The Trump administration has finalized a rule ending federal Medicaid and Children’s Health Insurance Program funding for certain gender-affirming care for transgender minors, a move that is set to take effect in October.
Under the new policy, Medicaid will no longer provide federal funding for gender-affirming surgeries and hormone treatments for transgender minors, while CHIP will stop covering the treatments for people under 19, according to the administration.
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The rule is scheduled to take effect on October 13, 2026. Puberty blockers, hormone therapy and gender-affirming surgeries are among the treatments affected by the policy. Mental health services for transgender youth will continue to be covered.
The administration has defended the change as a measure to protect children and prevent federal taxpayer money from being used for treatments it considers harmful.
Centers for Medicare & Medicaid Services Administrator Mehmet Oz and Health and Human Services Secretary Robert F. Kennedy Jr. have supported the policy, arguing that the treatments targeted by the rule can carry significant long-term risks.
The policy does not itself make gender-affirming care illegal. Instead, it prevents federal Medicaid and CHIP funds from being used to pay for specified treatments, potentially shifting financial responsibility to states, families or private insurers.
The administration’s action follows President Donald Trump’s broader efforts to restrict gender-affirming care for minors. Trump signed an executive order in January 2025 directing federal agencies to take steps to end federal support for gender-transition procedures involving children.
The new rule has drawn strong opposition from medical organizations and LGBTQ+ advocates. The American Medical Association and American Academy of Pediatrics have continued to support access to gender-affirming care based on individual medical needs, while opponents of the rule argue that the federal government is interfering with medical decisions and state authority.
The policy is also expected to face legal challenges. Democratic state attorneys general and advocacy organizations have criticized the move and are preparing to challenge the administration’s authority to restrict federal funding for the treatments.
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At least 27 states already have laws restricting gender-affirming care for minors, according to the Associated Press. The federal policy could further limit access for low-income transgender youth in states where the treatments remain legal.
The administration estimates that the change will save about $235 million over 10 years. Children already receiving hormone therapy will receive a six-month transition period after the rule takes effect, according to the administration.
The rule represents another major step in the Trump administration’s campaign to restrict federal support for gender-affirming care and is likely to become part of a broader legal and political fight over transgender healthcare in the United States.