WASHINGTON, D.C. — President Donald Trump’s administration took major steps Thursday in a campaign to block minors’ access to gender-affirming care nationwide.
Under two proposed new rules from the Centers for Medicare and Medicaid Services, hospitals would be barred from providing gender transition treatment for children as a condition of participating in Medicare and Medicaid programs, and Medicaid funding would be prohibited from being used to fund such care for minors.
As most hospitals receive Medicare and Medicaid funding, the rules would essentially have the effect of a nationwide ban if they are finalized.
The announcement came a day after the U.S. House passed a bill that would impose federal criminal penalties for gender-affirming care for minors and hours before it advanced a separate measure that would prohibit Medicaid funding for gender transition treatment for minors.
The proposed regulations, which will next undergo a period of public comments, are certain to draw legal challenges.
The efforts build on Trump’s executive order in January that restricted access to gender-affirming care for kids.
More than half of states already have laws or policies aimed at limiting youth access to gender-affirming care, according to the nonpartisan health research organization KFF.
Health and Human Services Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz announced the proposals alongside several other health officials at a press conference at HHS headquarters in Washington, D.C.
The room featured a handful of GOP members of Congress. At least two Republican state attorneys general — Ken Paxton of Texas and Todd Rokita of Indiana — were also in attendance.
At the press conference, Food and Drug Administration Commissioner Dr. Marty Makary said the FDA is also sending “warning letters” to 12 breast binder manufacturers and sellers for “illegal marketing of breast binders for children for the purposes of treating gender dysphoria.”
Breast binders are used to flatten tissue in the chest.
Kennedy said his agency’s Office for Civil Rights is moving to “reverse the Biden administration’s attempt to include gender dysphoria within the definition of disability.”
House passes anti-transgender bills
The proposed rules are part of the Trump administration’s broader anti-trans agenda.
Trump has signed executive orders that make it the “policy of the United States to recognize two sexes, male and female,” aimed to bar openly transgender service members from the U.S. military, and sought to prohibit trans athletes from competing on women’s sports teams consistent with their gender identity.
Meanwhile, efforts at the congressional level to restrict youth access to gender-affirming care face a dismal path in the Senate, where any legislation would likely need the backing of at least 60 senators to advance past the filibuster.
The House passed a measure Wednesday night, 216-211, that would subject medical professionals to up to 10 years in prison for providing gender-affirming care for minors.
Rep. Marjorie Taylor Greene, who sponsored the legislation, called its passage a “win for children all over America,” in a social media post Wednesday.
It’s likely the last legislative achievement for the Georgia Republican, who is resigning from Congress in early January.
Four Republicans voted against the measure: Reps. Gabe Evans of Colorado, Brian Fitzpatrick of Pennsylvania, Mike Kennedy of Utah and Mike Lawler of New York.
Three Democrats voted with the GOP to back the bill: Reps. Henry Cuellar and Vicente Gonzalez of Texas and Don Davis of North Carolina.
The House also passed a measure Thursday, 215-201, from Texas GOP Rep. Dan Crenshaw and Greene that aims to prohibit “Medicaid funding for gender transition procedures for minors.”
Cuellar, Gonzalez and Davis also backed the GOP-led bill, along with fellow Democratic Rep. Marie Gluesenkamp Perez of Washington state.
‘Cruel and unconstitutional attacks’
Kelley Robinson, president of the Human Rights Campaign, an LGBTQ+ advocacy group, blasted the administration’s proposals, saying they “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.”
Robinson also emphasized that the rules are “proposals, not binding law,” and called on community members, health care providers, administrators and allies to “be vocal in pushing back by sharing the ways these proposals would be devastating to their families and the healthcare community at large.”
The American Civil Liberties Union also condemned the administration’s proposals and vowed to challenge the efforts in court.
Chase Strangio, co-director of the ACLU’s LGBTQ & HIV Rights Project, dubbed the proposals “cruel and unconstitutional attacks on the rights of transgender youth and their families.”
Strangio said the proposals would “force doctors to choose between their ethical obligations to their patients and the threat of losing federal funding” and “uproot families who have already fled state-level bans, leaving them with nowhere to turn for the care they need to survive and thrive.”
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