Trump administration moves to ban hospitals from providing gender-affirming care to young people
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The Trump administration moved Thursday to restrict gender-affirming care for minors across the country, threatening to cut federal funding for hospitals that offer treatments like puberty blockers, hormone therapy or surgical procedures.
The proposed rules, if finalized, would affect nearly every hospital in the country, which relies on payment from the federal government to operate — Medicare and Medicaid have paid for half of hospital days for more than 95% of establishments, according to the American Hospital Association.
Medicaid and the Children’s Health Insurance Program, which provide health insurance coverage to more than 77 million adults and children, also would not be able to fund treatments for people under 18 and 19, respectively.
“So-called gender-affirming care has inflicted lasting physical and psychological harm on vulnerable young people,” HHS Secretary Robert F. Kennedy Jr. said at a news conference Thursday. “It’s not medicine, it’s malpractice.”
The Trump administration will also order the Food and Drug Administration to send warning letters to 12 manufacturers and retailers they say are illegally marketing breast belts to children. Breast girdles, compression garments worn to flatten the appearance of the breasts, could be subject to seizure if manufacturers don’t comply, Kennedy said.
Additionally, HHS will direct the Office for Civil Rights to remove gender dysphoria as a qualified disability to ensure that the proposed rules do not violate nondiscrimination requirements. Previously, the Biden administration decided to designate gender dysphoria as a disability under the Americans with Disabilities Act.
Restricting minors’ access to gender-affirming care has been a priority for the Trump administration. Days after his inauguration, President Donald Trump signed an executive order to ban federal funding for gender-affirming medical treatments for young people. It also directed HHS to release a documentary report on gender-affirming care.
The report, released in May, broadly disavows gender-affirming treatments, including surgical procedures, hormonal therapies and puberty blockers, and encourages providers to rely on behavioral therapy for minors experiencing gender dysphoria or incongruity between their sex assigned at birth and their gender identity.
The recommendations run counter to those issued by major medical associations. The American Medical Association, the American Psychological Association and the American Academy of Pediatrics have independently endorsed the recommendations of the World Professional Association for Transgender Health, a nonprofit organization dedicated to transgender health care research, which recommends a social, psychological, behavioral and medical approach to treating gender dysphoria.
Trump condemned the organization. On Thursday, Kennedy said: “The American Medical Association, the AAmerican The Academy of Pediatrics has peddled the lie that chemical and surgical gender rejection procedures could be beneficial for children with gender dysphoria.
The Trump administration says gender-affirming treatments fail to meet health standards and expose children to “irreversible harm,” such as impaired brain development, infertility and decreased bone density.
On Thursday, Kennedy released a statement declaring that “gender rejection procedures in children and adolescents are neither safe nor effective as a treatment modality for gender dysphoria.” incongruity or other related disorders in minors and, therefore, do not meet recognized professional standards of health care.
HHS highlighted these standards in its proposed rule, arguing that the regulation circumvents federal law requiring that CMS not control the “practice of medicine” or how services are provided.
“…We believe that providing the [sex-rejecting procedures] because children do not constitute health care and therefore are not encompassed under the term “practice of medicine,” one of the proposed rules states. “Therefore, the proposed rule would not regulate the practice of medicine. »
Susan J. Kressly, president of the American Academy of Pediatrics, called the proposed rules a “baseless intrusion into the patient-doctor relationship” that focused “disproportionate attention on the denial of care to a small population of adolescents.”
“Allowing the government to determine which groups of patients deserve care sets a dangerous precedent, and children and families will bear the consequences,” Kressly said in a statement.
The proposed regulations are the latest pressure on providers by the Trump administration, which has targeted hospitals and doctors who provide care to minors.
In May, CMS Administrator Dr. Mehmet Oz required certain hospitals to provide “complete financial data on all pediatric sex trait modifications” funded by the government. Earlier this year, the White House said it had directed the Justice Department to investigate providers and drug makers who allow young people to receive gender-affirming care.
In response, major health systems said they would suspend gender-affirming care for minors, including Kaiser Permanente. and the University of Pittsburgh Medical Center.
The proposed Medicare and Medicaid rules will solicit public comment for 60 days after being published in the Federal Register on December 19.
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