By Theresa Gaffney, Daniel Payne, and Chelsea Cirruzzo. Originally published in STAT on Dec. 18, 2025.
Staff Attorney John Card was quoted in this article.
The Trump administration is making its most forceful attempt yet at restricting gender-affirming care for transgender youth in the U.S.
The Centers for Medicare and Medicaid Services proposed on Thursday two rules to withhold federal funds in connection with gender-affirming care for trans minors, including puberty blockers, hormones, and surgery. The most stringent rule would bar facilities that offer this care from receiving any funding from the federal Medicare or Medicaid programs.
The move is “effectively forcing providers to discontinue such services or risk losing Medicare and Medicaid funding,” Hannah Oliason, an attorney at Nilan Johnson Lewis who works with hospitals, said in an email on Wednesday about the expected rule — “even at the cost of reputational harm or state enforcement.”
The agency will also prohibit Medicaid and Children’s Health Insurance Program funds from being spent on gender-affirming care for minors. The public will have 60 days to submit comments on the proposed funding rules, after which the administration could change them or move to finalize them.
The proposals from CMS mark the latest of a slew of attempts by the Trump administration and Republicans to roll back access to this care for trans youth. It’s a campaign that started a week into President Trump’s term with an executive order that sought to ban transgender health care for people under 19. The order was later blocked by a federal judge.
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