The Trump administration has initiated a move to prohibit gender-affirming treatments for minors nationwide.

On Thursday, the Department of Health and Human Services (HHS) announced the potential withdrawal of federal funding from any U.S. hospital that provides transgender surgeries or medical treatments.

The announcement detailed that the Centers for Medicare & Medicaid Services (CMS) plans to issue a proposed rule that would prevent hospitals from conducting ‘sex-rejecting’ procedures on individuals under 18, should these hospitals wish to remain eligible for Medicare and Medicaid programs.

According to HHS, these procedures involve pharmaceutical or surgical methods aimed at altering a child’s physical appearance to match a gender identity that differs from their biological sex.

HHS emphasized that since nearly every U.S. hospital is part of Medicare and Medicaid, this measure seeks to ensure that the federal government does not partner with institutions that may either knowingly or unknowingly cause irreversible harm to children.

While HHS refers to these procedures as ‘sex-rejecting,’ the medical community commonly recognizes them as ‘gender-affirming’ care.

CMS will also release additional proposed rulemaking that will prohibit federal Medicaid and Children’s Health Insurance Program (CHIP) funding for gender-affirming care on minors. 

Currently, 23 states provide Medicaid funding for these interventions, which include hormone and puberty blockers, mental health support and gender-reassignment surgery, according to HHS.

The Department of Health and Human Services (HHS) under the Trump administration threatened Thursday to pull federal funding from hospitals providing gender-affirming care to minors. HHS Secretary Robert F Kennedy is pictured at left with President Donald Trump and Center for Medicare & Medicaid administrator Dr Mehmet Oz at right in September

The administration claimed that gender-affirming care on minors can ’cause irreversible damage, including infertility, impaired sexual function, diminished bone density, altered brain development, and other irreversible physiological effects’.

HHS Secretary Robert F Kennedy Jr signed Thursday a declaration based on an HHS report published in November, which found that procedures such as hormone blockers and surgery ‘do not meet professional recognized standards of health care’. 

‘Under the declaration, practitioners who perform sex-rejecting procedures on minors would be deemed out of compliance with those standards,’ HHS added. 

Kennedy said Thursday: ‘Under my leadership, and answering President Trump’s call to action, the federal government will do everything in its power to stop unsafe, irreversible practices that put our children at risk.

‘This Administration will protect America’s most vulnerable. Our children deserve better—and we are delivering on that promise.’

Puberty blockers are reversible and have been shown to be safe dating back to their FDA approval in 1993. 

The FDA is also issuing warning letters to 12 manufacturers and retailers for ‘illegal marketing’ of breast binders to children for the purposes of treating gender dysphoria, which is defined as significant distress a person feels from a mismatch between their gender identity and the sex they were assigned at birth.

Demonstrators are pictured marching to the Alabama state capitol building in Montgomery in February 2025 to protest bills that would impact transgender individuals

The agency said the binders are Class I medical devices that should only be used for women recovering from a mastectomy, which is the removal or one or both breasts, due to cancer. 

FDA Commissioner Dr Marty Makary said: ‘Illegal marketing of these products for children is alarming, and the FDA will take further enforcement action such as import alerts, seizures, and injunctions if it continues.’

The Biden administration had attempted to define gender dysphoria as a disability, but HHS said it is moving to reverse those measures. 

CMS administrator Dr Mehmet Oz said Thursday: ‘Children deserve our protection, not experimental interventions performed on them, that carry life-altering risks with no reliable evidence of benefit.

‘This proposal seeks to clarify that hospitals participating in our programs cannot conduct these unproven procedures on children. CMS will ensure that federal program standards reflect our responsibility to promote the health and safety of children.’ 

The proposed efforts have not yet been finalized. 

The above graph shows the number of gender-affirming top surgeries carried out in the US by year

Fewer than 0.1 per cent of all US adolescents receive gender-affirming medications or other care, a January study found. 

Transition surgery, which can include removing the breasts (also called ‘top surgery’) and changes to genitalia, under 18 is extremely rare and decided on a case-by-case basis by teams of primary care doctors, psychologists, endocrinologists, and surgeons.

Trans children typically begin their transition with puberty blockers. These medications delay the onset of puberty to provide the child and their family with more time to decide whether to pursue hormone therapies.

Hormone therapies, meanwhile, typically begin in a child’s teenage years to help them develop secondary sex characteristics. A girl transitioning to become a boy, for instance, may take hormones to deepen their voice and grow body hair.

After undergoing hormone therapy, a trans person may choose to undergo surgery to medically transition, though not everyone does this.

Professional medical organizations, including the American Academy of Pediatrics, the American Medical Association, and the American Psychological Association, maintain that gender-affirming care – surgery included – is necessary for the emotional and physical well-being of trans youth. 

The above shows insurance claims for mental health care, according to LexisNexis. They analyzed data from more than 300million patients

One of the main benefits of the procedures, the groups argue, is preventing depression and suicidal thoughts that often accompany gender dysphoria. 

Research from Yale University, for example, found that transgender individuals who were diagnosed with gender dysphoria were six times more likely to have a mood or anxiety disorder, three times more likely to be prescribed antidepressants and at least six times more likely to attempt suicide than their cisgender peers. 

The study also found that transgender individuals who had undergone gender-affirming surgery were significantly less likely to need mental health treatment for depression and anxiety disorders than those who didn’t get the care. 

An analysis published last year also found gender dysphoria diagnoses have spiked 133 per cent since 2019.