President Trump’s administration announced that Medicaid will no longer cover gender-affirming surgeries or hormone treatments for transgender minors, while the state Children’s Health Insurance Program, known as CHIP, will stop paying for those treatments for people under 19.
The move marks the latest policy targeting transgender people since Mr. Trump returned to the White House last year, adding to a broader set of federal actions affecting transgender health care and rights.
The new policy is scheduled to take effect on Oct. 13.
How much public money is currently being used to pay for gender-affirming care for transgender youth remains unclear. The Centers for Medicare and Medicaid Services did not answer questions about the policy on Tuesday.
At least 27 states have already prohibited gender-affirming care for people younger than 18. In states without such bans, many large hospitals have nonetheless scaled back or stopped offering some treatments. Gender-affirming surgeries for minors are uncommon, while puberty blockers and hormone therapy are more frequently used.
Under the policy, Medicaid and CHIP would continue covering mental health care for transgender minors. However, coverage for hormone treatments—including medications used to delay puberty and those that produce sex-related physical changes—would be phased out for patients already receiving them as of April 2027.
Mr. Trump said in a social media post on Tuesday that he had directed Dr. Mehmet Oz, the CMS administrator, to implement 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,” Mr. 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.
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“The Trump administration is terrorizing trans youth and their families with these kinds of actions, and it has to stop,” Human Rights 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 already announced it would cut off Medicaid and Medicare funding for hospitals that provide gender-affirming care for minors, along with 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 healthcare.
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. A challenge over the policy targeting hospitals is still pending.