U.S. Moves to Restrict Gender-Affirming Care for Minors: Proposed Rules Spark Debate

Washington, D.C., December 19, 2025 — The U.S. Department of Health and Human Services (HHS) on Thursday unveiled a series of regulatory proposals aimed at significantly restricting gender-affirming care for minors, including the use of puberty blockers, hormone therapies, and surgical interventions. The move builds on prior restrictions implemented during the Trump administration and represents the Biden administration’s latest efforts to regulate access to care for transgender youth.

According to HHS officials, the proposed rules are intended to curb what the administration characterizes as “experimental treatments” for children and adolescents experiencing gender dysphoria. However, the proposals run counter to the guidance of most major U.S. medical organizations, which support gender-affirming care as a safe and evidence-based treatment for transgender youth.

Scope of the Proposed Rules

The regulatory measures, if finalized, would:

• Prohibit hospitals and medical providers receiving federal Medicaid or Medicare funding from offering gender-affirming care to minors.

• Restrict access to puberty blockers, hormone therapy, and surgeries for children and adolescents under federal programs.

• Potentially reduce or eliminate coverage in nearly two dozen states where such treatments remain legal and are funded under Medicaid.

Currently, more than half of U.S. states already have laws that ban or restrict gender-affirming care for minors. The new federal proposals would further expand restrictions, creating significant barriers for families seeking treatment for transgender children.

Administration Statements and Legal Considerations

HHS Secretary Robert F. Kennedy Jr. and his deputies formally announced the proposed regulations, emphasizing the administration’s intention to review and limit access to gender-affirming interventions for minors nationwide.

Officials noted that the proposals are not final and are not legally binding. They are expected to face immediate legal challenges from advocacy groups, healthcare providers, and states that support gender-affirming care. Legal experts suggest that litigation could delay or block implementation for months or even years.

Medical Community Reactions

Major medical organizations, including the American Academy of Pediatrics, the American Medical Association, and the Endocrine Society, have long endorsed gender-affirming care as essential for the well-being of transgender youth. They argue that denying access can increase the risk of depression, anxiety, and suicidal ideation among transgender children and adolescents.

Critics of the HHS proposals warn that cutting off federal funding could have a disproportionate impact on low-income families who rely on Medicaid, effectively limiting treatment options for minors in states where gender-affirming care is otherwise legal.

Political and Social Context

The debate over gender-affirming care for minors has intensified in the U.S., with conservative lawmakers advocating stricter regulations and some Democratic-led states pushing back to protect access. The HHS proposals come amid a broader political and legal struggle over transgender rights, healthcare access, and federal versus state authority in regulating medical treatments.

As the public comment period and potential legal proceedings unfold, the future of gender-affirming care for minors in the United States remains uncertain. The proposals underscore the ongoing tension between federal oversight and the guidance of medical experts, raising questions about the balance between policy, medical ethics, and the rights of transgender youth.