New CMS rule prohibits Medicaid from funding surgeries
The Trump administration has finalized a rule ending federal Medicaid and Children’s Health Insurance Program (CHIP) funding for certain medical interventions intended to alter a minor’s physical characteristics to align with a gender identity different from the child’s biological sex.
The Centers for Medicare and Medicaid Services (CMS) finalized the rule Aug. 13, with the new policy scheduled to take effect Oct. 13, 2026. The rule applies to federal Medicaid funding for children under 18 and federal CHIP funding for children under 19.
The administration refers to the procedures as “sex-rejecting procedures,” a term that includes puberty blockers, cross-sex hormones and certain surgical procedures when used for the purpose of altering a child’s body to align with an asserted gender identity.
“We are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies,” President Trump wrote on Truth Social.
The rule represents the latest federal action by the Trump administration to restrict the use of taxpayer funds for medical gender-transition interventions involving minors.
Administration Cites Medical Evidence
CMS said its decision was based in part on a review of the available scientific evidence concerning medical interventions for children and adolescents experiencing gender dysphoria.
The Department of Health and Human Services released a comprehensive review in 2025 that identified significant concerns about puberty blockers, cross-sex hormones and surgical interventions, including potential long-term and irreversible effects.
CMS Administrator Dr. Mehmet Oz said the federal government has a responsibility to protect children and ensure taxpayer dollars are used appropriately.
“Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits,” Oz said. “By cutting off federal funds for these sex-rejecting procedures, we’re following the science, saving taxpayer dollars, and, most importantly, protecting children from potentially irreversible harm so they can truly flourish.”
Part of Trump’s Broader Policy
The new Medicaid rule follows President Trump’s January 2025 executive order directing federal agencies to take action against what the administration called the “chemical and surgical mutilation” of children.
The executive order directed the Department of Health and Human Services to take steps, consistent with applicable law, to end the use of federal programs to support medical interventions intended to transition children from one sex to another.
Since returning to office, the Trump administration has pursued a broader policy shift regarding transgender medical care, federal funding and government recognition of biological sex.
The administration’s HHS review has become a central component of that effort. In June 2026, HHS also cited its research when discussing concerns surrounding the clinical guidelines developed by the World Professional Association for Transgender Health (WPATH).
Supporters Applaud the Move
Conservative and pro-life organizations have welcomed the decision, arguing that taxpayers should not be required to finance medical interventions they believe can permanently alter a child’s body.
Liberty Counsel Founder and Chairman Mat Staver praised the administration for eliminating federal funding for the procedures.
“Permanently mutilating children is never the solution, and taxpayers should never be forced to fund it,” Staver said.
Supporters argue that the policy represents a significant shift toward protecting children from irreversible medical interventions while encouraging counseling and other non-surgical approaches to children experiencing gender dysphoria.
