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By Hollie Silverman and Dan Gooding
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President Donald Trump announced Tuesday that his administration will stop using federal Medicaid funds to pay for gender-affirming surgeries and hormone treatments for transgender minors, prompting questions about whether access to such care will remain available in states that have enacted protections for transgender youth.
Trump's decision marks the latest move in his administration's broader effort to restrict protections and services for trans youth. It has already backed policies aimed at limiting transgender students' participation in school sports, while Republican-led states across the country have enacted bans on transgender athletes competing on teams that align with the students' gender identity.
States that protect gender-affirming care can still allow providers to offer treatment and may be able to use state funding streams to help cover services.
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Trump announced the change in a Truth Social post, saying: "Today, at my direction, Dr. Mehmet Oz announced that Medicaid will NO LONGER fund gender transition surgeries and hormones for minors."
He added that his administration would not pay for what he called "barbaric surgeries and practices" and argued that the policy would protect children.
According to the Centers for Medicare & Medicaid Services, (CMS) the new rule will end federal Medicaid funding for gender-affirming surgeries and hormone therapies for minors and will also bar the Children's Health Insurance Program (CHIP) from covering those treatments for people under 19.
The policy is scheduled to take effect in October.
What States Still Protect Access?
A review of the latest Kaiser Family Foundation (KFF) policy tracker shows that the national landscape remains deeply divided.
As of May, 27 states have enacted laws or policies limiting youth access to gender-affirming care, meaning the remaining states have not adopted such restrictions. KFF estimates that roughly half of transgender youth ages 13 to 17 live in states with restrictions on care.
States that have generally moved to protect access include much of the West Coast and Northeast, including California, Oregon, Washington, Colorado, Minnesota, Illinois, New York, Massachusetts and several others. Several of them have adopted "shield" laws or policies designed to protect providers and patients seeking care that is legal under state law.
Even so, Trump's Medicaid action could still affect families in those states because federal funding plays a significant role in state Medicaid programs.
While care may remain legal, the loss of federal reimbursement could create new coverage barriers for lower-income families.
Why the Policy Doesn't End Care Nationwide
KFF's tracker shows that restrictions on gender-affirming care remain governed largely at the state level. Some states prohibit treatments such as puberty blockers or hormone therapy for minors, while others expressly protect access.
Court battles continue across the country, with KFF reporting that 18 states are facing legal challenges to restrictions on youth gender-affirming care.
The Supreme Court's 2025 decision in United States v. Skrmetti upheld Tennessee's ban on gender-affirming care for minors, giving states greater legal authority to maintain such restrictions. However, that ruling did not require states to ban care, leaving a patchwork of different policies across the country.
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What Advocates and Opponents Say
The Trump administration says the change is intended to protect children from treatments it argues can cause irreversible harm. Health and Human Services Secretary Robert F. Kennedy Jr. said the government would no longer use Medicaid and CHIP funds for procedures that "fail to meet the evidentiary standard our children deserve." Oz, CMS administrator, said the rule was about "following the science" and protecting children.
LGBTQ+ advocates strongly disagree. Kelley Robinson, president of the Human Rights Campaign, said the rule interferes with medical decisions made by families and doctors.
Major medical organizations, including the American Medical Association and American Academy of Pediatrics, continue to support access to gender-affirming care under established clinical guidelines.
Trump's statement that Medicaid will no longer fund gender-transition surgeries and hormone treatments for minors is consistent with the administration's newly announced policy. However, the move does not eliminate gender-affirming care nationwide.
Access will continue to depend heavily on state laws, and many states still maintain policies protecting transgender youth and the providers who treat them.
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