The Trump administration’s campaign to eradicate transgender health care for young people has run into a series of legal roadblocks: Judges have ruled against Justice Department subpoenas, a declaration from the health secretary, and parts of the president’s executive order halting all federal support for this care. But a new rule finalized this week by the Centers for Medicare and Medicaid Services may prove more difficult to challenge.
The agency announced Tuesday it was barring the use of federal Medicaid and CHIP dollars to pay for pediatric gender-affirming medications and surgery. Then on Thursday, the Department of Health and Human Services released a report on diagnostic coding practices among gender-affirming care clinicians and referred hundreds of health care groups to the Justice Department for investigation into those practices. Despite many court losses, the administration has successfully pressured at least dozens of hospitals into closing or pausing gender-affirming care programs.
“What we see here is an ideological campaign to eradicate access to a kind of treatment because the president doesn’t like it,” said Elana Redfield, federal policy director at the Williams Institute, a UCLA School of Law think tank focused on LGBTQ+ issues. “But I would describe [the final CMS rule] as sort of a gray area,” Redfield said.
