The Trump administration on Thursday announced sweeping measures to restrict gender-affirming health care for U.S. minors.
Among them, the administration plans to withhold federal money that could be used for gender-affirming care for minors from hospitals and health care providers, despite substantial evidence that such care is safe and effective. The effort could severely restrict access to gender-affirming care for young transgender people across the U.S., including in states with already established legal protections.
“This morning, I signed a declaration: sex-rejecting procedures are neither safe nor effective treatment for children with gender dysphoria,” said Secretary of Health and Human Services Robert F. Kennedy, Jr., at a press event to announce the new rules on Thursday.
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Health care providers have criticized the measures as “frustrating” and against medical evidence.
“It’s sad, it’s frustrating,” says Johana Oviedo, an obstetrician based in New York City and a fellow with Physicians for Reproductive Health. “Everyone has the right to health care that is evidence-based, and we do just that. We provide evidence-based health care. That is why providers and all the major medical organizations agree that gender-affirming care is evidence-based; it is lifesaving, and it’s necessary.”
Today’s proposal is “probably the scariest moment” in a broad campaign to stigmatize transgender people, says Meredithe McNamara, an adolescent medicine specialist and an assistant professor of pediatrics at Yale School of Medicine. “This cannot be allowed to go through.”
The announcement, staged at HHS’s headquarters at the Hubert H. Humphrey Building in Washington, D.C., was given to an audience that included conservative activists and politicians, many of whom were recognized in Kennedy’s opening remarks.
The new proposed rules target hospitals and providers who receive federal funding through the governmental health insurance programs Medicare and Medicaid, which includes almost all hospitals, Oviedo says. Facilities providing gender-affirming care to kids and teens would no longer receive that funding under the proposals. They would prohibit using federal dollars under the Children’s Health Insurance Program to provide gender-affirming care. Officials on Thursday estimated that some $30 million in federal funds went toward gender-affirming care in 2023.
The Food and Drug Administration is also issuing letters to manufacturers of breast binders, Kennedy said at the press event. And the proposals could affect people with disabilities by revoking a Biden administration move to classify gender dysphoria as a disability. In addition, the administration is issuing a warning to health care providers and other stakeholders that puberty blockers and other medical interventions that fall under the umbrella of gender-affirming care are not supported by evidence, according to Kennedy.
“These policies and proposals misconstrue the current medical consensus and fail to reflect the realities of pediatric care and the needs of children and families,” wrote Susan Kressly, president of the American Academy of Pediatrics, in a statement in response to the announcement. “We call on HHS to immediately reverse course and rescind these harmful proposals.”
Gender-affirming care can include medical, mental health and social care that enables people to align their physical and social traits with their internal gender identity. It can range from counseling to puberty blockers to hormones and, in some rare cases, surgery, among other interventions. Several studies have shown that young people with access to gender-affirming care have better mental and emotional health outcomes than those without access, while blocking access to care has been shown to worsen mental health, including increasing the risk of suicide.
“Gender-affirming care is, in many, many aspects, lifesaving,” says Oviedo, who provides such care. “There is plenty of evidence that shows it decreases anxiety and depression in our patients. We also have to trust our patients and their families. And I think they should be allowed to live their own authentic lives and not have government interfere in that.”
The move is the latest effort by the Trump administration and Republican lawmakers that targets transgender people: it comes just a day after the U.S. House of Representatives passed a bill seeking to criminalize gender transition treatment for minors, which is unlikely to pass the Senate. Earlier this year Kennedy released a report that attacked gender-affirming care and rejected the medical consensus of experts in transgender care. And President Donald Trump has issued several executive orders that deny the existence of transgender people and aim to restrict their access to care or participation in sports. Trans people were also banned from serving in the military in July, and the Department of State has moved to force Americans to list their sex assigned at birth on their passport, regardless of their gender identity.
The new rules will almost certainly be challenged in court; several advocacy organizations have vowed to fight the measures. There will be a 60- to 90-day period in which experts and the public will be able to provide comments to the HHS before the agency issues a final ruling. The comment period for the proposal to remove gender dysphoria’s classification as a disability will be 30 days.
“This is a watershed moment for the scientific community to emphatically denounce the falsehoods in everything that the HHS has produced during the Trump administration regarding trans health,” McNamara says. “We have to be relentless about how we continue to furnish the truth about this care—about how beneficial it is, about how important it is, about how non-negotiable it is.”
Additional reporting by Tanya Lewis.
Editor’s Note (12/18/25): This article was edited after posting to include more details about the press event and the proposed new rules, comments from Meredithe McNamara and information about Susan Kressly’s statement.