Updated December 18, 2025 at 3:40 PM MST
Health officials from the Trump administration announced several moves Thursday that will have the effect of essentially banning gender-affirming care for transgender young people, even in states where it is still legal.
Health Secretary Robert F. Kennedy Jr. and Dr. Mehmet Oz, who leads Medicaid and Medicare, announced the measures in a press conference at the headquarters of the Department of Health and Human Services in Washington, D.C.
"So-called gender affirming care has inflicted lasting physical and psychological damage on vulnerable young people," Kennedy said. "This is not medicine. It is malpractice."
The American Academy of Pediatrics pushed back strongly against HHS's actions.
"These policies and proposals misconstrue the current medical consensus and fail to reflect the realities of pediatric care and the needs of children and families," said AAP President Dr. Susan J. Kressly.
New rules
The ban takes the form of two new proposed rules from Medicaid and Medicare. The first prohibits doctors and hospitals from receiving federal Medicaid reimbursement for gender-affirming care provided to transgender patients younger than age 18. Medicaid is the health care program that covers low-income Americans.
The second rule blocks all Medicaid and Medicare funding for any services at hospitals that provide pediatric gender-affirming care. Virtually every hospital in the country takes Medicare, which covers older Americans and the disabled. Because hospitals rely on Medicare, the rule would have a wide-ranging effect.
Supporters and opponents of transgender rights agree that, taken together, the forthcoming hospital rules could make access to pediatric gender-affirming care across the country extremely difficult, if not impossible.
The care is already banned in 27 states. The proposed rules will be entered into the Federal Register on Friday and that starts a 60-day comment period. The rules would not take effect immediately.
The American Civil Liberties Union has announced plans to sue to stop the rules; other legal action is also expected.
"These rules are a baseless intrusion into the patient-physician relationship," the AAP's Kressly said. "Patients, their families, and their physicians—not politicians or government officials —should be the ones to make decisions together about what care is best for them."
Kennedy and others at the press conference insisted that AAP and others — including transgender people themselves — are wrong.
"There is no such thing as being transgender," said activist Chloe Cole, who uses her experience of transitioning as a young person and regretting it to advocate for government restrictions on this care.
Cole continued, "To the young people out there who are struggling with this mental illness, I want you to know, it's not too late to accept the beautiful way that God has created you."
Other actions to restrict care
The pivot to the topic of transgender minors comes one day after Republicans in the House of Representatives passed a package of health care bills that do not extend subsidies for people who buy health insurance in Affordable Care Act plans.
Kressly, of the pediatrics academy, said that the new measures do nothing to bring down health care costs and instead, "unfairly stigmatize a population of young people."
The legislative package Congress considered this week included a bill, introduced by Rep. Marjorie Taylor Greene, R-Ga., that makes it a crime to provide gender-affirming care to transgender minors, punishable by a fine or prison time of up to 10 years. It passed on Wednesday.
Another bill, passed Thursday, was introduced by Rep. Dan Crenshaw, R-Texas. It would prohibit Medicaid reimbursement for gender-affirming care for youth. Both bills would also have to pass the Senate to become law.
At Thursday's press conference, Dr. Marty Makary, who heads the Food and Drug Administration, announced that the FDA would be sending warning letters to businesses that manufacture chest binders and advertise them to young people.
Dr. Jay Bhattacharya, who leads the National Institutes of Health, talked about grants rescinded earlier this year on research affecting transgender young people.
Since Day 1
The actions are consistent with steps President Trump has taken since his first day in office. On Day 1, he signed an executive order declaring that the United States "will not fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another."
Since then there have been other measures including:
- HHS released a report critical of the research that supports access to this care.
- A federal suicide prevention lifeline specifically for transgender youth was canceled, as were hundreds of millions of dollars in scientific research funding related to LGBTQ health.
- Federal health officials warned state Medicaid directors to tread carefully, and the Department of Justice announced subpoenas of some children's hospitals and threatened providers with prosecution.
One family reacts
For one mom of a transgender teen in California, the rules and bills released this week are concerning. She asked that NPR not name her or her child because she fears she could lose her job or risk her family's safety by speaking about their experiences.
"It feels like we're being hunted," she says.
She describes her own process of learning about the options for gender-affirming care for her teenager and concluding that the benefits outweighed the risks. "If we can't stop the government from legislating what health care families can receive in consultation with their doctors, then I don't recognize this America," she says.
Her son is 15-years-old and has been taking testosterone for about 6 months. He is a scout, he runs cross-country, and wants to work in a math or science field. His friends know he is transgender but not everyone at his high school does.
"I kind want to make it clear — I came out to my parents and said that I wanted to start [hormone therapy] and it took them a long time to be OK with that," he says. "We went to a lot of therapy. We had a lot of discussions. My parents — they were scared for me to start it." He says both he and his parents researched it: "It wasn't just like a whim."
He says starting hormone therapy brings to mind a hiking metaphor: "I was like, 'Oh, this is the path that's going to take me to where I want.' I feel like my body is going in the right direction."
The changes the Trump administration and Congress are doing worry him. "It feels like someone's throwing me into the bush just off the path I'm on," he says. "And that's kind of terrifying. I don't want to be lost. I want to keep going where I'm going."
Copyright 2025 NPR
