Health and Human Services Sec. Robert F. Kennedy Jr. (C) (Photo via the HHS Facebook)
The U.S. Department of Health and Human Services announced Dec. 18 that it will pursue regulatory changes that would make gender-affirming healthcare for transgender children more difficult, if not impossible, to access.
The shift in federal healthcare policy stems directly from President Donald Trump’s Jan. 28 executive order, Protecting Children From Chemical and Surgical Mutilation, which formally establishes U.S. opposition to gender-affirming care and pledges to end federal funding for such treatments.
The executive order outlines a broader effort to align HHS with the Trump–Vance administration’s policy goals and executive actions. Those actions include defunding medical institutions that provide gender-affirming care to minors by restricting federal research and education grants, withdrawing the 2022 HHS guidance supporting gender-affirming care, requiring TRICARE and federal employee health plans to exclude coverage for gender-affirming treatments for minors, and directing the Justice Department to prioritize investigations and enforcement related to such care.
HHS has claimed that gender-affirming care can “expose them [children] to irreversible damage, including infertility, impaired sexual function, diminished bone density, altered brain development, and other irreversible physiological effects.” The nation’s health organization published a report in November, saying that evidence on pediatric gender-affirming care is “very uncertain.”
The Centers for Medicare and Medicaid Services is now in the process of proposing new rules that would bar hospitals from performing what the administration describes as sex-rejecting procedures on children under age 18 as a condition of participation in Medicare and Medicaid programs. Nearly all U.S. hospitals participate in Medicare and Medicaid. HHS said that “this action is designed to ensure that the U.S. government will not be in business with organizations that intentionally or unintentionally inflict permanent harm on children.”
Health and Human Services Secretary Robert F. Kennedy Jr. released a statement alongside the announcement.
“Under my leadership, and answering President Trump’s call to action, the federal government will do everything in its power to stop unsafe, irreversible practices that put our children at risk,” Kennedy said. “This administration will protect America’s most vulnerable. Our children deserve better — and we are delivering on that promise.”
Those claims stand in direct opposition to the positions of most major medical and healthcare organizations.
The American Medical Association, the nation’s largest and most influential physician organization, has repeatedly opposed measures that restrict access to trans healthcare.
“The AMA supports public and private health insurance coverage for treatment of gender dysphoria and opposes the denial of health insurance based on sexual orientation or gender identity,” a statement on the AMA’s website reads. “Improving access to gender-affirming care is an important means of improving health outcomes for the transgender population.”
Jennifer Levi, senior director of transgender and queer rights at GLBTQ Legal Advocates and Defenders, warned the proposed changes would cause significant harm.
“Parents of transgender children want what all parents want: to see their kids thrive and get the medical care they need. But this administration is putting the government between patients and their doctors. Parents witness every day how their children benefit from this care — care backed by decades of research and endorsed by major medical associations across the country. These proposed rules are not based on medical science. They are based on politics. And if allowed to take effect will serve only to drive up medical costs, harm vulnerable children, and deny families the care their doctors say they need. These rules elevate politics over children — and that is profoundly unAmerican.”
Human Rights Campaign President Kelley Robinson echoed Levi’s sentiments.
“The Trump administration is relentless in denying health care to this country, and especially the transgender community. Families deserve the freedom to go to the doctor and get the care that they need and to have agency over the health and wellbeing of their children,” Robinson said. “But these proposed actions would put Donald Trump and RFK Jr. in those doctor’s offices, ripping health care decisions from the hands of families and putting it in the grips of the anti-LGBTQ+ fringe. Make no mistake: these rules aim to completely cut off medically necessary care from children no matter where in this country they live. It’s the Trump administration dictating who gets their prescription filled and who has their next appointment canceled altogether.
The announcement comes just after U.S. Rep. Marjorie Taylor Greene (R-Ga.) advanced legislation in Congress that would make it a felony to provide gender-affirming care to a child.
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