CMS Ends Medicaid and CHIP Funding for Gender-Affirming Care for Minors

The Centers for Medicare and Medicaid Services issued a final rule Aug. 11 barring federal Medicaid dollars for what it calls "sex-rejecting procedures" — including puberty suppression, cross-sex hormone therapy and related surgeries — for anyone under 18, and bars CHIP plans from covering the same care for people under 19. The rule takes effect Oct. 12; beneficiaries already receiving hormone therapy can continue for six months afterward. HHS Secretary Robert F. Kennedy Jr. and CMS Administrator Mehmet Oz said the rule ends funding for treatments they called unsupported by evidence; Trump called the procedures "barbaric" in a social media post.

Medical and LGBTQ advocacy groups, including the Human Rights Campaign and the Trevor Project, said the rule overrides decisions made by patients, families and doctors, and cited research linking this care to lower rates of depression and suicide among transgender youth. Under 1% of transgender minors receive surgical care, a 2024 study found.

States that currently cover this care for minors under Medicaid or CHIP will have to fund it entirely with state money once the rule takes effect Oct. 12; no legal challenge had been filed as of this report.