New Federal Policy to Terminate Medicaid and CHIP Coverage for Youth Gender-Affirming Care

The Trump administration has announced that Medicaid will no longer cover gender-affirming surgeries or hormone therapies for transgender minors. Additionally, the Children’s Health Insurance Program (CHIP) will cease funding these treatments for individuals under the age of 19.

This decision follows a series of administrative actions targeting transgender healthcare initiatives implemented since the start of the current administration. The new policy is scheduled to take effect on October 13.

Specific details regarding the total amount of taxpayer funding currently dedicated to gender-affirming treatments for youth remain unavailable, as the Centers for Medicare and Medicaid Services (CMS) has not yet responded to inquiries regarding the policy’s financial impact.

Currently, at least 27 states have enacted bans on gender-affirming care for minors. Even in jurisdictions without such bans, several major hospitals have ceased offering certain treatments. While gender-affirming surgeries in minors are relatively infrequent, puberty blockers and hormone therapies are more widely utilized.

Under the new regulations, Medicaid and CHIP will maintain coverage for mental health services for transgender minors. However, coverage for hormone treatments—which are utilized for both puberty suppression and facilitating sex-related physical changes—will be phased out for those currently receiving them by April 2027.

In a social media post on Tuesday, President Trump stated he had instructed CMS Administrator Dr. Mehmet Oz to implement this 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,” the President wrote.

LGBTQ+ advocacy groups have strongly criticized the move. Josh Rovenger, legal director for LGBTQ Advocates and Defenders, stated the rule “is putting up barriers between parents and their ability to make the best medical decisions for their children” and noted that the policy would likely face legal challenges.

Kelley Robinson, President of the Human Rights Campaign (HRC), issued a statement condemning the action, claiming “the Trump administration is terrorizing trans youth and their families with these kinds of actions, and it has to stop.” The HRC is currently engaged in litigation against the administration regarding efforts to deny gender-affirming care coverage under federal employee benefit plans.

While the American Medical Association and many prominent medical organizations support access to gender-affirming healthcare, the American Society of Plastic Surgeons noted earlier this year that there may be “insufficient evidence” to suggest that the benefits of certain surgeries for minors experiencing gender dysphoria outweigh the potential risks.

The administration has introduced several other measures, including cutting Medicaid and Medicare funding for hospitals that provide gender-affirming care to minors, banning transgender athletes from female sports competitions, and restricting the ability of individuals to select male, female, or “X” designations on passports.

The administration also released a report last year advocating for the use of therapy as the sole intervention for transgender youth, rather than broader medical healthcare options.

Many of these initiatives have encountered legal resistance. While the U.S. Supreme Court has allowed the passport policy to remain in effect and permitted states to enforce sports bans, a lower court previously ruled against the administration’s claims that these treatments are unsafe and ineffective. Legal challenges regarding policies targeting hospitals remain ongoing.

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