HHS under Health Secretary Robert F. Kennedy Jr. has proposed two rules aimed at restricting gender‑affirming care for minors: one would bar hospitals that provide such care from Medicare and Medicaid participation, and the other would prohibit federal funds from paying for care for people under 18. The proposals must complete the formal rulemaking process and could face legal challenges. Major medical bodies, including the AMA and AAP, support access to puberty blockers and hormone therapy for many transgender youths, saying these treatments are medically appropriate in certain cases.
HHS Proposes Rules to Restrict Gender‑Affirming Care for Minors — What You Need to Know
A protester holds a sign in support of gender-affirming care for transgender youth outside of the US Supreme Court on June 18, 2025, in Washington, DC. | Anna Moneymaker/Getty Images
The Trump administration, through Health Secretary Robert F. Kennedy Jr. and the Department of Health and Human Services (HHS), has announced proposed rules that would sharply limit access to gender‑affirming health care for people under 18.
What happened?
On Thursday, HHS proposed two rules intended to block federal support for gender‑affirming care for minors. One rule would make hospitals that provide such care ineligible to participate in Medicare and Medicaid; the other would prohibit the use of federal funds to pay for gender‑affirming treatments for people under 18, including puberty blockers, hormone therapy, or surgery. Both proposals must complete the formal rulemaking process before they can take effect.
Context
Restrictions on transgender people’s participation in public life and access to medical care have been a prominent feature of the second Trump administration. In January, President Trump issued executive orders condemning what he called "gender ideology extremism" and described gender‑affirming care in stark terms. The administration also recently received court approval to implement a passport policy that requires listing a person’s sex as recorded at birth.
Why this matters
Major medical organizations — including the American Medical Association (AMA) and the American Academy of Pediatrics (AAP) — support medically supervised gender‑affirming care for many adolescents. Such care most commonly involves reversible interventions like puberty blockers and hormone therapy rather than surgery. The proposed rules conflict with that professional guidance and could reduce access to care that clinicians and families consider essential for the health and well‑being of many transgender youths.
What’s next
The rules must go through notice‑and‑comment rulemaking, a process that can include legal challenges and revisions. If finalized, the proposals could affect hospitals, insurers, and families nationwide and would likely prompt litigation and state‑level responses.
Note: For a lighter diversion, my colleague shared a delightful essay arguing that The Muppet Christmas Carol is the best screen adaptation of Dickens’s A Christmas Carol. If you’re looking for seasonal reading, Dickens’s original is always worth revisiting.
