By Nadia Ntiamoah
The administration of US President Donald Trump is moving to end federal Medicaid and Children’s Health Insurance Program (CHIP) funding for gender-affirming surgeries and hormone treatments for transgender minors, marking another major step in its broader effort to restrict access to gender-related healthcare for young people.
According to the Associated Press report, the new policy is scheduled to take effect on October 13, 2026, and would affect Medicaid coverage for gender-affirming surgeries and hormone treatments for transgender people under 19. The CHIP programme would similarly stop paying for such treatments for those below 19.
The move follows a series of actions by the Trump administration targeting gender-affirming healthcare and transgender rights.
President Trump said on Tuesday that he had directed Dr Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services (CMS), to implement the change.
Trump defended the policy in strongly worded terms, arguing that the government should not use public funds to support what he described as harmful and irreversible medical procedures involving children.
However, LGBTQ+ rights organisations and medical advocates have strongly opposed the move, arguing that the federal government is interfering with medical decisions made by families and healthcare professionals.
Josh Rovenger, legal director of GLBTQ Legal Advocates and Defenders, said the policy would create barriers between parents and their ability to make healthcare decisions for their children and indicated that the measure would face a legal challenge.
The Human Rights Campaign has also condemned the administration’s action. Its president, Kelley Robinson, accused the administration of creating fear and pressure for transgender young people and their families.
The organisation is already challenging another administration policy concerning coverage of gender-affirming care under federal employee benefit plans.
The dispute reflects a broader national battle in the United States over the medical treatment of transgender minors. At least 27 states had already banned gender-affirming care for people under 18, according to the report, while some major hospitals in states without such bans have independently stopped offering certain treatments.
Gender-affirming surgeries involving minors are described in the report as rare, while puberty blockers and hormone treatments are more commonly used forms of care.
Under the new policy, Medicaid and CHIP would continue covering mental-health treatment for transgender minors. However, coverage of hormone treatments would be phased out, including treatments used to suppress puberty or produce physical changes associated with sex characteristics. The report says the phase-out would also affect individuals already receiving such treatments, with the relevant changes extending into April 2027.
The administration’s position has nevertheless faced significant opposition from sections of the medical community. The American Medical Association and many other major medical organisations support access to gender-affirming care, although there is disagreement within the medical profession over certain procedures, particularly surgeries involving minors.
The American Society of Plastic Surgeons, for instance, said earlier in 2026 that it found insufficient evidence to establish that the benefits of chest, genital and facial surgeries for minors experiencing gender dysphoria outweigh the potential risks.
The latest Medicaid and CHIP decision is part of a wider series of policies pursued by the Trump administration concerning transgender people. The administration has also moved against federal funding for hospitals providing gender-affirming care to minors, restricted transgender participation in women’s and girls’ sports, and introduced restrictions concerning sex designations on US passports.
The administration also released a report in 2025 advocating a therapy-focused approach for transgender youth rather than broader gender-affirming healthcare.
Several of these policies have already entered the courts, creating another major legal battleground between the federal government, states, families, medical organisations and LGBTQ+ advocacy groups.
The US Supreme Court has allowed the administration’s passport policy to remain in effect and has permitted states to enforce transgender sports restrictions. However, a lower court rejected the administration’s broader declaration that gender-affirming treatments are unsafe and ineffective, while litigation challenging the policy targeting hospitals remains ongoing.
The financial implications of the latest policy remain unclear. The AP report said it was not immediately known how much taxpayer money is currently being spent through Medicaid and CHIP on gender-affirming treatments for transgender young people. CMS had not responded to questions about the amount of federal funding involved.
The controversy therefore goes beyond the question of government spending. At its centre is a fundamental disagreement over who should determine appropriate healthcare for transgender minors—the federal government, individual states, medical professionals or parents and families.
