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The Trump administration on Tuesday released a final rule blocking the use of federal Medicaid dollars for transgender healthcare for minors, as well as barring Children’s Health Insurance Program (CHIP) plans from paying for gender-affirming procedures for minors.
The final rule released by The Centers for Medicare and Medicaid Services (CMS) bars Medicaid dollars from paying for what it refers to as “sex-rejecting procedures for children under 18” as well as blocking CHIP agencies from paying for the same procedures for people under the age of 19.
Program beneficiaries who are currently receiving cross-sex hormone therapy can continue to claim benefits for six months after the rule’s effective date, which appears set to be Oct 12, 2026.
“Today, we are ending federal taxpayer funding for sex-rejecting procedures on children,” Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said in a statement. “These interventions carry serious risks and can cause irreversible harm. The federal government will no longer use Medicaid and CHIP dollars to fund procedures that fail to meet the evidentiary standard our children deserve.”
CMS Administrator Mehmet Oz said the rule was “following the science, saving taxpayer dollars, and, most importantly, protecting children from potentially irreversible harm so they can truly flourish.”
In a statement on social media, President Trump wrote, “We are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies.”
The vast majority of transgender youth do not receive surgeries before adulthood, with less than one percent of minors in a 2024 study found to have received some form of surgical gender-affirming care.
The same study found that cisgender, male youths reported a higher uptake of gender-affirming surgical care than their transgender counterparts. Among individuals who received breast reductions, 97 percent were cisgender male minors seeking treatment for gynecomastia.
Several advocacy groups were quick to condemn the finalized rule.
“Every young person is entitled to the health care that they, their parents, and their medical providers agree that they need, without politicians interfering with these important and highly personal decisions,” Human Rights Campaign President Kelley Robinson said in a statement. “The Trump administration is terrorizing trans youth and their families with these kinds of actions, and it has to stop.”
Ma’ayan Anafi, senior counsel for health equity and justice at the National Women’s Law Center, accused the administration of “jeopardizing vital health care.”
Rodrigo Heng-Lehtinen, The Trevor Project’s senior vice president of public engagement campaigns, called the rule a “dangerous restriction on doctor-prescribed health care.”
“Personal medical decisions should be made by individual patients, their doctors, and their families – not by a one-size-fits-all mandate from the federal government,” said Heng-Lehtinen. “While there have been many recent headlines about transgender health care, this type of care is nothing new; it has been provided for decades, is based on scientific research, and is supported by all of our country’s leading medical and mental health associations.”
Heng-Lehtinen cited research by his organization which found the type of care being restricted by this rule was associated with lower rates of depression and suicide among transgender youth.
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