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The administration of President Donald Trump announced on Thursday a series of regulatory actions aimed at effectively prohibiting gender-affirming care for minors, thereby expanding its offensive against the transgender community in the United States.
The measures, presented by the Department of Health and Human Services (HHS) and led by Secretary Robert F. Kennedy Jr., represent the most significant step taken by the Republican government so far to restrict the use of puberty blockers, hormone therapies, and surgical interventions for transgender children and adolescents, according to Telemundo.
Cuts to federal funds as the main tool
The central focus of the proposals consists of withdrawing federal funding from Medicaid and Medicare for hospitals and medical centers that provide gender-affirming care to minors. In practice, this would jeopardize the continuity of these services even in the nearly two dozen states where such treatments remain legal and funded by public resources.
According to data from the KFF research group, Medicare and Medicaid programs cover nearly 44% of national hospital spending, making this measure a crucial leverage point in the healthcare system.
Additionally, the use of Medicaid funds to cover treatments such as puberty blockers, hormones, and surgeries for minors under 18 years old would be explicitly prohibited.
A policy contrary to medical consensus
The proposals move in the opposite direction of the recommendations from most major medical organizations in the United States, including the American Medical Association, which have warned about the risks of limiting access to healthcare for gender dysphoria.
Despite this, Kennedy defended the initiative with strong statements: “The so-called gender affirmation care has caused lasting physical and psychological harm to vulnerable youth. This is not medicine; it is negligence,” he stated during the presentation of the plan.
Other measures included in the package
The HHS announcement also includes:
FDA warnings to 12 manufacturers of chest binders, accused of "illegal marketing" of these products to minors as treatment for gender dysphoria.
An attempt to reverse the inclusion of gender dysphoria as a disability, a measure promoted by the administration of Joe Biden.
These actions are part of a broader strategy to restrict any form of recognition or medical attention related to gender identity in minors.
Reactions and possible legal challenges
Civil rights organizations reacted strongly. The Human Rights Campaign denounced that the Trump Administration aims to “force providers to make an impossible decision: abandon transgender youth or lose federal funding.”
“These actions place Donald Trump and RFK Jr. within medical offices, taking medical decisions away from families and handing them over to the most radical anti-LGBTQ+ sector,” stated Kelley Robinson, president of the organization, according to El País.
A long regulatory road
The proposals are not yet final or legally binding. They will undergo a 60-day public comment period, followed by regulatory reviews, and it is highly likely that they will face legal challenges.
However, the announcement represents a significant blow to transgender individuals in the United States, particularly for minors, whose access to this type of care is already restricted in more than half of the states in the country.
A sustained offensive since January
Since his return to the White House, Trump has pushed an aggressive agenda against the rights of transgender individuals. On January 20, his first day in office, he signed an executive order that recognizes only two "immutable" sexes, male and female, and instructed the HHS to terminate what he called "the chemical and surgical mutilation of children."
Subsequently, the government initiated investigations against doctors and clinics, which led to more than twenty hospitals reducing or closing programs for transgender minors.
This week, in addition, the Republican-controlled House of Representatives approved a bill that would classify the provision of gender-affirming care to minors as a felony, with penalties of up to 10 years in prison for doctors. Another bill banning Medicaid payments for these treatments is expected to be voted on soon.
Meanwhile, the debate over gender-affirming care is becoming one of the most polarizing fronts in current American politics, with profound legal, medical, and social implications.
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