The Trump administration is finalizing rules to end Medicaid funding for sex change procedures, including cross-sex surgeries and hormones, for minors.
The Department of Health and Human Services is finalizing a controversial rule that would block Medicaid reimbursement for healthcare providers who give gender transition procedures to minors, the Washington Examiner confirmed.
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HHS spokeswoman Emily Hilliard told the Washington Examiner that Secretary Robert F. Kennedy Jr. “is drawing a clear line” that children in the United States “will not be subjected to life-altering interventions on the taxpayer’s dime without reliable evidence of safety and clinical benefit.”
“Under the leadership of Secretary Kennedy, federal health care dollars will support evidence-based care that protects children and puts their long-term health first,” Hilliard said.
Medicaid, which is jointly funded by the state and federal government but run independently by states, and the Children’s Health Insurance Program cover roughly 34.5 million children nationwide.
The new rule, first made public on Dec. 19, 2025, would prohibit state Medicaid and CHIP programs from reimbursing providers for what the administration calls “sex-rejecting procedures” for minors with gender dysphoria, including puberty blockers, cross-sex hormones, and surgical interventions such as vaginoplasty or mastectomy.
The rule does not hinder access to mental health treatment for children on Medicaid suffering from gender dysphoria, medically defined as the emotional distress that comes with a conflict between perceived gender identity and biological sex.
HHS officials told the Washington Examiner that most children enrolled in Medicaid are eligible for psychotherapy services under the Early and Periodic Screening, Diagnostic, and Treatment requirements, which cover behavioral health conditions.
The finalized rule comes after HHS last month withdrew a more aggressive rule that would have withheld Medicare and Medicaid funding for hospitals and healthcare professionals providing transgender medical care to patients of any age.
Withholding Medicare funding for healthcare providers would have effectively enacted a nationwide ban on transgender medical procedures, as nearly all hospitals in the United States depend upon federal reimbursement to remain afloat.
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Hilliard told the Washington Examiner the finalized rule blocking Medicaid funding for child sex change medicine protects taxpayer dollars.
“American taxpayers should never be forced to finance interventions when the evidence of benefit is insufficient and the potential consequences for children can be serious and irreversible,” Hilliard said.
