Doctors says Medicaid change to gender-affirming care will harm vulnerable youth

The Trump administration has decided to halt Medicaid's payment for gender-affirming surgeries and hormone treatments for transgender minors. This change will come into effect on October 13. The state Children's Health Insurance Program (CHIP) will also stop covering these treatments for individuals under 19. The extent of the financial impact on taxpayer-funded gender-affirming health care for transgender youth remains uncertain.

While at least 27 states have already banned gender-affirming care for those under 18, many major hospitals have already ceased providing certain treatments. Gender-affirming surgeries for minors are relatively uncommon, with puberty blockers and hormone treatments being more prevalent. The policy mandates that Medicaid and CHIP will continue to fund mental health care for transgender minors but will phase out coverage for hormone treatments, which could still be provided to those already receiving them up until April 2027.

President Trump attributed this change to Dr. Mehmet Oz, the CMS administrator, in a social media post, stating that taxpayer money will not be used to fund "barbaric surgeries and practices" that can cause irreversible harm to young bodies. LGBTQ+ rights advocates, however, view this policy as a means of preventing parents from making the best medical decisions for their children and are prepared to challenge it in court.

Human Rights Campaign President Kelley Robinson emphasized that the Trump administration is "terrorizing trans youth and their families" with these actions and that it must cease. Despite significant opposition, the American Medical Association and most other major medical organizations support access to gender-affirming care. The American Society of Plastic Surgeons, however, has stated that there is insufficient evidence to suggest that the benefits of chest, genital, and facial surgeries for minors experiencing gender dysphoria outweigh the risks.

The administration has also announced plans to cut off Medicaid and Medicare funding for hospitals providing gender-affirming care for minors, bar transgender athletes from competing in girls' and women's sports, and prevent people from designating their sex as male, female, or X on passports. A report released earlier this year recommended therapy as the only form of treatment for transgender youth, rather than broader gender-affirming healthcare.

Most of these changes have faced legal challenges, with the Supreme Court upholding the passport policy and allowing states to enforce sports bans, and a lower court ruling against the administration's declaration that the treatments are unsafe and ineffective. A challenge over the policy targeting hospitals is still pending.