The Trump administration wants to cut funds to hospitals that provide gender-affirming health care to transgender youth.
Health Secretary Robert F. Kennedy Jr. announced two proposed rules Thursday which would ban Medicaid and Children’s Health Insurance Program reimbursements for transgender care for youth, and block all Medicaid and Medicare funding to hospitals that provide gender-affirming care for minors.
“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,” Kennedy said when announcing the regulations. “This is not medicine. It is malpractice.”
Kennedy added that he had also signed a declaration that youth transgender care did not meet standards of care and that HHS would seek to restrict the definition of disability under the Americans with Disabilities Act to not include gender dysphoria, as some courts have found.
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The proposed rules,which were first reported in October, are not final and cannot go into effect until after a period of public comment. But if implemented, they would not only heavily restrict access to health care for transgender kids but also could put some hospitals in serious financial peril. Hospitals heavily rely on Medicaid and Medicare spending to cover the cost of care.
Leading medical organizations like the American Medical Association, the American Academy of Pediatrics and the Endocrine Society all support gender-affirming care and say it “saves lives.”
In a statement, Jamila Perritt, president and CEO of Physicians for Reproductive Health, called the proposed rules a “deliberate and targeted attack” on transgender youth and an attempt to strongarm hospitals into choosing between providing pediatric gender-affirming care and accepting federal funding.
During the first year of President Donald Trump’s second term, Republicans have repeatedly attempted to block federal funds from being used on gender-affirming care. House Republicans tried to add such a provision to the president’s budget bill. It was ultimately removed after Democrats’ quietly organized to take it out of the text on procedural grounds, as NOTUS previously reported.
Kennedy announced that the Food and Drug Administration had sent letters to 12 manufacturers of breast binders warning them that if they marketed their products to children they could face enforcement actions, including product seizure.
More than 185,000 transgender Americans say Medicaid is their primary source of health insurance, according to the Williams Institute.
“These rules would be a significant escalation in the Trump administration’s attack on access to transgender health care,” Katie Keith, director of the Center for Health Policy and the Law at Georgetown University, told NPR when the rules were first reported in October.
Kennedy’s announcement comes a day after House lawmakers passed a bill, sponsored by Rep. Marjorie Taylor Greene, criminalizing gender-affirming care for trans youth. That bill would make it a felony to offer trans health care to minors, imprisoning health providers for up to 10 years for offering that health care, though it is unlikely to pass in the Senate.
“All Republicans care about is making the rich richer and attacking trans people. They are obsessed with trans people,” Rep. Sarah McBride, the first transgender member of Congress, told reporters on Wednesday. “They are trying to politicize a misunderstood community and misunderstood care.”
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