Trump moves to ban trans care for minors in US hospitals

The Trump administration has unveiled a sweeping set of regulatory proposals aimed at effectively banning gender‑affirming healthcare for minors across the United States, triggering widespread concern among medical professionals, civil rights advocates and hospital systems.

Under measures announced on Thursday, the Department of Health and Human Services (HHS) plans to cut off Medicare and Medicaid funding to any hospital providing puberty blockers, hormone therapy or surgical interventions to trans people under 18. The rules would also bar Medicaid and the Children’s Health Insurance Program from covering such treatment, even in states where it remains legal.

Nearly all US hospitals rely heavily on federal reimbursement, meaning the proposed changes could make gender‑affirming care for minors virtually inaccessible nationwide. Advocates warn that many facilities may suspend services pre‑emptively to avoid jeopardising vital funding streams, compounding an already fragmented and politically fraught landscape for trans healthcare in the country.

HHS officials characterised the treatments as “sex‑rejecting procedures”, arguing that federal money should not support them. Medical organisations, including the American Medical Association, strongly dispute that view, saying gender‑affirming care is evidence‑based and often lifesaving for young people experiencing gender dysphoria.

The proposals follow a January executive order from Trump directing federal agencies to halt gender‑affirming care for minors and to use funding conditions to enforce restrictions. Several lawsuits have already been filed against the administration’s efforts, and further legal challenges are expected. The rules must undergo a formal rulemaking process, including public consultation, before they can take effect.

If implemented, the changes would affect access in nearly two dozen states where gender‑affirming care is still legally available and publicly funded, while reinforcing bans already in place in more than half of US states. Healthcare providers, legal experts and transgender rights groups say the proposals could deepen inequalities in access, forcing families to travel long distances - or even leave the country - to secure care for their children.