Trump moves to restrict transgender care for children, Kennedy labels treatments ‘malpractice’

Trump administration targets transgender youth care

The U.S. Department of Health and Human Services announced a series of regulatory measures aimed at effectively banning gender-affirming care for minors, expanding broader Trump administration restrictions on transgender Americans.

The comprehensive proposals — the most significant actions yet taken by this administration to limit puberty blockers, hormone therapy, and surgical procedures for transgender children — would cut federal Medicaid and Medicare funding for hospitals providing gender-affirming care and block the use of federal Medicaid dollars for such treatments.

“This is not medicine, it is malpractice,” Health Secretary Robert F. Kennedy Jr. said during a news conference on Thursday. “Sex-rejecting procedures rob children of their futures.”

The new rules would jeopardize access to care in nearly two dozen states where drug treatments and surgical procedures for transgender youth remain legal and Medicaid-funded, including both federal and state contributions.

The proposals contradict the guidance of most major U.S. medical organisations. Advocates for transgender children sharply rejected the administration’s claims, warning that Thursday’s actions could put lives at risk.

“The multitude of efforts we are seeing from federal legislators to strip transgender and nonbinary youth of the health care they need is deeply troubling,” said Rodrigo Heng-Lehtinen of The Trevor Project, a nonprofit focused on suicide prevention for LGBTQ+ youth. He described the measures as a “one-size-fits-all mandate from the federal government” on a decision that should be made between a doctor and patient.

Medicaid programs in slightly less than half of states currently cover gender-affirming care. At least 27 states have adopted laws restricting or banning the care. The Supreme Court’s recent decision upholding Tennessee’s ban means most other state laws are likely to remain in place.

The proposals announced by Kennedy and his deputies are not final or legally binding. The federal government must go through a lengthy rulemaking process, including periods of public comment and document rewrites, before the restrictions becoming permanent. They are also likely to face legal challenges.

But the proposed rules will likely further intimidate health care providers from offering gender-affirming care to children and many hospitals have already ceased such care in anticipation of federal action.

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 Americans. Losing access to those payments would imperil most U.S. hospitals and medical providers.

The same funding restrictions would apply to a smaller health program, the State Children’s Health Insurance Program, when it comes to care for people under the age of 19, according to a federal notice posted Thursday morning.

Kennedy also announced Thursday that the HHS Office of Civil Rights will propose a rule excluding gender dysphoria from the definition of a disability.

In a related move, the Food and Drug Administration issued warning letters to a dozen companies that market chest-binding vests and other equipment used by people with gender dysphoria. Manufacturers include GenderBender LLC of Carson, California and TomboyX of Seattle. The FDA letters state that chest binders can only be legally marketed for FDA-approved medical uses, such as recovery after mastectomy surgery.

Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, on Thursday called transgender treatments “a Band-Aid on a much deeper pathology,” and suggested children with gender dysphoria are “confused, lost and need help.”

Polling shows many Americans agree with the administration’s view of the issue. An Associated Press-NORC Center for Public Affairs Research survey conducted in May found that about half of U.S. adults approved of how Trump was handling transgender issues.

Chloe Cole, a conservative activist known for speaking about her gender-transition reversal, spoke at the news conference to express appreciation. She said cries for help from her and others in her situation, “have finally been heard.”

But the approach contradicts the recommendations of most major U.S. medical organizations, including the American Medical Association, which has urged states not to restrict care for gender dysphoria.

“In an effort to strongarm hospitals into participating in the administration’s anti-LGBTQ agenda, the Trump Administration is forcing health care systems to choose between providing lifesaving care for LGBTQ+ young people and accepting crucial federal funding,” Dr. Jamila Perritt, a Washington-based OB/GYN and president and CEO of Physicians for Reproductive Health, said in a statement.

“This is a lose-lose situation where lives are inevitably on the line. “

The announcements build on a wave of actions President Donald Trump, his administration and Republicans in Congress have taken to target the rights of transgender people nationwide.

On his first day in office, Trump signed an executive order that declared the federal government would recognize only two immutable sexes: male and female. He also has signed orders aimed at cutting off federal support for gender transitions for people under age 19 and barring transgender athletes from participating in girls’ and women’s sports.

On Wednesday, a bill that would open transgender health care providers to prison time if they treat people under the age of 18 passed the U.S. House and heads to the Senate. Another bill under consideration in the House on Thursday aims to ban Medicaid coverage for gender-affirming care for children.

Young people who persistently identify as a gender that differs from their sex assigned at birth are first evaluated by a team of professionals. Some may try a social transition, involving changing a hairstyle or pronouns. Some may later also receive hormone-blocking drugs that delay puberty, followed by testosterone or estrogen to bring about the desired physical changes in patients. Surgery is rare for minors.