The Trump administration has released a finalized version of a new rule that will bar federal insurance, including the Children’s Health Insurance Program (CHIP), from covering gender-affirming care for trans youth. CHIP is a joint federal-state health insurance program that provides low-cost health care for families that can’t afford private insurance.
“Every young person is entitled to the health care that they, their parents, and their medical providers agree that they need, without politicians interfering with these important and highly personal decisions,” said Kelly Robinson, president of the Human Rights Campaign (HRC) in response to the policy. “The Trump administration is terrorizing trans youth and their families with these kinds of actions, and it has to stop.”
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The rule will prevent federal Medicare and Medicaid plans from covering gender-affirming care for anyone under the age of 18, and bar federal CHIP plans from covering it for anyone under 19. This only affects federal funding, and for states where gender-affirming care for trans minors is legal, state Medicaid and CHIP plans will still be able to cover gender-affirming care.
The rule was first proposed by the Centers for Medicare and Medicaid Services (CMS), which is overseen by Dr. Mehmet Oz, back in October 2025. While there was a public comment period and other bureaucratic processes, the general spirit of the rules from CMS and the Department of Health and Human Services (HHS) remains unchanged in the final document.
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The Trevor Project’s senior vice president, Rodrigo Heng-Lehtinen, pointed out that in that public comment period, there were around 35,000 responses, and emphasized that this was “a dangerous and unnecessary attempt to prevent transgender and nonbinary young people from accessing the best-practice health care they need to lead healthy and happy lives.”
The rule is now set to go into effect on October 13, 2026. There will be a six-month grace period for those who are already receiving hormones under the federal programs during which they can still claim on those plans, but after that they will be cut off as well.
Throughout the document, the new rule continues the Trump administration’s use of the phrase “Sex-Rejecting Procedures,” a derogatory term for gender-affirming care that arose in the Trump administration in early 2025 and avoids using “transgender” outside of quotes and titles.
“Today, we are ending federal taxpayer funding for sex-rejecting procedures on children,” said HHS Secretary Robert F. Kennedy Jr. “These interventions carry serious risks and can cause irreversible harm. The federal government will no longer use Medicaid and CHIP dollars to fund procedures that fail to meet the evidentiary standard our children deserve.”
Kennedy’s comments, as well as similar ones from Oz and Trump himself, push false narratives about the harms of gender-affirming care. All major medical associations in the United States agree that gender-affirming care is safe. At the same time, studies have found that depriving trans youth of gender-affirming care is deleterious to their mental health and well-being.
In a statement, the Trevor Project noted, “Research shows that access to transgender health care is associated with significantly lower rates of depression and suicide risk among transgender and nonbinary young people.”
Heng-Lehtinen went on to call the rule a “dangerous restriction on doctor-prescribed health care,” and said, “Personal medical decisions should be made by individual patients, their doctors, and their families – not by a one-size-fits-all mandate from the federal government.” He also highlighted that “this type of care is nothing new; it has been provided for decades, is based on scientific research, and is supported by all of our country’s leading medical and mental health associations.”
All of this comes as HRC is already challenging a rule from Trump’s Office of Personnel Management that bars health insurance programs for federal workers and their dependents from covering gender-affirming care.
This is one of two attempts from the Trump administration introduced over the last year in the hopes of controlling gender-affirming care through federal funding. What has been finalized this week is a rule that would prevent Medicare, Medicaid, or CHIP funding from being used to pay for gender-affirming care for minors.
That is distinct from rules proposed in December 2025 by the Centers for Medicare and Medicaid Services (CMS). Those rules would have barred any hospital in the US that provided gender-affirming care to minors from receiving any Medicare or Medicaid funds at all. However, the Trump administration appeared to back off that tactic last month.
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