Updated December 18, 2025 at 2:20 PM EST
Health officials from the Trump administration announced several moves Thursday that will have the effect of essentially banning gender-affirming care for transgender young people, even in states where it is still legal.
Health Secretary Robert F. Kennedy Jr. and Dr. Mehmet Oz, who leads Medicaid and Medicare, announced the measures in a press conference at the headquarters of the Department of Health and Human Services in Washington, D.C.
The ban takes the form of two new proposed rules from Medicaid and Medicare. The first would prohibit doctors and hospitals from receiving federal Medicaid reimbursement for gender-affirming care provided to transgender patients younger than age 18. Medicaid is the health care program that covers low-income Americans.
The second would block all Medicaid and Medicare funding for any services at hospitals that provide pediatric gender-affirming care. Virtually every hospital in the country takes Medicare, which covers older Americans and the disabled. Because hospitals rely on Medicare, the rule would have a wide-ranging effect.
Supporters and opponents of transgender rights agree that, taken together, the forthcoming hospital rules could make access to pediatric gender-affirming care across the country extremely difficult, if not impossible. The care is already banned in 27 states. The proposed rules will be entered into the Federal Register on Friday and that starts a 60-day comment period. The rules would not take effect immediately.
The American Civil Liberties Union has announced plans to sue to stop the rules.
Legislative action
The pivot to the topic of transgender minors comes one day after Republicans in the House of Representatives passed a package of health care bills that do not extend subsidies for people who buy health insurance in Affordable Care Act plans.
The legislative package included a bill, introduced by Rep. Marjorie Taylor Greene, R-Ga., that makes it a crime to provide gender-affirming care to transgender minors, punishable by a fine or prison time of up to 10 years. It passed on Wednesday.
Another bill, introduced by Rep. Dan Crenshaw, R-Texas, would prohibit Medicaid reimbursement for gender-affirming care for youth. It is scheduled for a vote on Thursday. Both bills would also have to pass the Senate to become law.
One family reacts
For one mom of a transgender teen in California, the rules and bills released this week are concerning. She asked that NPR not name her or her child because she fears she could lose her job or risk her family's safety by speaking about their experiences.
"It feels like we're being hunted," she says.
She describes her own process of learning about the options for gender-affirming care for her teenager and concluding that the benefits outweighed the risks. "If we can't stop the government from legislating what health care families can receive in consultation with their doctors, then I don't recognize this America," she says.
Her son is 15-years-old and has been taking testosterone for about 6 months. He is a scout, he runs cross-country, and wants to work in a math or science field. His friends know he is transgender but not everyone at his high school does.
"I kind want to make it clear — I came out to my parents and said that I wanted to start [hormone therapy] and it took them a long time to be OK with that," he says. "We went to a lot of therapy. We had a lot of discussions. My parents — they were scared for me to start it." He says both he and his parents researched it: "It wasn't just like a whim."
He says starting hormone therapy brings to mind a hiking metaphor: "I was like, 'Oh, this is the path that's going to take me to where I want.' I feel like my body is going in the right direction."
The changes the Trump administration and Congress are making worry him. "It feels like someone's throwing me into the bush just off the path I'm on," he says. "And that's kind of terrifying. I don't want to be lost. I want to keep going where I'm going."
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