On Thursday, the Centers for Medicare and Medicaid Services (CMS) proposed two rules that would prevent most hospitals from providing gender-affirming care—including puberty blockers, hormones, and surgery—for transgender youth.Why It’s Relevant
Since the start of his second term, President Donald Trump has made it clear that his administration will recognize only two genders. The CMS rules are the latest move to restrict access to gender-affirming care for transgender youth.
Organizations including APA have emphasized the mental health benefits of deliberative and supportive gender-affirming care as well as the danger that restrictive policies pose to the health of the transgender community. In a recently revised position statement, APA reasserted that families and youth should have access to the full range of gender-affirming treatment options.
The Proposed Rules
One of the CMS rules would bar any hospitals that participate in Medicare and Medicaid programs from providing youth with “sex-rejecting procedures.” Those procedures include “any pharmaceutical or surgical intervention that attempts to align an individual’s physical appearance or body with a stated identity that differs from the individual’s sex.”
The other rule would prohibit state Medicaid and Children’s Health Insurance Program plans from covering these procedures. Approximately half of children in the U.S. receive their health care through Medicaid.
What’s More
The Food and Drug Administration has sent warning letters to manufacturers of chest binders, which many gender-diverse individuals use to flatten their chests, and ordered them to stop marketing these devices to youth.
On Wednesday, the House of Representatives passed two bills (HR 3492 and HR 498) that would ban gender-affirming medical care for youth nationwide and establish criminal offenses for those providing such care, including a prison term of up to 10 years.
APA, the American Academy of Pediatrics, the American College of Physicians, and the American College of Obstetricians & Gynecologists sent a letter to Congress in which they warned that these bills represent a threat to patient welfare.
“Physicians and other health professionals should never be criminalized or penalized for providing care consistent with evidence-based guidelines and best clinical judgment,” the letter stated. “Physicians, not the federal government, are best positioned to work with patients and their families to address their unique medical and mental health care needs.”
What’s Next
CMS’ proposed rules were published today in the Federal Register and are subject to a 60-day comment period (through February 17). It is unclear how long it will take to finalize the rules, with STAT reporting that it could take several months or up to a year.
Related Information
Source
U.S. Department of Health and Human Services. HHS acts to bar hospitals from performing sex-rejecting procedures on children. Published December 18, 2025. www.hhs.gov/press-room/hhs-acts-bar-hospitals-performing-sex-rejecting-procedures-children.html
(Image: Getty Images/iStock/martinedoucet)
