U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. moved on Thursday to cut children’s access to gender-affirming care, marking one of the Trump administration’s most sweeping restrictions yet on transgender healthcare.
Kennedy proposed rules barring hospitals that deliver such care from Medicare and Medicaid programs and prohibiting Medicaid and the Children’s Health Insurance Program from paying for it.
The moves are the latest in a wider crackdown by the Trump administration on the rights of transgender people through the elimination of legal protections in the military, healthcare, education and the workplace.
“Medical professionals or entities providing sex-rejecting procedures to children are out of compliance with … standards of healthcare,” said Kennedy, contradicting the nation’s largest medical organizations.
The American Academy of Pediatrics and the American Medical Association endorse gender-affirming care, saying decisions should rest between children, parents and healthcare professionals.
AAP President Susan Kressly criticized the move as misrepresenting medical consensus and said it would harm families in need.
Republican President Donald Trump signed an executive order in January seeking to roll back protections and healthcare coverage for transgender people.
His Department of Justice has already cracked down on some hospitals that provide the care, resulting in a lawsuit by 16 Democratic states seeking to block the moves.
Nearly all U.S. hospitals participate in the Medicare program for people aged 65 and older or who have disabilities. Around 53% of U.S. children receive their health coverage through the federal and state-based Medicaid and CHIP programs.
Top U.S. health officials denounced gender-affirming care during an hour-long press conference on Thursday.
“The blurring of the lines between sexes and radical social agendas, is a hatred for nature as God designed it,” said Kennedy’s deputy, Jim O’Neill.
Officials announced additional steps including a rule reversing the classification of gender dysphoria as a disability, which would exempt organizations restricting gender-affirming care from anti-discrimination laws. The Food and Drug Administration will issue warnings to 12 companies marketing breast binders for treating gender dysphoria.
WIDER CAMPAIGN
State officials, including New York Attorney General Letitia James, vowed to challenge the measures, while Maryland Health Secretary Meena Seshamani, who served as deputy Medicare and Medicaid chief under former President Joe Biden, said Medicaid coverage for gender-affirming care remains unchanged for now.
The proposed rules are subject to a public comment period – 60 days for the CMS rules and 30 days for the disability designation reversal – before they can be finalized.
Civil rights groups swiftly condemned the proposals; GLBTQ Legal Advocates & Defenders called them “unAmerican” and the American Civil Liberties Union pledged to challenge them in court.
U.S. health data analyzed for Reuters by Komodo Health indicates more than 121,000 children aged 6 to 17 were diagnosed with gender dysphoria between 2017 and 2021, with 17,683 of those starting puberty blockers or hormone therapy.
Both figures are likely undercounts, as many cases are not formally diagnosed or receive treatment outside insurance coverage.
The Trump administration has sought this year to ban transgender people from the military, bar them from designating the sex reflecting their gender identities on passports, and prohibit federal workers from using bathrooms reflecting their gender identity.
