President Donald Trump’s administration said that Medicaid will stop paying for gender-affirming surgeries and hormone treatments for transgender minors and the state Children’s Health Insurance Program won’t pay for the treatments for those under 19.
The announcement is the latest in a series of policies from the administration aimed at transgender people that began the day Trump returned to office last year.
The policy is to take effect Oct. 13.
It is not clear how much taxpayer funding is going to cover gender-affirming treatments for transgender youth now. The Centers for Medicare and Medicaid Services did not respond to questions about the policy on Tuesday.
At least 27 states have already banned gender-affirming care for those under 18. Even in states that haven’t, many major hospitals have stopped providing some of the treatments. And gender-affirming surgeries for minors are rare. Puberty blockers and hormone treatments are more common.
The policy calls for Medicaid and CHIP to continue to pay for mental health treatment for transgender minors but phase out coverage of hormone treatments that are used both to block puberty and to produce sex-related physical changes for those already receiving them as of April 2027.
Trump said in a social media post Tuesday that he directed Dr. Mehmet Oz, the CMS administrator, to make the change.
“We are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies,” Trump said in his post.
Advocates for LGBTQ+ young people look at it differently.
GLBTQ Legal Advocates and Defenders legal director Josh Rovenger said the rule “is putting up barriers between parents and their ability to make the best medical decisions for their children” and would face a legal challenge.
“The Trump administration is terrorizing trans youth and their families with these kinds of actions, and it has to stop,” Human Right Campaign President Kelley Robinson said in a statement.
HRC is already suing the administration for efforts to bar gender-affirming care coverage under federal employee benefit plans.
The American Medical Association and most other major medical organizations support access to gender-affirming care, though the American Society of Plastic Surgeons said earlier this year that it found “insufficient evidence” that the benefits of chest, genital and facial surgeries on minors experiencing gender dysphoria — or the unease a person may have because their assigned gender and gender identity don’t match — outweigh the risks.
The administration has made other moves, such as barring transgender athletes from sports competitions for girls and women and blocking people from being able to choose male, female or X to designate their sex on passports.
It also released a report last year urging therapy only for transgender youth and not broader gender-affirming health care.
Most of the changes have faced legal challenges. The U.S. Supreme Court let the administration’s passport policy stand and allowed states to enforce the sports bans. A lower court ruled against the administration’s declaration that called the treatments unsafe and ineffective.
—Geoff Mulvihill