US bars federal funding of gender-affirming care for low-income minors

President Donald Trump's administration has finalized a rule that prevents two major federal health programs – Medicaid and the Children's Health Insurance Program (CHIP) – from funding gender-affirming treatments for minors, including puberty blockers, hormone therapy, and surgeries for gender dysphoria. This decision impacts nearly 35.5 million US children covered by these programs.

The rule, set to take effect in October, suspends federal funding for these procedures, shifting the responsibility to states, families, and private insurance. The administration argues that there is insufficient evidence supporting the benefits of these treatments and that they may pose irreversible risks to minors.

Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz defended the decision, stating that it aligns with scientific consensus and safeguards children from potential harm. However, major US medical organizations, such as the American Academy of Pediatrics and the American Medical Association, oppose the restriction, asserting that decisions regarding such care should be made by children, parents, and healthcare professionals.

The rule triggers a legal clash with 14 states and the District of Columbia that have enacted "shield laws" protecting gender-related healthcare. These states may either abandon coverage or bear the entire cost themselves. CMS estimates that the rule will reduce combined Medicaid and CHIP spending by approximately $235 million over a decade, with $138 million in federal funds and $97 million in state funds saved.

Despite opposition from over 90% of public comments received, the government proceeded with the rule. Children currently on hormone therapy through Medicaid or CHIP will receive six months of continued coverage for a gradual tapering-off period. This measure comes amidst a broader crackdown on transgender rights, including restrictions on military service, passports, and federal workplace policies.