Medicare Stops Funding for Minors’ Gender-Affirming Care

WASHINGTON, D.C. — The Centers for Medicare & Medicaid Services (CMS) has issued a directive to states prohibiting the use of Medicaid funds for gender-affirming care for minors. The announcement was made by Dr. Mehmet Oz, the newly confirmed CMS administrator, who stated that the agency aims to prioritize child protection.

In a statement released on April 11, Oz emphasized that Medicaid will no longer cover gender reassignment surgeries or hormone treatments for individuals under 18 years of age. He characterized these procedures as potentially causing “permanent, irreversible harm, including sterilization.” Oz affirmed that it is essential for medical care to be “lawful, necessary, and truly in the best interest of patients.”

CMS communicated this change through a letter to state Medicaid directors. Deputy Administrator Drew Snyder signed the letter, which underscored the obligation of states to ensure care is delivered in a manner aligned with the beneficiaries’ best interests.

Oz’s appointment was confirmed following a largely party-line vote, during which Sen. Josh Hawley expressed concerns over Oz’s previous comments supporting transgender care and abortion rights. Hawley ultimately backed Oz’s nomination after he reportedly altered his positions on these issues.

A study conducted in 2023 by JAMA Network Open reported that from 2016 to 2019, over 25,000 individuals aged 19 to 30 underwent gender-affirming procedures, with only 8% of those being minors aged 12 to 18. The same study indicated that approximately one in four patients receiving these procedures were covered by Medicaid.

President Donald Trump previously enacted a policy declaring that the U.S. would not “fund, sponsor, promote, assist, or support” gender-affirming care. Critics of gender-affirming treatments often describe them as “maiming and sterilizing” children.

Despite the controversy, several medical organizations, including the American Academy of Pediatrics, have endorsed gender-affirming care policies. However, recent state laws targeting transgender individuals have been linked to increased suicide attempts among trans and nonbinary people aged 13 to 24, according to research by the Trevor Project.

In his statement, Oz cited costs for gender-affirming care as high as $134,000, adding that some countries are reconsidering these interventions. He articulated a belief that psychotherapy should be the first treatment approach, rather than life-altering drugs or surgeries. “This isn’t about politics or stigma. It’s about protecting people from decisions they may not fully understand, and consequences they can’t undo,” Oz said.

Adrianna Rodriguez contributed to this report.