Medicaid to stop funding gender-affirming care for minors in Trump ruling
A doctor with a child (Getty Images, stock)
The Trump administration has finalised a rule barring federal Medicaid and Children’s Health Insurance Program (CHIP) funds from being used for gender-affirming healthcare for children.
The rule was finalised Tuesday (11 August) and is set to take effect on 13 October. States that currently allow Medicaid or CHIP to cover gender-affirming care for minors will no longer be able to use federal funds for those services and would have to finance the care themselves if they choose to continue covering it.
President Donald Trump celebrated the change in an 11 August Truth Social post, describing gender-affirming healthcare as “barbaric” and saying the rule would spare children from what he called potentially harmful procedures, as well as throwing a jab at politicians across the aisle, writing “the Dumocrat Party wants your kids to be able to chop off their reproductive organs before they are old enough to vote”.
Health and Human Services Secretary Robert F. Kennedy Jr. similarly characterised the treatments affected by the rule as “sex-rejecting procedures”, arguing that they carry serious risks and can cause irreversible harm in a statement.
The administration’s policy encompasses a range of healthcare, including puberty blockers and hormones. Gender-affirming healthcare can also include mental health and other medical services intended to help people align aspects of their gender expression, such as appearance or voice, with their gender identity. This care applies to not just transgender minors, but nonbinary, intersex, and cisgender patients as well.
Importantly, gender-affirming surgeries are very rare among minors, and are more common for cisgender youth as opposed to trans youth according to research published in JAMA Network Open in 2024. The new rule nevertheless covers other forms of care that are more commonly used, including puberty blockers and hormone treatment.
Medical and LGBTQ+ organisations have strongly criticised the policy. The National Alliance on Mental Illness has cited research indicating that access to gender-affirming care can improve mental health outcomes.
Human Rights Campaign President Kelley Robinson said that healthcare decisions should be made by young people, their families and their medical providers rather than politicians, adding that the Trump administration is “terrorising trans youth and their families,” in a statement to The Hill.
Rodrigo Heng-Lehtinen of the Trevor Project similarly argued to The Hill that the federal government should not impose a “one-size-fits-all mandate” on highly personal medical decisions, noting that gender-affirming care has been provided for decades and is supported by major medical and mental health organisations.
The rule does not eliminate federal Medicaid or CHIP coverage for mental health services for children generally. Instead, it specifically targets federal funding for healthcare classified under the administration’s new restrictions.
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