Trump Cuts Medicaid Funding for Youth Gender-Affirming Care

The final rule, published by the Centers for Medicare & Medicaid Services, applies to Medicaid and the Children's Health Insurance Program. Medicaid will no longer cover gender-affirming surgeries and hormone treatments for transgender minors, while CHIP will stop covering these treatments for individuals under 19. Puberty blockers are also affected.

Mental health services for transgender youth remain covered. The administration projects the policy will reduce federal spending by $138 million over the next decade, and children currently receiving hormone therapy will have a six-month transition period after the rule takes effect.

The policy does not criminalize gender-affirming care. It only withholds federal funds, shifting the financial burden to states, families, or private insurers. At least 27 states already have laws restricting such care for minors, and the federal rule could further limit access for low-income transgender youth in states where the treatments remain legal.

The American Medical Association and the American Academy of Pediatrics have voiced opposition, reaffirming support for gender-affirming care based on individual medical needs. Democratic state attorneys general and advocacy groups are preparing legal challenges, arguing the administration lacks authority to restrict federal funding for these treatments.

The rule follows an executive order signed by President Donald Trump in January 2025 directing federal agencies to end support for gender-transition procedures involving children. Centers for Medicare & Medicaid Services Administrator Mehmet Oz and Health and Human Services Secretary Robert F. Kennedy Jr. have backed the policy, citing potential long-term risks of the treatments.