HHS official warns of irreversible risks as Trump admin restricts funding for youth gender procedures

Trump Administration Issues Rule Barring Medicaid and CHIP Funding for Gender Dysphoria Treatments in Minors

The Department of Health and Human Services has finalized a rule that ends federal Medicaid and Children’s Health Insurance Program coverage for puberty blockers, cross-sex hormones, and surgeries used to treat gender dysphoria in individuals under 18. The policy takes effect October 13 and includes a six-month transition period for current patients to taper off medications rather than discontinue them abruptly.

Assistant Secretary for Health Adm. Brian Christine, a urologist who oversees public health programs at HHS and leads the U.S. Public Health Service Commissioned Corps, described the change as consistent with available evidence on outcomes. Christine told Fox News Digital that gender dysphoria is a recognized condition that historically affected a small percentage of the population, primarily adult males. He stated that recent increases in diagnoses among minors, particularly adolescent females, exceed what would be expected from epidemiological patterns alone and may reflect social influences.

Christine said the majority of minors diagnosed with gender dysphoria resolve their distress when provided mental health counseling and supportive care without medical intervention. He expressed concern that puberty blockers, cross-sex hormones, and surgeries carry risks of infertility, bone density loss, sexual dysfunction, and other long-term effects, and argued that federal funds should not support these interventions for minors. The rule does not prohibit the procedures themselves, only their reimbursement through Medicaid and CHIP.

Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz said the policy follows scientific assessments, reduces taxpayer expenditures, and limits exposure of minors to interventions whose benefits remain under review. President Trump posted on Truth Social that the administration would not use federal dollars for such treatments, citing irreversible effects on developing bodies.

Christine distinguished the administration’s approach from the term “gender-affirming care,” which he said does not accurately describe procedures that alter secondary sex characteristics. He referred to the interventions as “sex-rejecting procedures” and maintained that they do not resolve underlying psychological issues. Twenty-seven states currently restrict these medical interventions for minors, according to data compiled by KFF.

The rule applies only to federal program funding. States may continue to cover the treatments with state funds if they choose, and private insurance coverage is unaffected. Christine noted that earlier diagnostic patterns involved adult males and that the recent rise in cases among minors represents a shift in presentation that requires further study.

Medical organizations including the American Academy of Pediatrics and the Endocrine Society have issued guidelines supporting individualized assessment and, in some cases, medical interventions for adolescents with persistent gender dysphoria after psychological evaluation. European health authorities in England, Sweden, Finland, and Norway have conducted systematic reviews and subsequently restricted routine use of puberty blockers outside research settings, citing weak evidence of long-term benefit and documented risks.

Christine said the administration’s position prioritizes mental health evaluation and counseling as the primary response. The policy change follows earlier executive direction from the White House to CMS to cease federal reimbursement for these services. Current patients will receive a structured six-month period to adjust medication regimens under medical supervision, after which federal funding for ongoing treatment ends.

The administration has framed the measure as protecting minors from interventions whose effects on brain development, fertility, and skeletal health continue to be examined in ongoing research. Critics of the policy, including several medical specialty groups, maintain that withholding coverage may limit access to care for families who have completed diagnostic evaluations. The rule leaves clinical decision-making authority with states and providers while removing one source of payment.