US Department of Health and Human Services Proposes Regulatory Actions to Restrict Gender-Affirming Care for Minors
The US Department of Health and Human Services has unveiled a series of regulatory actions aimed at effectively banning gender-affirming care for minors, building on the Trump administration’s broader restrictions on transgender Americans. The proposals include cutting off federal Medicaid and Medicare funding from hospitals that provide gender-affirming care to children and prohibiting federal Medicaid dollars from being used to fund such procedures.
Regulatory Actions and Their Impact
The sweeping proposals would imperil access to gender-affirming care in nearly two dozen states where drug treatments and surgical procedures remain legal and funded by Medicaid, which includes federal and state dollars. Health Secretary Robert F. Kennedy Jr. stated, “This is not medicine, it is malpractice,” and claimed that sex-rejecting procedures rob children of their futures. However, advocates for transgender children strongly refuted the administration’s claims about gender-affirming care, saying that Thursday’s moves would put lives at risk.
Rodrigo Heng-Lehtinen, of The Trevor Project, a nonprofit suicide prevention organization for LGBTQ+ youth, expressed concerns about the proposals, calling them a “one-size-fits-all mandate from the federal government” on a decision that should be between a doctor and patient. The proposals run counter to the recommendations of most major US medical organizations, including the American Medical Association, which has urged states not to restrict care for gender dysphoria.
Medical Community’s Response and Concerns
Dr. Jamila Perritt, a Washington-based OB/GYN and president and CEO of Physicians for Reproductive Health, stated, “In an effort to strongarm hospitals into participating in the administration’s anti-LGBTQ agenda, the Trump Administration is forcing health care systems to choose between providing lifesaving care for LGBTQ+ young people and accepting crucial federal funding.” This approach has sparked concerns among medical professionals, who argue that it would lead to a lose-lose situation where lives are inevitably on the line.
The FDA has also issued warning letters to companies that market chest-binding vests and other equipment used by people with gender dysphoria, stating that these products can only be legally marketed for FDA-approved medical uses. Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, has referred to transgender treatments as “a Band-Aid on a much deeper pathology,” suggesting that children with gender dysphoria are “confused, lost and need help.”
Current State of Transgender Rights and Healthcare
Medicaid programs in slightly less than half of states currently cover gender-affirming care, while at least 27 states have adopted laws restricting or banning the care. The Supreme Court’s recent decision upholding Tennessee’s ban means most other state laws are likely to remain in place. Tennessee’s law, known as SB1, prohibits medical treatments like puberty blockers or hormone therapy for transgender adolescents under the age of 18.
The proposed rules will likely further intimidate health care providers from offering gender-affirming care to children, and many hospitals have already ceased such care in anticipation of federal action. Nearly all US hospitals participate in the Medicare and Medicaid programs, the federal government’s largest health plans that cover seniors, people with disabilities, and low-income Americans. Losing access to those payments would imperil most US hospitals and medical providers.
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