The Trump administration has finalized a rule that would pull funding for gender-affirming care for minors from Medicaid and the Children's Health Insurance Program.
The Centers for Medicare & Medicaid Services said Tuesday that the final rule is based on both national and international research from the Department of Health and Human Services that "identified significant evidence gaps" as well as "documented serious safety concerns."
Based on that research, the agency concluded "that the evidence supporting these interventions for children remains insufficient to justify federal taxpayer funding." It said that some medical associations, such as the American Society of Plastic Surgeons, are also updating their positions on these services.
However, most leading medical associations—including the American Academy of Pediatrics, the American Medical Association and the American Psychological Association—disagree with the conclusion that these services carry limited benefit alongside substantial risk.
Procedures that fall under the final rule include puberty blockers, hormone therapy and surgical interventions. CMS said the rule is set to take effect on Oct. 13.
The funding will remain available for a tapering-off window of up to six months for children who are currently undergoing hormone therapy, CMS said. The rule also does not apply to mental health services.
HHS Secretary Robert F. Kennedy, Jr. said in the announcement that these surgeries "fail to meet the evidentiary standard our children deserve."
"By cutting off federal funds for these sex-rejecting procedures, we’re following the science, saving taxpayer dollars, and, most importantly, protecting children from potentially irreversible harm so they can truly flourish," said CMS Administrator Mehmet Oz, M.D.
The rule was originally proposed in December alongside a sweeping "declaration" from Kennedy that hospitals offering gender-affirming care to minors would be barred from participation in Medicare and Medicaid. That declaration received a swift legal challenge.
HHS said earlier this summer that it was still planning to take action on the rule, which has been under review at the Office of Management and Budget since June 16. The broader administration has also cut deals with some major systems to end the services for minors and set aside funds for patients who may seek a return to their birth gender, and has managed to pressure dozens of providers to suspend such services on their own terms.