The Trump administration on Tuesday barred federal Medicaid dollars from being used to provide gender-transition medication and surgery to transgender adolescents.
The treatments are already banned in most Republican-led states, and have been the topic of fraught international debate among health authorities. But most major medical societies in the United States, including the American Academy of Pediatrics, continue to support medical gender transition for young people who experience marked distress over their gender identity.
In a statement announcing the rule, Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, a branch of the Health and Human Services Department, said, “Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits.”
In a report issued last year, the department concluded that the risks of gender transition treatments — which include drugs that block puberty, hormone therapies and, in rarer cases, surgeries — outweigh any benefits. The report prioritized psychotherapy for minors who experience incongruence between their sex and gender identity.
The new rule, first proposed last year, is the latest in a series of efforts by the administration to block health providers from offering the treatments in states where they are legal. A previous effort was derailed earlier this year, when a federal judge ruled that the administration could not bar hospitals that provide such treatment from receiving funds for other types of care from the major federal health payment programs on the basis of a declaration by Health Secretary Robert F. Kennedy Jr.
Transgender rights advocates said the rule would be challenged in court.
“No federal law prohibits this care,” said Josh Rovenger, legal director of GLAD Law, an organization focused on L.G.T.B.Q. civil rights. “Decades of research confirm that established medical care for transgender youth is effective, safe, and essential to their well-being.”
According to a recent analysis by the Congressional Budget Office, the government spent about $100 million on gender transition treatments for minors over the five years from 2019 through 2023. The analysis found that the rate of gender surgery among minors insured by Medicaid was extremely low, at 3.44 per 100,000 among 15- to 17-year-olds.
Under the rule released on Tuesday, health law experts said states could choose to pay for the costs of treatment that federal dollars would no longer cover. The rule also prohibits federal funds from the Children’s Health Insurance Program, or CHIP, from covering transition care for people under the age of 19.
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