An executive order threatens to cut off funding for gender-affirming care for minors, igniting controversy across the nation.
Story Highlights
- President Trump’s executive order aims to restrict gender-affirming care for those under 19.
- HHS and CMS demand hospitals disclose financial data on gender-affirming procedures.
- Court blocks funding cuts, pending appeals, as legal battles unfold.
- Proposed rules could eliminate coverage for such care in ACA plans.
Trump Administration’s Executive Push
On January 28, 2025, President Trump signed Executive Order 14187, titled “Protecting Children From Chemical and Surgical Mutilation.” This order mandates federal agencies to halt funding and coverage for gender-affirming care for minors, defined as individuals under 19. The order also targets TRICARE and the Federal Employee Health Benefits Program, aiming to end their support for these medical interventions.
This executive action has sparked significant legal challenges, with a federal district court in Maryland enjoining the order’s funding provisions nationwide in the case of PFLAG, Inc. v. Trump. The decision is under appeal at the Fourth Circuit, keeping the nationwide injunction in place as the legal process continues.
Regulatory Measures and Hospital Compliance
In a move to enforce the executive order, HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet (Dr.) Oz have issued letters to hospitals and healthcare providers. These letters demand the disclosure of policies and procedures for treating gender dysphoria in children, informed consent protocols, and financial data related to pediatric gender-affirming care. The administration’s aim is to gather detailed information that could further restrict these medical practices.
The proposed CMS marketplace rules, announced in March 2025, seek to eliminate coverage for gender-affirming care in Affordable Care Act (ACA) plans. These rules reframe these medical interventions as “sex trait modification” and have faced strong opposition from various stakeholders, including medical associations and advocacy groups.
Impact on Healthcare and Families
The executive order and subsequent regulatory actions have created a chilling effect on healthcare providers, many of whom are uncertain about how to proceed given the legal and regulatory landscape. Hospitals may pause or scale back their pediatric gender-affirming services due to the potential legal and financial risks posed by the administration’s stance.
Families relying on ACA plans for coverage of gender-affirming care face immediate threats of losing insurance support. This could lead to increased out-of-pocket costs and barriers to accessing necessary medical care for transgender youth, exacerbating stigma and mental health challenges within this vulnerable population.
Sources:
CMS Issues Letters to Hospitals on Gender-Affirming Care Practices
WBL Health Care Policy Webinar
RFK Jr. and Dr. Oz Announce Health Insurance Reforms
