Trump Administration Takes Aim at Pediatric Gender-Affirming Care Amid Provider Alerts and Billing Controversies

WASHINGTON — The U.S. Department of Health and Human Services (HHS) has called for a halt to various treatments for children experiencing gender dysphoria, specifically mentioning puberty blockers, cross-sex hormones, and surgeries. This directive aligns with a broader critique of current medical practices regarding gender-affirming care.

In a timely statement, the Centers for Medicare & Medicaid Services (CMS) issued letters to hospitals nationwide, indicating their intent to conduct a comprehensive review of federal payment policies concerning these procedures. CMS Administrator Dr. Mehmet Oz expressed concerns about the irreversible nature of such treatments, particularly when funded by taxpayers.

Secretary Robert F. Kennedy Jr. released an open letter urging healthcare providers to heed a recent HHS report which suggested changes in treatment protocols for gender dysphoria. Notably, the report has faced significant backlash from esteemed health organizations, which deemed it flawed.

The HHS letter emphasizes psychotherapy as a non-invasive alternative to medical interventions, questioning the validity of the World Professional Association for Transgender Health’s Standards of Care. It argues that existing guidelines are excessively influenced by legal and political factors rather than clinical evidence.

The report cites the Hippocratic Oath, stressing the medical community’s obligation to avoid harm. It concludes that when medical interventions present disproportionate risks, healthcare providers should refrain from offering them, even if patients request these treatments. HHS has yet to comment on potential repercussions for providers who disregard this guidance.

In response, the World Professional Association for Transgender Health (WPATH) and other organizations condemned the HHS report, asserting that it misrepresents scientific research and ignores the insights of experienced professionals. They argue the report fails to adhere to rigorous scientific standards and neglects critical findings that support gender-affirming treatments.

Dr. Susan J. Kressly, president of the American Academy of Pediatrics, criticized the report for misrepresenting the medical consensus and undermining pediatric care realities. Silence followed from both WPATH and the American Academy of Pediatrics regarding the HHS letter published on Wednesday.

The Endocrine Society, representing over 18,000 healthcare providers, stated that its guidelines maintain transparency and best practices for treating individuals with gender dysphoria. Their stance remains that medical interventions are beneficial for transgender adolescents.

Matt Rose from the Human Rights Campaign criticized the HHS letter as intentional disinformation aimed at undermining healthcare choices made between families and their doctors. According to Rose, this approach jeopardizes the well-being of the community reliant on evidence-based care.

Conversely, Louisiana Republican Sen. Bill Cassidy praised the HHS letter, calling attention to the risks associated with gender transition procedures for minors. He supported the directive as a necessary step towards safeguarding children’s health.

In a related action, CMS’s letter to hospitals requests detailed information about decision-making processes regarding consent for procedures involving minors with gender dysphoria. Hospitals are also instructed to report any adverse events associated with these procedures and the corresponding billing information, as part of a thorough review of federal payment policies for individuals under 19.