Medicaid and CHIP will no longer fund puberty blockers, cross-sex hormones or sex-change surgeries for children under a new Trump administration rule.
Medicaid to stop paying for child transition care, with the Trump administration saying federal health programs will no longer fund puberty blockers, cross-sex hormones or sex-change surgeries for minors. The change, announced Tuesday by the Centers for Medicare & Medicaid Services, also applies to the Children’s Health Insurance Program, ending taxpayer coverage for those procedures and therapies for children.
CMS Administrator Dr. Mehmet Oz said the rule reflects the administration’s effort to shield children from what he described as experimental, life-changing interventions that carry serious long-term risks and lack reliable proof of clinical benefit. He said children deserve protection rather than procedures that can produce potentially irreversible harm, and argued the government is following the science while saving taxpayer money. Secretary of Health and Human Services Robert F. Kennedy Jr. said the federal government would no longer use Medicaid and CHIP dollars to pay for procedures that do not meet the evidentiary standard children deserve.
The policy does not end coverage for mental health treatment tied to gender dysmorphia and related conditions. Those services will continue under Medicaid and CHIP. What changes is coverage for the medical interventions at the center of the debate: cross-sex hormones, puberty blockers and sex-change surgical operations for minors. CMS and HHS said those treatments can lead to lasting effects, including infertility, impaired sexual function, reduced bone density and altered brain development.
The move marks a sharp reversal from years in which conservatives said federal programs were being used to support gender transition care for children. Supporters of the new rule cast it as a return to caution and a warning against moving faster than the evidence. Oz said the administration was drawing a clear line and would not allow children to undergo life-altering interventions at taxpayer expense without dependable evidence that the care is safe and beneficial.
“Medicaid and CHIP will no longer fund puberty blockers, cross-sex hormones or sex-change surgeries for children under a new Trump administration rule.”
Background work on the policy ran through HHS, which reviewed national and international research on sex-change procedures in minors before CMS moved to change coverage rules. Officials said that review found major gaps in the evidence and serious safety concerns. CMS pointed in particular to the United Kingdom’s Cass Review, led by Dr. Hilary Cass, which concluded in 2024 that research on puberty blockers and cross-sex hormones was limited and not conclusive, and that medical practice had advanced faster than the proof of safety.
The issue has already produced legal and political fights across the country. At the same time, a large children’s hospital in the United States is set to open a detransition clinic after a settlement with the Trump Justice Department and the state.
For families, physicians and taxpayers, the new Medicaid and CHIP rule could reshape access to care and intensify the national fight over how far medicine should go when treating gender distress in children. The government says current patients will have a six-month phase-out period for hormone treatments once the rule takes effect, giving the policy an immediate but not abrupt reach. The bottom line for Americans is that federal health dollars are being pulled out of child transition care, and the next battles will likely play out in statehouses, courtrooms and hospitals.
Frequently asked questions
What child transition treatments will no longer be covered?
Medicaid and Chip will stop paying for puberty blockers, cross-sex hormones and sex-change surgeries for minors.
Will mental health care still be covered?
Yes. The rule does not affect mental health treatment for gender dysmorphia and other conditions under Medicaid and Chip.
Why did the administration say it changed the policy?
CMS and Hhs said the treatments carry serious risks, lack reliable evidence of clinical benefit and can cause irreversible harm.
What happens to children already receiving hormone treatment?
CMS said funding will phase out over six months from the date the rule takes effect.
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