The Department of Health and Human Services announced several different plans to further restrict gender affirming care to people under 18 across the country on Thursday. If finalized, these actions could effectively make it impossible for transgender minors to receive most affirming health care at hospitals.
These proposals are not legally binding. The government is required to go through a lengthy rulemaking process—including public comment—before the restrictions become permanent. The administration is also expected to face a wall of legal backlash.
HHS Secretary Robert F. Kennedy, Jr. began the department’s press conference by accusing medical professionals of “malpractice,” saying “they betrayed their Hippocratic Oath to do no harm.”
The most chilling of the new regulatory actions would include cutting off federal Medicaid and Medicare funding from hospitals that provide gender affirming care to young people and prohibiting federal Medicaid dollars from being used to fund such procedures. Nearly every hospital in the country accepts this type of federal funding and relies on it to operate.
Kellan Baker, a Senior Advisor for Health Policy with the Movement Advancement Project, told Mother Jones that the Trump administration was putting politics ahead of science and patients.
“This administration does its policymaking by threats and this instance is no different,” said Moore.
The ACLU has already announced that it will challenge the proposals. Chase Strangio, who co-directs the organization’s LGBT & HIV Rights Project, called the proposals “gratuitous,” “cruel,” and “unconstitutional.”
“If this administration moves forward with this attempt to enact a national ban on our medical care through coercion, the ACLU will see them in court.”
While the speakers at Thursday’s announcement spent an outsized amount of time talking about surgery, the moves would also impact puberty blockers, hormone therapy, and chest binders. (A Harvard study from last year found that gender affirming surgeries are actually rarely performed on transgender youth.)
The officials at the press conference announcing the proposed changes cited President Donald Trump’s mandate in his January executive order “PROTECTING CHILDREN FROM CHEMICAL AND SURGICAL MUTILATION.” Days earlier, Trump claimed, defying science, that “the policy of the United States” was “to recognize two sexes, male and female.”
A 2022 statement from American Academy of Pediatrics reads, “There is strong consensus among the most prominent medical organizations worldwide that evidence-based, gender-affirming care for transgender children and adolescents is medically necessary and appropriate.” “It,” the statement continues, “can even be lifesaving.”
While Thursday’s proposals about federal funding for hospitals have a long road to being enacted, this move injects more confusion and fear into an already challenging—and sometimes nightmarish—reality for young transgender people trying to access care.
Health care for transgender youth already faces several restrictions around the country. According to the KFF, 27 states have enacted laws or policies limiting youth access to gender-affirming care, 24 states impose professional or legal penalties on providers who include this care in their practices, and half of transgender youth ages 13-17 currently live in a state that has enacted restrictions on gender affirming care.
“I think parents, families of trans young people, and those young people themselves are terrified because they are being literally attacked by their own government. That is not a position we should want any young person or any family to be in,” Baker, the policy analyst, noted.
On Thursday, the Food and Drug Administration also announced that it issued 12 warning letters to companies that market chest-binding vests and other equipment used by people with “gender dysphoria.” The letters alleged that these companies are illegally marketing to children. The FDA also threatened legal action these companies don’t comply with the agency’s directives. Officials also wrote a letter to health care providers, families, and policymakers on Thursday, claiming that gender-affirming care is dangerous.
Another regulation proposed by the Trump administration: remove gender dysphoria from being recognized as a disability under the civil rights law Section 504 of the Rehabilitation Act.
The move marked a new low in the administration’s treatment of people with disabilities, according to one advocate.
“The Trump administration’s attempt to carve out gender dysphoria from disability nondiscrimination protection is harmful, baseless, and cruel,” National Women’s Law Center senior counsel Ma’ayan Anafi told Mother Jones. “As numerous courts have recognized, laws like [these] which ensures disability nondiscrimination in federally funded programs, can protect people with gender dysphoria from discrimination.”
“I actually think they think more about trans people than trans people think about trans people.”
This move is not surprising, and it has precedent from Republican leadership. In a September 2024 lawsuit filed by 17 states, Texas Attorney General Ken Paxton tried to get the gender dysphoria proponents of Section 504 thrown out. The attorneys general originally claimed that Section 504 was unconstitutional, risking the fate of the law altogether, but that part of the lawsuit was dropped earlier this year. On October 31, a US district judge administratively closed the case but wrote that parties can refile.
Some lawmakers across the country are already pushing back on the announcement and promising to protect access to care.
New York Attorney General Letitia James spoke to young trans people in a social media post on Thursday, “I won’t let this administration come for you, your doctors, or your lifesaving health care. Your health care is still legal and protected.”
The Trump administration’s Thursday announcement comes one day after the House passed Rep. Marjorie Taylor Greene’s anti-trans bill, the “Protect Children’s Innocence Act.”
If enacted, the law would allow health care providers to face felony charges and up to 10 years in prison if they treat young people under the age of 18 with puberty blockers, hormones, and surgeries. It also provides an avenue to punish anyone who consents to or transports a minor to the care. This includes the parents of transgender minors, a diversion from the GOP’s continued stated interest to protect parental rights.
Before its passage, Rep. Sarah McBride (D-Del.) critiqued her Republican colleagues, saying they seemed “obsessed with trans people.”
“I actually think they think more about trans people than trans people think about trans people,” McBride, who is the first out transgender member of Congress, said in a more direct address than her usual remarks on the topic. “They are consumed with this, and they are extreme on it,” she said, adding that Republicans are “trying to politicize a misunderstood community and misunderstood care.”
In the Thursday press conference, top representatives from Trump’s administration laid out an extremely strict future for transgender health care in the country—one that purports to be led by “gold-standard science.”
For Baker, this phrase stands out.
“The fact that the administration continuously repeats the phrase ‘gold standard science’ has unfortunately come to be a marker of when it is doing exactly the opposite,” he told Mother Jones. “It’s a tell, if you will. It is an indication that what is happening is there is an intentional effort to destroy the very thing that they are claiming to uphold.”
