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Washington: The Trump administration has unveiled sweeping new restrictions that aim to stop gender-affirming medical care for transgender children nationwide by cutting off federal funding to hospitals that provide puberty blockers, hormone therapy or surgical interventions.
In a move that will be watched by other countries debating the medical merits and ethics of gender care for teenagers, the US government will prohibit federal Medicaid money being used to fund such procedures, and strip Medicaid and Medicare funding from hospitals provide the treatments.
US Secretary of Health Robert F. Kennedy Jr.Credit: Bloomberg
This would apply in about two dozen US states where drug treatments and surgery for transgender youth are legal and funded by Medicaid, the Associated Press reported. Just over half of the US’s 50 states have already banned or restricted gender-affirming care for minors.
US Health Secretary Robert F. Kennedy Jr. called gender-affirming care “junk science” that was driven by ideological pursuits, not the wellbeing of children.
“So-called gender-affirming care has inflicted lasting physical and psychological damage on vulnerable young people. This is not medicine, it is malpractice,” he said as he announced the changes on Thursday (Friday AEDT).
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“The Trump administration will not stand by while ideology, misinformation and propaganda push vulnerable young people into decisions they cannot fully understand and that they can never reverse.”
The new regulations are being put out for public comment before their implementation, and are likely to face legal challenges and fierce resistance from medical groups and community advocates.
Human Rights Campaign, the US’s largest LGBTQ civil rights organisation, said the Trump administration’s changes would make best-practice healthcare for transgender youth nearly impossible nationwide.
“These rules aim to completely cut off medically necessary care from children no matter where in this country they live,” said the group’s president, Kelley Robinson.
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“It’s the Trump administration dictating who gets their prescription filled and who has their next appointment cancelled altogether.”
The Trevor Project, an organisation focused on suicide prevention among LGBTQ youth, warned that restricting “medically necessary care” risked the lives of transgender and non-binary young people.
“Personal medical decisions ought to be made between patients, their doctors and their families, not through a one-size-fits-all mandate from the federal government,” said the group’s senior vice president Rodrigo Heng-Lehtinen.
“The multitude of efforts we are seeing from federal legislators to strip transgender and non-binary youth of the healthcare they need is deeply troubling.”
US President Donald Trump has made eliminating transgender recognition, care and policy a priority of the first year of his second administration.
Among his earliest executive orders was a move to ban the participation of trans women from women’s sports – also through the use of federal funding – and the US military has moved to ban and kick out transgender service members.
The administration has officially decreed that there are only two sexes, male and female. “These sexes are not changeable and are grounded in fundamental and incontrovertible reality,” Trump’s order on January 20 said.
The president also regularly derides Democrats for pursuing policies he calls “transgender for everybody”, and claims – without providing evidence – that about 97 per cent of the population agrees with him.
It’s the latest contentious move by Kennedy, who recently ordered the Centres for Disease Control and Prevention to abandon its stance that vaccines don’t cause autism and who has appointed vaccine sceptics to review the child immunisation schedule.
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The new announcement represents another major setback for advocates of gender-affirming care for minors.
Under that treatment model, children’s statements about their gender identity do not automatically result in transition, but it is assumed they should be taken seriously and acted on – usually through puberty blockers, hormone therapy and potentially surgery.
In 2024, British paediatrician Hilary Cass handed down a highly critical review of the gender-affirming care model in the United Kingdom, leading that country to impose an indefinite ban on the routine prescription of puberty blockers. The National Health Service is now beginning new clinical trials of the drugs.
More broadly, the Cass review questioned the wisdom of affirming children’s apparent gender incongruence through medical intervention, and urged parents and doctors to consider other factors such as mental health, sexual orientation, adverse experiences and wellbeing at school.
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“For most young people, a medical pathway will not be the best way to manage their gender-related distress,” Cass wrote.
In January, the Australian government announced its own review into health guidelines for trans and gender diverse children and adolescents, led by the National Health and Medical Research Council (NHMRC) and the Therapeutic Goods Administration.
Interim advice on the use of puberty blockers is not expected until the middle of 2026.
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