Medicaid to Stop Paying for Trans Minors' Hormones, Surgery

Medicaid will stop paying for gender-affirming surgeries and hormone treatments for transgender minors, the Trump administration announced, and the state Children's Health Insurance Program will not cover the treatments for anyone under 19.

The policy is to take effect Oct. 13. It calls for Medicaid and CHIP to continue paying for mental health treatment for transgender minors, while phasing out coverage of hormone treatments — used both to block puberty and to produce sex-related physical changes — for patients already receiving them as of April 2027.

President Donald Trump said in a social media post Tuesday that he directed Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, to make the change. "We are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies," Trump wrote.

It is not clear how much taxpayer funding currently covers such treatments for transgender youth. CMS did not respond to questions about the policy on Tuesday.

At least 27 states have already banned gender-affirming care for those under 18, and many major hospitals in other states have stopped providing some treatments. Gender-affirming surgeries for minors are rare; puberty blockers and hormone treatments are more common.

Advocacy groups said they would fight the rule. Josh Rovenger, legal director at GLBTQ Legal Advocates and Defenders, said it "is putting up barriers between parents and their ability to make the best medical decisions for their children" and would face a legal challenge. Human Rights Campaign President Kelley Robinson said the administration "is terrorizing trans youth and their families with these kinds of actions, and it has to stop." HRC is already suing over efforts to bar the care from federal employee benefit plans.

The American Medical Association and most other major medical organizations support access to gender-affirming care. The American Society of Plastic Surgeons said earlier this year that it found "insufficient evidence" that the benefits of chest, genital and facial surgeries for minors with gender dysphoria outweigh the risks.

The administration has also moved to cut Medicaid and Medicare funding for hospitals providing the care to minors, barred transgender athletes from girls' and women's competitions, and blocked sex markers other than the one assigned at birth on passports. The Supreme Court let the passport policy stand and allowed states to enforce sports bans; a lower court ruled against the administration's declaration that the treatments are unsafe and ineffective, and the challenge over the hospital policy is pending.