Washington, D.C. — The U.S. Department of Health and Human Services announced a series of proposed regulatory actions intended to implement an executive order issued by President Donald Trump directing the department to end certain medical procedures on minors that the administration describes as posing irreversible risks.
Under the proposal, the Centers for Medicare & Medicaid Services would issue a notice of proposed rulemaking barring hospitals from performing specified pharmaceutical or surgical interventions on individuals under age 18 as a condition of participation in Medicare and Medicaid. Because nearly all U.S. hospitals participate in these programs, the policy would effectively prohibit such procedures at facilities seeking to retain federal reimbursement.
CMS also plans a separate proposed rule to prohibit federal Medicaid funding for the same procedures for individuals under 18 and to apply a similar restriction to the Children’s Health Insurance Program for individuals under age 19. HHS stated that 27 states currently do not provide Medicaid coverage for these procedures.
HHS officials said the proposed rules are grounded in the agency’s authority under the Social Security Act to establish standards necessary to protect patient health and safety. The department cited concerns about long-term effects, including infertility, impaired sexual function, bone density changes, and other irreversible outcomes.
Health and Human Services Secretary Robert F. Kennedy Jr. signed a formal declaration concluding that the procedures do not meet professionally recognized standards of care, based on a peer-reviewed HHS report. Under the declaration, practitioners performing such procedures on minors would be considered out of compliance with those standards.
CMS Administrator Mehmet Oz said the proposed rules aim to clarify that hospitals participating in federal programs may not conduct what he described as unproven interventions on children, adding that CMS has a responsibility to ensure program standards promote patient safety.
Separately, the U.S. Food and Drug Administration announced it is issuing warning letters to 12 manufacturers and retailers for what it described as illegal marketing of breast binders to children for the treatment of gender dysphoria. FDA Commissioner Marty Makary said further enforcement actions, including seizures or injunctions, could follow if violations continue.
HHS also proposed revising regulations under Section 504 of the Rehabilitation Act of 1973 to clarify that gender dysphoria not resulting from physical impairments is excluded from the definition of disability. Deputy Secretary Jim O’Neill said the change is intended to provide regulatory clarity and ensure that federally funded organizations may adopt evidence-based policies without violating disability nondiscrimination requirements.
The department cited claims data indicating that nearly 14,000 minors received such procedures between 2019 and 2023. HHS said public comment will be accepted as part of the rulemaking process before any final regulations are adopted.
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