Health and Human Services Secretary Robert F. Kennedy Jr. unveiled a major policy shift Thursday aimed at ending federal support for gender-transition medical interventions for minors, signaling one of the most aggressive health care actions of President Donald Trump’s second administration.
The initiative targets puberty blockers, cross-sex hormones and surgical procedures involving children, with officials declaring these treatments fall outside accepted standards of care.
Kennedy signed a peer-reviewed declaration asserting that procedures designed to alter a minor’s sex characteristics are neither safe nor effective.
Providers who perform such interventions on patients under 18 could be deemed noncompliant with federal patient-safety requirements, potentially exposing hospitals and practitioners to enforcement actions, The Post Millennial reports.
As part of the plan, the Department of Health and Human Services (HHS) is instructing the Centers for Medicare & Medicaid Services to begin rulemaking that would bar hospitals offering these procedures from participating in Medicare and Medicaid.
Nearly all U.S. hospitals rely on federal reimbursement, meaning the proposal could sharply restrict access nationwide.
Kennedy criticized major medical organizations for supporting what he described as ideologically driven practices.
“This is not medicine. It is malpractice,” he said, accusing the American Medical Association and the American Academy of Pediatrics of abandoning evidence-based care and failing vulnerable children.
The policy builds on an executive order President Trump signed shortly after taking office, reversing a Biden-era directive on “trans” inclusion.
Trump emphasized recognizing biological sex as immutable and prioritizing child protection, privacy and freedom of conscience in federal health policy.
HHS officials said CMS will rely on authority under the Social Security Act to establish patient-safety standards for hospital participation.
The department said the rulemaking is intended to ensure the federal government does not fund institutions that “intentionally or unintentionally inflict permanent harm on children.”
Additional actions include warning letters from the Food and Drug Administration to manufacturers of breast binders, cautioning against marketing the products to children.
Kennedy said the devices, developed for post-mastectomy patients, can impair lung function and cause lasting health issues when used by minors, according to USA Today.
HHS is also moving to remove gender dysphoria from a list of disabilities protected under prior federal regulations.
Officials said the change clarifies that restrictions on sex-rejecting procedures do not violate federal nondiscrimination requirements tied to funding.
The announcement coincided with House passage of the “Protect Children’s Innocence Act,” sponsored by Rep. Marjorie Taylor Greene (R-GA).
The bill would make it a federal felony to perform sex-change surgeries or prescribe puberty blockers for minors, carrying penalties of up to 10 years in prison. The measure passed 216–211, largely along party lines.
Despite House approval, the bill faces uncertainty in the Senate due to procedural and leadership challenges.
Democrats and civil liberties groups condemned the policy, with the ACLU calling it “the most extreme anti-trans bill ever considered by Congress,” and “trans” Rep. Sarah McBride (D-DE) accusing Republicans of fixating on “trans” issues.
New York Attorney General Letitia James labeled the move “reprehensible” and vowed legal action.
Administration officials emphasized insufficient long-term evidence supports the safety of puberty blockers and cross-sex hormones for children, noting that Medicare policy often shapes private insurance coverage, which could magnify the impact of the proposed rule.
As federal rulemaking proceeds and potential legal challenges loom, the administration framed the initiative as part of a broader child-protection agenda, setting the stage for an extended political and judicial battle over pediatric gender medicine in the United States.
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