A new Trump administration proposal that would essentially end transgander care for young adults could have serious mental and physical consequences on patients currently receiving treatments, Oregon advocates say.
The proposal from the U.S. Department of Health and Human Services would prohibit all Medicaid and Medicare funding for any services at hospitals that also provide gender-affirming care for children and young adults, according to proposals by the Department of Health and Human Services as reported by NPR. If approved and enacted, the rule is expected to make access to pediatric gender affirming care almost nonexistent.
Blair Stenvick of Basic Rights Oregon told The Lund Report that the move amounts to “scapegoating” the young people who’ve sought gender-affirming care while “creating a false choice that sacrifices their care and their physical and mental well being.”
“What this role will do is just take that choice away from families for young people who maybe have already begun this path of transitioning as a young adult, but are still under the age of 18,” Stenvick said. “This would take away medical care that they're already receiving and interrupt their transition process, which would cause a lot of mental grief.”
The proposal goes further than previous executive orders that have called for an end of government funding applied to gender-affirming care for youths. In this case, a hospital or medical facilities participation in the Medicaid or Medicare programs would depend on whether they provided gender affirming services.
A draft of the sweeping proposal was obtained by NPR, along with another draft plan to end reimbursements from Medicaid and the Children's Health Insurance Program, or CHIP, specifically for pediatric gender care services. NPR reports that the rules are expected to be released publicly in early November, according to an employee at the Centers for Medicare and Medicaid Services, and the public comment period could take months before any formal rule goes into effect.
Gender-affirming care includes a range of medical, mental health, and non-medical services intended to affirm an individual’s gender identity. It is supported by the American Academy of Pediatrics, the American Medical Association, the American College of Obstetricians and Gynecologists and the World Health Organization, and is associated with improved mental health outcomes for transgender people.
“It really makes clear that this administration's goal is to isolate, to ‘other’” a small and vulnerable population for political gain, said Stenvick, who added that news of this latest proposal comes as no surprise given the administration's previous actions to restrict gender-affirming care.
“We knew it was a possibility — the Trump administration has made it very clear that they want to target a very small population of youth,” Stenvick said.
From the first week of taking office, Trump has made ending transgender care and transgender rights a steady theme of his administration — issuing several executive orders to end government funding to medical facilities for gender affirming services for youths and young adults. The administration and the states, including Oregon, have sparred over the issue in the courts, and both the Department of Justice and the Federal Trade Commission have engaged in investigations into hospitals around their transgender care practices.
Even prior to these proposals, access to transgender care has been scaled back since Trump took office. Earlier this year, following an executive order from the president, several hospitals across the country discontinued surgical procedures for transgender youth under 18, including Kaiser Permanente’s nationwide network, while continuing other nonsurgical treatments such as puberty blockers. A study by Harvard’s School of Public Health found that gender affirming surgeries are rarely performed on transgender youth.
Stenvick stressed that gender affirming care for young adults is a gradual and tailored process, done in collaboration with doctors, mental health professionals and families, and doesn't start until the youth has shown a persistent pattern of identification.
According to KFF Health News, 27 states have already enacted laws and policies that limit youth access to gender affirming care. Oregon state law protects access to medically needed care to all populations, including care specific to the LGBTQ+ community.
Oregon Attorney General Dan Rayfield, who joined Washington and Minnesota in suing the Trump administration over gender-affirming care funding, issued a statement to The Lund Report saying his office is committed to making sure the care stays protected and remains available in Oregon.
“It’s really cruel to see an administration use people’s health care – care that thousands of Oregonians rely on – as a political bargaining chip,” Rayfield said. “These patients deserve the same coverage and compassion as everyone else.”
Stenvick noted that people’s rights to health care are interconnected, and that some medical procedures a transgender person might receive are also used by cisgender patients. “And if they can politicize health care and politicize Medicaid and Medicare funding for this, they can do it for other things, too.”
Rayfield’s office has compiled an online toolkit with information about gender-affirming healthcare options and navigating the healthcare system, resources for legal concerns and discrimination protections, and information for transgender individuals who face obstacles receiving care.
