The Trump administration has directed the Centers for Medicare and Medicaid Services to terminate Medicaid and state Children’s Health Insurance Program coverage for gender-affirming medical treatments for transgender minors, according to an announcement made this week. Medicaid will cease funding gender-affirming surgeries and hormone treatments for youth, while CHIP coverage will end for those under 19. The policy is scheduled to take effect Oct. 13. Mental health services for transgender minors will continue to be covered under both programs, though hormone treatments will be phased out for individuals already receiving them as of April 2027.
This action represents the latest in a series of administration policies affecting transgender individuals that began when the administration took office last year. Currently, at least 27 states have already implemented bans on gender-affirming care for those under 18. Additionally, many major hospitals across states without such bans have voluntarily discontinued certain treatments. Gender-affirming surgeries for minors remain uncommon, while puberty blockers and hormone treatments are more widely utilized among the transgender youth population receiving such care.
Opponents of the policy argue it undermines parental medical decision-making authority. Legal advocates have indicated they plan to challenge the rule in court. Major medical organizations, including the American Medical Association, support access to gender-affirming care for transgender youth. However, the American Society of Plastic Surgeons stated earlier this year that it found “insufficient evidence” that the benefits of certain surgical procedures on minors with gender dysphoria outweigh associated risks.
The administration has pursued multiple related policy changes affecting transgender individuals, including restrictions on transgender athletes’ participation in sports competitions for girls and women, limitations on passport sex designation options, and the release of a report recommending therapy-only approaches for transgender youth. Several of these measures have faced legal challenges, with mixed results in the courts.
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