr. and other department officials are scheduled to provide details about the moves later Thursday.

The HHS official said the Centers for Medicare and Medicaid Services will begin the rulemaking process to prohibit hospitals from providing puberty blockers, hormone therapy and surgeries to minors as a condition of participation in Medicare and Medicaid, and to bar Medicaid funding from being used for such care.

Dr. Kenneth Haller, a pediatrician based in St. Louis, called HHS’ actions “anti-science” during a press briefing held by the Human Rights Campaign, the nation’s largest LGBTQ advocacy group, on Tuesday. He said efforts to restrict access to such care still allow the treatments for children with other conditions that affect hormone production, for example.

As long as the treatments affirm a child’s birth gender, Haller said, “these people don’t have a problem with it.” He added, “that same care for kids who are transgender is what they say is wrong. There’s no science behind it.”

HHS also announced Thursday that the Food and Drug Administration will issue warning letters to 12 manufacturers and retailers of breast binders for minors for the purposes of treating gender dysphoria, which is the distress that results from a misalignment between a person’s gender identity and birth sex, alleging that the manufacturers are participating in illegal marketing, the department official said.

HHS’ Office for Civil Rights also proposed a revision to Section 504 of the Rehabilitation Act of 1973, which prohibits discrimination in federally funded programs, to clarify that the definitions of “disability” exclude gender dysphoria that does not result from physical impairments. The HHS official said the clarification is intended to “resolve an ambiguity” that the Biden administration introduced into the preamble of Section 504 in 2024 that suggested gender dysphoria may qualify as a disability and, as a result, “created confusion about the scope of HHS funding recipients obligations to those individuals under the disability rights requirements of section 504.”

The proposed CMS rules will be finalized after a 60-day comment period, the department official said.

The HHS proposals are the latest effort from the Trump administration to restrict access to certain transgender care for both minors and adults.

In the first few weeks of his second term, President Donald Trump issued multiple executive orders targeting trans people, including an order declaring that there are only two unchangeable sexes and another barring federal funding from going to hospitals that provide transition-related care to minors. In May, HHS released a review declaring that the quality of evidence regarding the effects of gender-affirming care for minors “is very low,” breaking with the majority of U.S. medical associations, which support access to such care and have condemned efforts to restrict it.

The Trump administration’s policies built on an increasingly restrictive environment for trans care. In the last few years, 27 states have enacted measures prohibiting access to certain transition-related treatments for minors, according to Movement Advancement Project, an LGBTQ think tank. Families who could afford it began traveling to the remaining states where care remained legal.

But in July, the federal government began investigating providers across the country, resulting in more than 20 hospitals — including those in liberal cities such as Los Angeles and Boston — rolling back or ending their gender-affirming care programs for minors and some young adults.

The environment has led some trans adults and families with trans children, like the Gonzales’, to leave the country. Rachel Gonzales’ three children are fifth-generation Texans, and she has been fighting anti-trans legislation in the state since her trans daughter, Libby, was 6 years old. For years, she has said they had no plans to leave the state. But due to the federal government’s actions to restrict access to transition care, she and her husband moved Libby, who is now 15, and their other two children out of the United States to a country Gonzales declined to disclose.

“Living in Texas, we became targets of politicians who have boldly rejected the consensus of medical experts and decided that they know better than Libby, my husband and I, and our team of physicians and have opted to use us as their political targets, instead of allowing us the parental rights that they so claim to advocate for,” Gonzales said during the press briefing held by the Human Rights Campaign.

Just a day before the HHS announcement, the House passed a bill that would charge doctors with a felony punishable by up to 10 years in prison if they provide gender-affirming care for minors. The legislation, introduced by Rep. Marjorie Taylor Greene, R.-Ga., is expected to die in the Senate but marks the harshest federal penalty for doctors providing transition-related care to minors ever passed by the House.

Greene called the bill’s passage “a win for children all over America,” in a post on X on Wednesday.

Rep. Dan Crenshaw, R.-Texas, introduced another bill the House will vote on Thursday that would prohibit Medicaid from covering gender transition procedures for anyone under the age of 18.