The final rule released by The Centers for Medicare and Medicaid Services (CMS) bars Medicaid dollars from paying for what it refers to as “sex-rejecting procedures for children under 18” as well as blocking CHIP agencies from paying for the same procedures for people under the age of 19.
Program beneficiaries who are currently receiving cross-sex hormone therapy can continue to claim benefits for six months after the rule’s effective date, which appears set to be Oct 12, 2026.
In a statement on social media, President Trump wrote, “We are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies.”
Advocacy groups quickly condemned the rule.
Human Rights Campaign President Kelley Robinson accused the administration of " terrorizing trans youth and their families with these kinds of actions."
Rodrigo Heng-Lehtinen, The Trevor Project’s senior vice president of public engagement campaigns, called the rule a “dangerous restriction on doctor-prescribed health care.”
Most transgender youth do not receive surgeries before adulthood, with less than one percent of transgender or gender diverse minors in a 2024 study found to have received some form of surgical gender-affirming care and cisgender male minors actually reporting a higher uptake of gender-affirming surgery.
