Last month, the United States Secretary of Health and Human Services (HHS) Robert F. Kennedy, Jr. announced two new rules that would decimate the ability of transgender adolescents to receive transition-related health care. These rules are an interpretation of President Trump’s junk science executive order that tasked federal agencies with revoking policies based on the standards of care issued by the World Professional Association for Transgender Health (WPATH).
The two proposed rules refer to trans health care as “sex-rejecting procedures,” evoking the pseudoscientific idea that sex is biological, innate, and immutable. These policies also cite the HHS report on gender dysphoria in adolescents, a document so flawed that it cited a retracted paper. This gaping lapse in scholarly ethics highlights how politics tainted the report’s conclusions.
Per federal law, HHS is required to publish proposed rules in the Federal Register for a 60 day period of public comment. This period is open for both rules until February 17, so this is your opportunity to advocate on behalf of trans adolescents and their right to transition. The content of your comments are up to you, and if you are looking to include some facts on this life-saving care, I have compiled some QSL resources which you may find helpful.
Below, you will find links to the two proposed rules and a short description about what they entail. You are not required to submit your name or any identifying information with your comment.
RIN 0938-AV73. This proposed rule would prevent federal payments for Medicaid and the Children’s Health Insurance Program (CHIP) from covering trans health care for adolescents, removing this care from coverage under these programs. Notably, Congress proposed a similar provision in its 2025 reconciliation bill but removed it before passage. This HHS rule includes a pernicious exception that allows for the continuation of nonconsensual surgeries on intersex youth. Comment on this proposed rule here.
RIN 0938-AV87. This rule is even broader and would prevent any hospital which provides health care to Medicare and Medicaid recipients from providing health care to trans adolescents. Given that most large hospital systems participate in Medicare and Medicaid, this rule amounts to a de facto ban on transition-related care for adolescents. Like the first rule, this one also includes an exception for nonconsensual surgeries on intersex youth. Comment on this proposed rule here.
While HHS is not required to listen to the comments that are posted, voicing your displeasure is one way to keep the pressure on a flailing regime that continues to show wanton disregard to basic human dignity. If enacted, these rules will inflict bodily harm on some of the most vulnerable members of our society. Fortunately, there are a few additional efforts to halt these discriminatory rules from taking effect.
Nineteen states and the District of Columbia have already filed a lawsuit to block the implementation of the two proposed rules. The ACLU has also promised to challenge the constitutionality of these proposals. In support of this effort, the ACLU is collecting signatures on a petition (Tell HHS: Hands Off Our Care) to be delivered to HHS decrying these political attacks on life-saving health care. You can sign the ACLU’s petition here. Your name and contact information are required to sign, but you can ask to be listed as “Anonymous” on the public signatory list if you so choose.
At its core, HHS is threatening to end payments to hospitals from Medicare and Medicaid as an extortion tool to eliminate health care for trans youth. Unfortunately, HHS is not waiting until these rules are finalized to scare hospital systems, and two Colorado hospitals have already withdrawn care since the proposed rules were announced.
Notably, these threats will not affect independent clinics or doctors who do not receive Medicare or Medicaid payments, meaning that there may be opportunities for trans adolescents to shift their care to independent providers. While not ideal, this may be the best option for those who have had or will have their care withdrawn. The Trans Youth Emergency Project can assist adolescents and their families in finding independent clinicians to continue their health care and offers one-time travel grants for those who will need to travel to receive the care they need.
Additionally, states (or anyone with the financial capacity to front the costs) can establish new independent clinics to circumvent HHS’ malicious policies. Vermont legislators have already introduced a bill to do just that. It is currently too early to tell whether that bill be enacted into Vermont law, but this effort provides a template for legislators across the country to step up and fill in the gaps left by HHS’ disregard for trans lives. If you live in a state where trans health care for adolescents is legal, reach out to your state representatives and let them know that state-funded clinics will be a vital link in ensuring the continuation of care for trans adolescents.
If you know of any other opportunities to push back on HHS’ malicious policies, please share them in the comments!
from the archive
