Just before the holidays last year, on Dec. 18, the Department of Health and Human Services announced regulatory proposals to suspend hospitals from providing gender affirming treatments to trans youth patients.
The proposals stem from an executive order signed by President Donald Trump in January 2025 and seek to block hospitals from receiving Medicare and Medicaid funds if they offer “pharmaceutical and surgical interventions” to affirm trans minor patients.
The later paragraphs of the press release issued by the staff of Secretary Robert F. Kennedy confirm that some of the treatments HHS is targeting include puberty blockers, hormone replacement therapy, and gender affirming surgeries. The proposed changes will also rip youth patients who are already receiving treatments away from their gender affirming healthcare.
Critics of gender affirming treatments for trans youth argue that they are too life-changing and too accessible for trans youth, but research indicates that a larger number of breast reduction surgeries are performed on cisgender boys without any suspicion. Research also indicates that the regret rate among gender affirming surgeries is low among trans people.
HHS has already referred the Seattle Children’s Hospital to the HHS Inspector General Office for providing of these treatments to children, even though the regulations are supposed to be only be in the public comment phase right now. Seattle Children’s Hospital also already took efforts to reduce its gender affirming services before the new proposals were made.
The announcement also proclaims that HHS has sent a letter to 12 manufacturers and retailers producing and selling breast binders to treat gender dysphoria, threatening “import alerts, seizures, and injunctions” if the companies don’t comply with government orders.
The announcement asserts that HHS can implement these rules because the Social Security Act allows the department to implement “conditions of participation” for hospitals receiving Medicare and Medicaid funds.
Experts on trans healthcare like Erin Reed, however, argue that the new rules will violate Section 1801 of the Social Security Act, the Constitutional Separation of Powers, and the 10th Amendment to the Constitution.
Nineteen states and Washington, D.C., are suing HHS over the proposals, including California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Wisconsin, and Washington state.
The public can join in the effort by submitting comments on the proposed changes from now until Feb. 17, 2026.
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