The Trump administration has proposed two federal rules that would restrict access to gender-affirming care for transgender minors nationwide.
The proposed regulations, issued by the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS), would bar federal Medicaid funds from covering transition-related care for transgender youth under 19 and threaten to strip federal funding from hospitals that provide gender-affirming treatments to minors.
HHS officials told NBC News that CMS will begin the federal rule-making process with a 60-day public comment period, after which the rules could be finalized.
As with many anti-transgender policies, the restrictions would apply only to minors whose gender identity does not align with their sex assigned at birth. Intersex children and those with hormonal or endocrinological conditions whose gender identity aligns with their natal sex would still be allowed to receive the same treatments barred for transgender youth.
Separately, HHS announced it would issue warning letters to 12 manufacturers and retailers of breast binders, accusing them of illegally marketing products to minors with gender dysphoria.
HHS has also proposed revising Section 504 of the Rehabilitation Act of 1973 to explicitly state that gender dysphoria does not qualify as a “disability,” a change intended to eliminate existing requirements that federally funded employers accommodate individuals with the condition.
The two proposed rules, along with the Section 504 revision and the crackdown on breast binders, are part of the Trump administration’s broader effort to discourage transgender people — particularly minors — from transitioning, or pursuing what HHS calls “sex-rejecting procedures.” The actions align with past executive orders that reject the validity of gender identity and threaten to strip federal funding from institutions providing gender-affirming care to anyone under 19.
“The Trump administration, true to form, has doubled down on its attack on the health and well-being of transgender youth,” said Sasha Buchert, director of the Non-Binary and Transgender Rights Project at Lambda Legal. “In doing so, they deliberately target affordable health care more broadly, holding hostage both hospitals and everyone who relies on Medicaid.”
Buchert noted that the proposed rules are not yet in effect and could still be altered before being finalized.
“We encourage all to use the comment portals provided to let HHS know just how dangerous and cruel these proposed regulations are,” Buchert said.
The proposals come amid recent congressional action aimed at blocking access to gender-affirming care for minors.
One bill, sponsored by U.S. Rep. Marjorie Taylor Greene (R-Ga.), would penalize doctors, parents, and others who assist minors in obtaining gender-affirming care. Another, introduced by Rep. Dan Crenshaw (R-Texas), would prohibit Medicaid funds from being used to cover transition-related treatments.
Twenty-six states already bar minors from accessing gender-affirming care, with providers in many states facing the loss of their medical licenses. In six states, doctors and others who assist minors can be charged with felonies.
In July, the Trump administration launched investigations into doctors and clinics providing gender-affirming care to minors, accusing them of “healthcare fraud” and threatening prosecution.
As a result, nearly two dozen hospitals and clinics nationwide — including in states without bans — rolled back or ended gender-affirming care programs for minors and some young adults, with several of those decisions now facing legal challenges.
The American Civil Liberties Union condemned the proposed rules and threatened legal action if the administration moves to implement them.
“The latest proposals would force doctors to choose between their ethical obligations to patients and the threat of losing federal funding, uprooting families who have already fled state-level bans and leaving them with nowhere to turn for care,” said Chase Strangio, co-director of the ACLU’s LGBTQ & HIV Rights Project.
“These rules aim to completely cut off medically necessary care from children no matter where in this country they live,” said Kelley Robinson, president of the Human Rights Campaign. “It’s the Trump Administration dictating who gets their prescription filled and who has their next appointment canceled altogether.”
A transgender woman has filed a lawsuit against hotel giant Hilton, alleging that she was assaulted by a security guard at the Hilton Dallas Lincoln Centre while she was a registered guest.
According to the complaint, filed in the 192nd Civil District Court in Dallas County, Kimberly Barnett, an Afro-Latina transgender woman from Nebraska, was staying at the hotel in late June while attending Dallas Pride Weekend and other LGBTQ events.
Barnett returned to the Hilton Dallas Lincoln Centre around 3:45 a.m. on June 24 and attempted to "valet her vehicle," according to the lawsuit.
Lucien Bates, a transgender man, says security guards threatened to arrest him after he used the women’s restroom at a Round1 arcade inside the North Riverside Park Mall in suburban Chicago. Bates, an Indiana resident, was visiting the venue on September 28 with his fiancé and a friend to play Dance Dance Revolution.
Bates, who presents as alt-masculine with facial hair and piercings, had just arrived at the arcade when he needed to use the restroom. He chose the women’s restroom, a decision he often makes in public because he feels safer there and is less likely to be harassed.
The 6th U.S. Circuit Court of Appeals has ruled that cisgender students may repeatedly and intentionally misgender transgender classmates, invalidating an Ohio school district's policies that sought to stop the practice.
In a 10-7 decision, the court found that Olentangy Local School District's prohibition on using "gendered language they know is contrary to the other student's identity," including pronouns and honorifics, infringes on the rights of students who believe there are only two genders.
The challenged policies include an anti-harassment rule prohibiting "discriminatory harassment" or bullying based on gender identity and other protected traits that "places a student or school employee in reasonable fear of harm," interferes with education or work, or disrupts school operations, according to The Associated Press.
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