On Tuesday, the Trump administration announced a rule barring federal Medicaid and Children’s Health Insurance Program funds from covering gender-affirming medical care for minors. The policy is scheduled to take effect October 13 and would apply to treatments including puberty blockers, hormone therapy, and surgeries, although surgical procedures are uncommon among minors.
Gender-affirming care encompasses mental health and medical services intended to align a person’s physical characteristics or gender expression with their gender identity. Such care may be provided to transgender, nonbinary, intersex, and cisgender patients, depending on individual circumstances.
Under the rule, federal contributions to Medicaid and CHIP could not be used for these treatments for children and adolescents. States would remain able to use their own funds to provide coverage. Federal coverage for children’s mental health services would not be affected.
The Centers for Medicare and Medicaid Services said the change followed a Department of Health and Human Services review of research from the United States and other countries. Federal officials said the review found evidence gaps and safety concerns that did not justify taxpayer funding. The administration did not provide clear details of those findings in the announcement.
Major medical organizations generally support gender-affirming care when delivered according to established clinical guidelines. Research cited by the National Alliance on Mental Illness indicates access may improve mental health outcomes for some young patients, while denial of care may worsen symptoms and increase suicide risk.
The rule comes amid broader political and legal disputes over transgender rights. According to KFF, 27 states have enacted restrictions on gender-affirming care for minors. President Donald Trump promoted the federal policy on Truth Social and linked it to the November midterm elections, urging voters to consider the issue when deciding which party should control Congress. The debate is expected to continue in courts nationwide.