Hospitals Could Lose All Federal Funding for Treating Trans Kids

New Rules Threaten Medicare and Medicaid

The Trump administration just made its biggest move yet to end gender-affirming care for minors across the country.

On December 18, 2025, health officials announced proposed rules that would cut off all Medicare and Medicaid funding from any hospital that provides puberty blockers, hormones, or related treatments to transgender patients under 18.

Since nearly every hospital in America depends on federal insurance payments to survive, the rules would force most facilities to choose between treating trans youth and staying open.

The announcement landed one day after the House passed a bill making such care a felony, and what happens next could reshape healthcare for hundreds of thousands of families.

RFK Jr. Calls It Malpractice

Health Secretary Robert F. Kennedy Jr. announced the proposed regulations at a press conference, calling doctors who provide gender-affirming care to minors a danger to children.

He signed a declaration stating that these procedures do not meet professional standards of healthcare.

CMS Administrator Dr. Mehmet Oz said the government would not let taxpayer money “go to hurt these children.”

Under the declaration, practitioners who perform these procedures on minors would be deemed out of compliance with professional standards.

The FDA also announced warning letters to 12 manufacturers of chest binders marketed to minors.

House Passes 10-Year Prison Bill

One day before the HHS announcement, the House voted 216-211 to pass a bill that would make providing gender-affirming care to minors a felony punishable by up to 10 years in prison.

The legislation, sponsored by Rep. Marjorie Taylor Greene of Georgia, would impose criminal penalties on physicians who provide puberty blockers, hormone therapy, or surgical care to patients under 18.

The bill would also expose parents who consent to such care to criminal liability.

The measure is unlikely to pass the Senate, where it would need Democratic support to overcome the filibuster.

Supreme Court Set the Stage

On June 18, 2025, the Supreme Court ruled 6-3 in United States v. Skrmetti that Tennessee’s ban on gender-affirming care for minors does not violate the Equal Protection Clause of the Constitution.

The decision set new precedent for how transgender people can be treated under U.S. law and signaled the Court would not intervene when states restrict medical care for trans youth.

Justice Sonia Sotomayor wrote in her dissent that the court had “abandoned transgender children and their families to political whims.”

The ruling gave legal cover to the 27 states that had already passed restrictions.

27 States Already Have Bans

In the last few years, 27 states have enacted measures prohibiting access to puberty blockers, hormone therapy, or surgeries for trans minors.

Families who could afford it began traveling to the remaining states where care remained legal. But the new federal rules would close that escape route.

Supporters and opponents of transgender rights agree that the forthcoming hospital rules could make access to pediatric gender-affirming care across the country extremely difficult, if not impossible.

21 Hospitals Quit This Year

More than 20 hospitals and health systems have temporarily or indefinitely rolled back transgender care for minors and some young adults this year amid threats of federal investigations and cuts to government funding.

Twelve hospitals have announced they have discontinued puberty blockers and hormone therapy for trans patients younger than 19. The closures happened in liberal cities like Los Angeles and Boston, not just conservative states.

Kaiser Permanente announced it would pause gender-related surgeries for patients under 18 on August 29, while Children’s National Hospital in Washington, D.C. said it would stop prescribing gender-affirming medications on August 30.

Doctors Groups Call It Harmful

Major national medical associations, including the American Academy of Pediatrics, the American Medical Association, and the American Academy of Child and Adolescent Psychiatry, argue that gender-affirming care is safe, effective, beneficial, and medically necessary.

The American Academy of Pediatrics said the new measures “unfairly stigmatize a population of young people” and do nothing to bring down healthcare costs.

Critics point out that the same medications are still allowed for children with other conditions, just not for treating gender dysphoria.

Surgery Is Extremely Rare

A study published in JAMA Pediatrics found that less than 0.1% of adolescents ages 8 to 17 with private insurance are transgender or gender diverse and are prescribed puberty blockers or gender-affirming hormones.

The study also found that no patients under 12 were prescribed hormones.

A 2024 study in JAMA Network Open found that the rate of teens ages 15 to 17 undergoing gender-affirming surgery was 2.1 per 100,000.

Most gender-affirming care for minors involves counseling, mental health support, and in some cases medication, not surgery.

Families Are Fleeing Abroad

The federal government’s actions have led some trans adults and families with trans children to leave the country.

One Denver family spent tens of thousands of dollars to move to New Zealand in July to protect their 9-year-old transgender daughter after Children’s Hospital Colorado said it could no longer provide care.

One Florida mom recently bought one-way tickets to Berlin so she and her 15-year-old trans daughter could move there next month.

But most families with trans children cannot afford to leave, even if they wanted to.

ACLU Vows Court Fight

The American Civil Liberties Union has announced plans to sue to stop the rules.

The ACLU called the legislation the most extreme anti-transgender measure ever considered by Congress and a direct attack on the rights of parents.

A federal court blocked parts of Trump’s January executive order on gender-affirming care in March, though the legal battles continue.

Civil liberties groups say the proposed rules violate constitutional protections and interfere with medical decisions that belong to families and doctors.

Rules Not Final Yet

The proposed rules will be entered into the Federal Register and start a 60-day public comment period. They would not take effect immediately.

It’s unclear how long it will take to finalize the rules, but with a substantial number of comments expected, it could take months or even a year.

For families with transgender children, that uncertainty is both a window of hope and a source of constant anxiety. Some are stockpiling medications.

Others are packing bags. And many are wondering whether the country they grew up in still has room for their kids.

This article was created with AI assistance and human editing.

Read more from this brand:

• Trump’s New $1 Million Visa Lets Ultra-Rich Foreigners Buy U.S. Green Cards
• Trump’s Plan Could Kill Nursing Schools, 140 Lawmakers Warn
• 39 States Have Been Taking Foster Kids Social Security Checks for Decades