HHS unleashes sweeping crackdown on child ‘sex-rejecting procedures,’ threatens hospital, Medicaid funding
The U.S. Department of Health and Human Services (HHS) announced a sweeping package of proposed regulatory actions Thursday to end "sex-rejecting procedures" on minors as part of President Donald Trump's January executive order calling on the department to protect children from "chemical and surgical mutilation."
"Today, we are taking six decisive actions guided by gold standard science and the week one executive order from President Trump to protect children from chemical and surgical mutilation," HHS Secretary Robert F. Kennedy Jr. said during a press conference Thursday afternoon announcing the proposed actions.
HHS is rolling out a series of policy updates and regulatory actions that effectively would defund hospitals that provide gender transition procedures, according to an HHS official.
The Centers for Medicare & Medicaid Services rolled out policy proposals that would bar hospitals from carrying out performing puberty blockers, cross-sex hormones and certain surgeries on patients under 18 as a "condition of participation in Medicare and Medicaid programs." The majority of U.S. hospitals participate in Medicare and Medicaid, according to HHS.
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The Centers for Medicare & Medicaid Services released another proposed rule that would block federal Medicaid funding for procedures aimed at altering the sex of a child under the age of 18, which HHS said also will apply to federal funding to the Children’s Health Insurance Program (CHIP) for the same procedures on individuals under the age of 19.
Collectively, according to the HHS official, the actions would ensure no federal funds directly support gender transition procedures on children.
"On my watch, HHS will stand for radical transparency and informed consent," said Kennedy. "We follow the evidence. We employ gold standard science. We honor the moral obligation to do no harm. There is divine worth in every person. It shines most brightly in our children that was commanded us to protect them."
The announcement comes after HHS released a peer-reviewed report in November that found medical procedures to alter a child's biological sex pose serious long-term dangers to children.
The report was released through the Office of the Assistant Secretary for Health and found that operations working to reject a child's biological sex — including the use of puberty blockers, cross-sex hormones and surgical operations — "are significant, long term, and too often ignored or inadequately tracked."
The November report was an update to HHS' May report that reviewed the evidence and best practices for children with gender dysphoria, which was criticized by a handful of medical groups for not identifying the study's authors and allegedly misrepresenting a medical consensus on the matter.
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In another Thursday crackdown, Kennedy signed a declaration that such procedures on children do not meet professional medical standards, based on the study, which warns "practitioners who perform sex-rejecting procedures on minors would be deemed out of compliance with those standards."
"They betrayed their Hippocratic Oath to do no harm," Kennedy said Thursday. "So-called gender-affirming care has inflicted lasting physical and psychological damage on vulnerable young people. This is not medicine. It is malpractice. We're done with junk science driven by ideological pursuits, not the well-being of children."
The Food and Drug Administration additionally announced Thursday, as part of the crackdown on trans medical issues for minors, that it sent warning letters to 12 manufacturers and retailers behind the "illegal marketing of breast binders to children."
At the civil rights level, HHS is moving to undo a Biden-era effort to treat gender dysphoria as a disability under federal law. A newly proposed revision to Section 504 of the Rehabilitation Act of 1973 would clarify that the definitions of "disability" and "individual with a disability" exclude "gender dysphoria" that is not the result of a physical impairment.
"The Biden-era amendment is designated gender dysphoria as a disability, serve the commercial interests of a predatory, multibillion dollar industry that betrayed the original intention of those laws engendered widespread public resentment against those laws among the American people, and discredit the statutes in the public mind," Kennedy said during the press conference Thursday.
The announcement is expected to be met with pushback from left-wing Democrats, who have continued championing "gender-affirming care" for kids.
Transgender issues became a political football toward the end of Trump's first administration and into the Biden administration, which repeatedly declared support for the trans community and trans youth. In November, 130 Members of Congress, for example, filed an amicus brief at the Supreme Court in November for a pair of cases focused on transgender students playing on a school sports team opposite their biological sex.
Supporters of medical procedures aimed at altering a child's sex argue preventing such medical care can lead to depression and anxiety, and even suicide and must be protected.
President Donald Trump has repeatedly railed against trans procedures for children as an "act of abuse" since before his reelection in 2024.
The president and the Make America Healthy Commission he established earlier in 2025 have doubled down that there are only two biological sexes, including Trump signing an executive order declaring the U.S. only recognizes male and female sexes while also ending a "radical and wasteful" diversity, equity and inclusion program within the government.