Trump Governance Proposes Rules Restricting Gender-Affirming Care for transgender Youth

The Trump administration is advancing its efforts to restrict gender-affirming care for transgender youth in the U.S. with two new proposed rules from the Centers for Medicare and Medicaid Services (CMS). These rules aim to withhold federal funds from healthcare providers offering such care.

The most far-reaching rule would alter the conditions for hospitals and clinics participating in federal funding programs, effectively barring those that provide gender-affirming care – including puberty blockers, hormones, and surgery – to minors. According to Hannah Oliason, an attorney at Nilan Johnson Lewis, this could “effectively forcing providers to discontinue such services or risk losing Medicare and Medicaid funding,” even at the cost of reputational harm or state enforcement.

CMS also proposes to prohibit the use of Medicaid and Children’s Health Insurance Program (CHIP) funds for gender-affirming care for individuals under the age of 19.

These actions follow a recent House vote on a bill banning clinicians from providing gender-affirming care to trans minors, though that bill is unlikely to pass the Senate. This represents an unprecedented push for national limitations on transgender healthcare.

This is not the first attempt by the Trump administration to limit access to this care. An executive order issued early in president Trump’s term, seeking to ban transgender health care for those under 19, was previously blocked by a federal judge.

While some view this care as unnecessary and risky,clinicians,patients,and advocates maintain that gender-affirming care is evidence-based and can be lifesaving.

Sources:

* https://public-inspection.federalregister.gov/2025-23465.pdf

* https://public-inspection.federalregister.gov/2025-23464.pdf

* https://www.statnews.com/2025/12/17/house-vote-bills-care-for-transgender-young-people-medicaid/