The Trump administration finalized a rule on Tuesday barring two major federal health programs from funding puberty blockers, hormone therapy and surgeries to treat gender dysphoria in minors, reshaping access for low-income youth nationwide.
The rule, scheduled for publication on Thursday and effective in October, cuts off funding under Medicaid and the Children’s Health Insurance Program, or CHIP, which together cover 35.5 million U.S. children.
Roughly a decade after U.S. specialty clinics began offering pediatric gender treatments, the government says it will no longer share the cost for children under 18 in Medicaid and under 19 in CHIP, citing what it called weak evidence of benefit and risks of irreversible harm.
The move marks one of the administration’s most sweeping restrictions yet on transgender healthcare. It forms part of a wider crackdown on the rights of transgender people through the elimination of legal protections in the military, healthcare, education and the workplace.
The rule does not ban the procedures but removes the federal support that makes them accessible to millions of low-income children, shifting the burden to states, families and private insurance.
“By cutting off federal funds for these sex-rejecting procedures, we’re following the science, saving taxpayer dollars, and, most importantly, protecting children from potentially irreversible harm so they can truly flourish,” Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz said in a statement.
The measure reflects a broader reassessment of pediatric gender medicine, even as major U.S. medical organizations back such care and warn against restricting it. The American Academy of Pediatrics and the American Medical Association say such decisions should rest with children, parents and healthcare professionals.
