The Trump Administration’s Latest Attack on Medically Necessary, Gender- Affirming Care

The Trump Administration’s Latest Attack on Medically Necessary, Gender- Affirming Care  

The Trump administration is continuing its attacks on access to health care for transgender Americans, this time by cutting off Medicare and Medicaid funding for hospitals that provide gender-affirming care to youth. The latest proposed rule, issued by the Centers for Medicare and Medicaid Services (CMS), would be devastating for transgender youth and their families, with grave consequences that extend to the entire health system on which we all rely.  

Because most hospitals rely on federal funding to stay open, this regulation will disrupt care for entire communities, further strain hospitals already reeling from H.R. 1’s drastic Medicaid cuts and weaken our health care system as a whole. Families USA opposes these actions and stands in strong solidarity with all LGBTQ+ communities, including transgender youth, in ensuring that all Americans have access to health care. 

The Importance of Gender-Affirming Care 

Gender-affirming care is a set of wide-ranging care and services that is supported by leading national medical professional associations in the United States, as both medically necessary and lifesaving. Gender-affirming care includes hormone treatment, psychotherapy, and sometimes surgery. This critically important care supports the mental and physical wellbeing of transgender patients and is also used to treat certain types of cancer, early onset puberty and other chronic conditions and health diagnoses across a broad patient population.  

Gender-affirming care, especially in partnership with a specialized gender-affirmative provider and support from family, can reduce stigma, address mental health challenges and reinforce a young person’s resiliency. Eliminating access to this care will result in negative health impacts for transgender youth, such as increased rates of depression, which can lead to limited participation in school and work, as well as self-harm and suicide. When patients are denied access to the care they need, they often end up sicker and need more expensive treatment in the long run. This harms family budgets and hospital finances alike, as hospitals bear the high cost of emergency care and simultaneously lose revenue when patients are forced to seek routine care elsewhere.  

Yet despite all evidence showing the importance of access to gender-affirming care, these services face numerous threats including executive orders, judicial actions and other administrative and legislative action. Escalating attacks on care are driving fear and uncertainty among patients and their providers, with a number of hospitals and health care systems across the U.S. choosing to preemptively pause administering gender affirming care to minors. As a result, many patients are left unable to access treatment plans or feel abandoned by their medical team, while providers are caught between delivering safe, medically necessary care and navigating a rapidly shifting legal landscape. 

The Threat to Gender Affirming Care is a Threat to All Health Care 

In their attempt to tie federal funding to politically motivated restrictions on care, the Trump administration shows it is willing to destabilize hospitals and compromise access to care for everyone, not just those in need of gender-affirming care. Hospitals who discontinue providing these services would face heavy administrative burden as they would be forced to use staff and financial resources to create new care plans and redirect patients to other providers and transfer patient medical records, ultimately impacting hospitals’ ability to care for the entire community. Conversely, if hospitals continue providing medically necessary care and lose their federal funding as a result, they would be forced to reduce overall services, cut staff and increase costs to try to keep their doors open.  

It is also critical to note that the proposed rule further endangers the sanctity of the trusted relationship between patients and their medical providers. Health care decision-making should be driven by evidence-based medicine, not fear of federal funding cuts. Medical decisions should be shared between patients and their doctors, in consultation with families as appropriate, and without interference from the government. 

Health Care Advocates Should Continue to Fight For Our Health Care 

Importantly, this rule is not final. Hospitals can and should continue to provide gender-affirming health care to their patients, to ensure all Americans have access to medically necessary care. 

And advocates should continue to speak out about the threats these actions pose to our health care system. This week, Families USA submitted a comment on the Trump administration’s proposed rule, urging them to withdraw it. You can read our full comment letter here. 

To find out more about what you can do to push back against attacks on health care for transgender youth and all families in America, please reach out to us. We are stronger and more powerful together.