The U.S. Department of Health and Human Services (HHS) announced new proposed regulations to restrict hospitals from performing what it calls "sex-rejecting procedures" on minors. The move follows an executive order from President Trump directing HHS to end such practices for children under 18.
The Centers for Medicare & Medicaid Services (CMS) will introduce a proposed rule that would make participation in Medicare and Medicaid programs conditional on hospitals not conducting these procedures on individuals under 18. Most U.S. hospitals are part of these federal programs, so the rule would have wide reach. CMS cites its authority under the Social Security Act to set standards aimed at protecting patient health and safety in participating hospitals.
Another proposed rule from CMS seeks to prohibit federal Medicaid funding for sex-rejecting procedures performed on children under 18, with a similar ban for Children’s Health Insurance Program (CHIP) funding affecting those under 19. Currently, 27 states do not provide Medicaid coverage for these procedures.
Sex-rejecting procedures referenced by HHS include puberty blockers, cross-sex hormones, and surgeries intended to change a child’s physical appearance or body to match an asserted gender identity different from their biological sex. According to HHS, these interventions can lead to permanent effects such as infertility, reduced sexual function, lower bone density, changes in brain development, and other irreversible outcomes.
Health and Human Services Secretary Robert F. Kennedy, Jr., signed a declaration based on an HHS peer-reviewed report stating that such procedures do not meet recognized professional health care standards. The declaration specifies that practitioners who perform these interventions on minors would be considered out of compliance with those standards.
“Under my leadership, and answering President Trump’s call to action, the federal government will do everything in its power to stop unsafe, irreversible practices that put our children at risk,” Secretary Kennedy said. “This Administration will protect America’s most vulnerable. Our children deserve better—and we are delivering on that promise.”
CMS Administrator Dr. Mehmet Oz added: “Children deserve our protection, not experimental interventions performed on them, that carry life-altering risks with no reliable evidence of benefit... This proposal seeks to clarify that hospitals participating in our programs cannot conduct these unproven procedures on children. CMS will ensure that federal program standards reflect our responsibility to promote the health and safety of children.”
The Food and Drug Administration (FDA) is also taking enforcement actions by sending warning letters to twelve manufacturers and retailers accused of illegally marketing breast binders—classified as Class 1 medical devices—to minors for gender dysphoria treatment purposes rather than approved uses like post-mastectomy recovery.
“Illegal marketing of these products for children is alarming, and the FDA will take further enforcement action such as import alerts, seizures, and injunctions if it continues,” said FDA Commissioner Marty Makary.
Additionally, HHS plans regulatory changes through its Office for Civil Rights clarifying that “gender dysphoria” unrelated to physical impairments does not qualify as a disability under Section 504 of the Rehabilitation Act of 1973—a reversal of previous efforts by the Biden administration.
“The Biden administration abused a law that was never intended to require health care providers or health programs to support transgender surgeries for minors,” said Health and Human Services Deputy Secretary Jim O’Neill. “Our rule would restore regulatory clarity and ensure that organizations receiving federal funds can set evidence-based policies without fear of violating federal civil rights requirements.”
Last month HHS released a peer-reviewed study titled Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices which found medical dangers associated with attempts at changing children's biological sex; claims data showed nearly 14,000 minors received sex-rejecting procedures between 2019-2023.
Assistant Secretary for Health Admiral Brian Christine issued a public message stating current evidence does not support claims about the safety or effectiveness of puberty blockers or related treatments in pediatric gender dysphoria cases: “Children’s health and well-being guide our every move... Evidence shows sex-rejecting puberty blockers, cross-sex hormones, and surgeries are dangerous. Providers have an obligation to offer care grounded in evidence and to avoid interventions that expose young people to a lifetime of harm.”
For more information about this policy initiative or supporting documentation—including the official declaration—visit .
