RESOLVING THE LEDGER
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The Trump administration on Tuesday finalized a plan to cut off federal Medicaid funding for hormone therapy, puberty blockers and surgeries for transgender youths.
Why it matters: The rule is the latest escalation in the administration's effort to limit transition-related care , which has tested the boundaries of executive powers and could undercut federal and state protections.
States may still use their own funds to cover gender-affirming care for youth in Medicaid or the Children's Health Insurance Program.
The Centers for Medicare and Medicaid Services rule doesn't cut off federal funding for psychotherapy related to gender dysphoria.
State of play: Beginning Oct. 13, states will not be able to claim federal Medicaid funding for gender-affirming health services, which the Trump administration refers to as "sex-rejecting procedures."
There will be a six-month period where states can continue to get funding for beneficiaries taking gender-affirming hormone therapies.
Seventeen states currently cover some degree of gender-affirming care for children under Medicaid and CHIP, according to the rule.
The administration said it's adopting the policy "help to protect these children" from gender-affirming procedures they see as harmful.
The rule cites 2025 HHS report that found weak evidence for pediatric gender-affirming medical interventions, as well as a review from the United Kingdom.
The American Academy of Pediatrics and other medical groups have said the HHS report misrepresents the current medical consensus and realities of care.
Administration officials acknowledged in the final rule concerns from some outside parties that restricting funding could lead to downstream health and social services costs, including increased use of mental health crisis centers. But they said the goal is not to save money.
Major medical groups including the American Medical Association consider transition-related care for kids with gender dysphoria to be safe and appropriate.
LGBTQ+ advocates said the new policy amounts to a dangerous restriction on physician-prescribed care.
Rodrigo Heng-Lehtinen, a senior vice president for the Trevor Project, called it a "dangerous and unnecessary attempt to prevent transgender and nonbinary young people from accessing the best-practice health care they need to lead healthy and happy lives."
The administration reportedly shelved a separate plan that would cut off Medicare funding to hospitals that provide transition-related care.
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