New Trump Administration Proposals Would Further Limit Gender Affirming Care for Young People by Restricting Providers and Reducing Coverage Authors: Lindsey Dawson and Scott Hulver Published: Dec 22, 2025

https://www.kff.org/lgbtq/new-trump-administration-proposals-would-further-limit-gender-affirming-care-for-young-people-by-restricting-providers-and-reducing-coverage/?utm_campaign=31978628-KFF-LGBTQ&utm_medium=email&_hsenc=p2ANqtz--9OXbX068T4x1UQ0OVUMEhdhUc-FrWGHcTYf095Oy_ws7FZTfQwaPHPWn9E6c2vG4FZQ2wLHrWIOf9UlFSui95XXXCIg&_hsmi=395626533&utm_content=395626533&utm_source=hs_email Examining Newly Proposed Federal Rules That Would Further Limit Youth Access to Gender Affirming Care Following the release of two proposed federal rules that aim to further limit youth access to gender affirming care, KFF examines what they include and what they could mean for transgender youth who seek this care, and for their providers. These rules align with a Trump Administration Executive Order released earlier this year and build on a range of other state and administrative actions intended to limit access to gender affirming care. One proposed rule prohibits the provision of certain gender affirming care services as a condition of hospital participation in Medicare and Medicaid. The KFF brief reviews the implications, which include restricting care access in most hospitals, including for patients with private insurance. With Medicare and Medicaid accounting for almost half of spending on care in hospitals, if the rule were finalized, hospitals are unlikely to continue providing gender affirming care. The other proposed rule would ban federal Medicaid and Children's Health Insurance Program payments for the same types of care across all providers (not just hospitals). As the KFF brief explains, this proposed rule would have a significant — though uneven — impact on access, limiting coverage for families who would find paying for gender affirming care out-of-pocket most challenging. The public has 60 days to comment on the rules, after which the administration could modify or take action to finalize them. If finalized, they are likely to face legal challenges. CONTACT: Craig Palosky | 202.654.1369| CraigP@kff.org