‘Not medicine, but malpractice’: Trump administration moves to cut off transgender care for children

Washington: The U.S. Department of Health and Human Services announced Thursday a slate of regulatory measures aimed at effectively prohibiting gender-affirming care for minors, expanding Trump administration curbs on transgender Americans.

These far-reaching proposals, the administration's boldest yet to limit puberty blockers, hormone therapy, and surgeries for transgender youth, bar federal Medicaid and Medicare funds to hospitals offering such care to children and block Medicaid payments for those procedures.

“This is not medicine, it is malpractice,” Health Secretary Robert F. Kennedy Jr. declared at a Thursday news conference on gender-affirming procedures on children. “Sex-rejecting procedures rob children of their futures.”

Thursday's moves threaten access in nearly two dozen states where drug treatments and surgeries remain legal and Medicaid-funded, blending federal and state resources.

The plans clash with guidance from leading U.S. medical bodies. Transgender youth advocates rejected the administration's assertions on gender-affirming care, warning that Thursday's steps endanger lives.

“The multitude of efforts we are seeing from federal legislators to strip transgender and nonbinary youth of the health care they need is deeply troubling,” said Rodrigo Heng-Lehtinen of The Trevor Project, a nonprofit suicide prevention group for LGBTQ+ youth, labelling the changes a “one-size-fits-all mandate from the federal government” on a doctor-patient choice.

Medicaid in under half the states covers gender-affirming care now. At least 27 states enacted bans or limits. The Supreme Court's recent upholding of Tennessee's ban suggests most state laws will endure.

Kennedy and deputies' proposals lack finality or legal force. The federal rulemaking process demands public comment periods and revisions before permanence, with lawsuits likely.

Yet the rules may deter providers from treating children, as many hospitals have already halted such care, fearing federal moves.

Nearly all U.S. hospitals join Medicare and Medicaid, the government's biggest plans for seniors, disabled individuals, and low-income groups. Forfeiting those funds would cripple most facilities and providers.

The same curbs extend to the State Children’s Health Insurance Program for under-19s, per a Thursday federal notice.

Kennedy revealed Thursday that the HHS Office of Civil Rights will propose excluding gender dysphoria from disability definitions.

Separately, the Food and Drug Administration sent warning letters to a dozen firms selling chest-binding vests and gear for gender dysphoria users, including GenderBender LLC of Carson, California, and TomboyX of Seattle. The FDA letters insist chest binders require approval only for cleared medical uses, like post-mastectomy recovery.

Centres for Medicare and Medicaid Services administrator Dr Mehmet Oz termed transgender treatments Thursday “a Band-Aid on a much deeper pathology,” positing children with gender dysphoria as “confused, lost and need help.”

Polls indicate broad American alignment with the administration's stance. A May Associated Press-NORC Centre for Public Affairs Research poll showed about half of U.S. adults approving of Trump's handling of the transgender issue.

Conservative activist Chloe Cole, known for her gender-transition reversal testimony, addressed the conference gratefully. She said cries for help from her and similar cases “have finally been heard.”

The strategy defies major U.S. medical groups like the American Medical Association, which urges states against restricting gender dysphoria care.

“In an effort to strongarm hospitals into participating in the administration’s anti-LGBTQ agenda, the Trump Administration is forcing health care systems to choose between providing lifesaving care for LGBTQ+ young people and accepting crucial federal funding,” said Dr Jamila Perritt, Washington OB/GYN and Physicians for Reproductive Health president and CEO, in a statement. “This is a lose-lose situation where lives are inevitably on the line.”

The moves cap a barrage of Trump administration and Republican congressional actions targeting transgender rights nationwide.

Trump, on day one, signed an executive order affirming federal recognition of only two sexes: male and female. He issued further orders slashing federal aid for under-19 gender transitions and barring transgender athletes from girls’ and women’s sports.

Wednesday, a House-passed bill exposing transgender care providers to prison for treating under-18s advanced to the Senate. Another House bill, introduced on Thursday, seeks to end Medicaid coverage for children's gender-affirming care.

Youth who persistently identify differently from birth-assigned sex undergo multidisciplinary evaluation. Some pursue social transition via hairstyle or pronoun shifts. Others later access puberty blockers, then testosterone or estrogen for physical alignment. Surgery remains rare for minors.

With inputs from AP