Trump administration ends Medicaid, CHIP funding for gender-affirming care for children

The Trump administration finalized a plan on Tuesday to eliminate federal Medicaid funding for hormone therapy, puberty blockers, and surgeries for transgender youths. This move is part of the administration's ongoing efforts to restrict transition-related care, which has pushed the limits of executive authority and could weaken federal and state protections for gender-affirming services.

While mental health counseling related to gender dysphoria remains eligible for federal Medicaid coverage, the Centers for Medicare and Medicaid Services (CMS) rule disqualifies funding for so-called "sex-rejecting procedures." States have until October 13 to continue receiving federal Medicaid funds for beneficiaries undergoing gender-affirming hormone therapies.

Seventeen states already provide some level of gender-affirming care for minors under Medicaid and the Children's Health Insurance Program (CHIP). The administration defended the policy as a means to safeguard children from procedures it deems harmful, citing a 2025 HHS report with weak evidence supporting pediatric gender-affirming medical interventions.

Additionally, the administration referenced a review from the United Kingdom, which aligns with the administration's stance. The American Academy of Pediatrics and other medical organizations have criticized the HHS report for misrepresenting the prevailing medical consensus and actual medical practices. Administration officials recognized concerns from outside parties that restricting funding could result in increased costs for mental health crisis services and other downstream health and social system expenses.

However, they emphasized that the primary objective is not to reduce expenses. Prominent medical societies, such as the American Medical Association, maintain that transition-related care for children dealing with gender dysphoria is both safe and appropriate. LGBTQ+ advocates vehemently oppose the new policy, deeming it a perilous and unnecessary attempt to obstruct transgender and nonbinary youth from accessing evidence-based medical treatment to maintain optimal health and well-being.