Kennedy seeks to cut US children's access to gender-affirming care

WASHINGTON — U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. moved on Thursday to restrict children’s access to gender-affirming care, marking one of the Trump administration’s most sweeping actions yet targeting transgender healthcare.

Kennedy proposed new rules that would bar hospitals providing such care to minors from participating in the Medicare and Medicaid programs. The proposal would also prohibit Medicaid and the Children’s Health Insurance Program (CHIP) from covering gender-affirming treatments.

The measures are part of a broader effort by the Trump administration to roll back protections for transgender people across healthcare, education, the military, and the workplace.

“Medical professionals or entities providing sex-rejecting procedures to children are out of compliance with established standards of healthcare,” Kennedy said, a position that contradicts guidance from major U.S. medical organizations.

The American Academy of Pediatrics (AAP) and the American Medical Association (AMA) both support gender-affirming care, stating that medical decisions should be made by patients, families, and qualified healthcare professionals. AAP President Susan Kressly criticized the proposed rules, saying they misrepresent medical consensus and could harm vulnerable families.

Republican President Donald Trump signed an executive order in January aimed at rolling back federal protections and healthcare coverage for transgender people. The Department of Justice has since taken action against some hospitals providing gender-affirming care, prompting a lawsuit by 16 Democratic-led states seeking to block the measures.

Nearly all U.S. hospitals participate in Medicare, which serves people aged 65 and older as well as those with disabilities. About 53% of U.S. children receive health coverage through Medicaid or CHIP, according to federal data.

During an hour-long press conference on Thursday, senior health officials sharply criticized gender-affirming care. Kennedy’s deputy, Jim O’Neill, said, “The blurring of the lines between sexes and radical social agendas is a hatred for nature as God designed it.”

Officials also announced additional steps, including a proposal to reverse the classification of gender dysphoria as a disability. Such a move would exempt organizations that restrict gender-affirming care from certain federal anti-discrimination laws. The Food and Drug Administration said it would issue warnings to 12 companies marketing breast binders for the treatment of gender dysphoria.

Wider Campaign

State officials said they would challenge the proposals. New York Attorney General Letitia James vowed legal action, while Maryland Health Secretary Meena Seshamani said Medicaid coverage for gender-affirming care remains unchanged for now.

The proposed rules will undergo public comment periods — 60 days for the Centers for Medicare and Medicaid Services regulations and 30 days for the disability classification change — before any final action is taken.

Civil rights groups quickly condemned the proposals. GLBTQ Legal Advocates & Defenders called them “un-American,” while the American Civil Liberties Union said it would challenge the measures in court.

U.S. health data analyzed by Komodo Health for Reuters shows that more than 121,000 children aged 6 to 17 were diagnosed with gender dysphoria between 2017 and 2021. Of those, about 17,683 began treatment with puberty blockers or hormone therapy. Researchers note the figures likely underestimate the total number of cases, as many are not formally diagnosed or treated through insurance.

Earlier this year, the Trump administration also moved to ban transgender people from serving in the military, prevent them from listing their gender identity on passports, and restrict federal employees from using bathrooms that align with their gender identity.

Trump has said his administration aims to end what he describes as the government’s promotion of “gender ideology,” a term widely used by conservative groups. LGBTQ advocates argue the phrase is dehumanizing and rooted in anti-transgender sentiment.

Transgender rights have become a highly divisive political issue in recent years. Several Republican candidates campaigned in 2024 on reversing transgender protections, and more than two dozen Republican-led states have enacted laws restricting or banning gender-affirming care for transgender youth. -Reporting by Ahmed Aboulenein in Washington, Chad Terhune in Los Angeles, and Daniel Wiessner in Albany, New York; Additional reporting by Bhargav Acharya in Toronto and Courtney Rozen in Washington; Editing by Caroline Humer and Matthew Lewis/Reuters