The Centers for Medicare & Medicaid Services (CMS), a Trump administration agency, announced Tuesday that Medicaid will cease funding for sex-change hormones and surgeries for minors. This decision aligns with the administration's commitment to protect children from "experimental and life-altering sex-rejecting procedures that carry serious long-term health risks and lack sufficiently reliable evidence of clinical benefit," according to CMS Administrator Dr. Mehmet Oz.
The Children's Health Insurance Program (CHIP), also funded by taxpayers, will similarly end coverage for these procedures. The rule does not impact mental health treatments for conditions such as gender dysphoria.
The move by CMS and the Department of Health and Human Services (HHS) follows a review of national and international research on sex-change procedures in minors. HHS Secretary Robert F. Kennedy Jr. stated that these interventions "carry serious risks and can cause irreversible harm." The review identified "significant evidence gaps" and "documented serious safety concerns," leading to the conclusion that federal taxpayer funding for such procedures could not be justified against the potential risks.
Citing research such as the United Kingdom's Cass Review, which concluded in 2024 that evidence for medical interventions like cross-sex hormones and puberty blockers was limited and not definitive, HHS Press Secretary Emily Hilliard noted that "the evidence of benefit is insufficient and the potential consequences for children can be serious and irreversible."
Procedures no longer covered under the new rule include cross-sex hormones, puberty blockers, and sex-change surgical operations. CMS and HHS assert that these treatments can lead to irreversible damage, including infertility, impaired sexual function, diminished bone density, altered brain development, and other lasting physiological effects.
The policy change comes after what some conservatives have described as "woke" policies that allowed federal funding for therapies and procedures enabling minors to transition physically before reaching adulthood. Oz stated, "Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits."
There will be a tapering-off period during which Medicaid and CHIP funding will gradually phase out. Children currently receiving hormone treatments will be eligible for funding for six months from the new rule's effective date.