Trumps Department of Health and Human Services (HHS) seeks to end all Medicaid and Medicare funding for young peoples gender-affirming care (GAC), according to newly proposed rules shared by NPR. A trans activist said the rules would amount to a de facto national ban on GAC.The proposed rules would prohibit all federal Medicaid and Medicare funding as well as funding through the federal Childrens Health Insurance Program (CHIP) for any services at hospitals that provide GAC for trans youth. Related Gov. Josh Shapiro blasts DOJ for trying to seize young trans patients private medical records These would be proposals that would go out for public comment, it would take months for the Trump administration to issue a final rule, and then, if past is prologue, we would see litigation over whatever the final rules are, Katie Keith, director of the Center for Health Policy and the Law at Georgetown University, told NPR.Terry Schilling, president of theAmerican Principles Project, a right-wing think tank that has pushed national transphobia as an effective Republican political strategy, said of the proposed rules, I think these restrictions are very good. Its going to change the entire transgender industry, and its going to take away a lot of their funding streams. Never Miss a Beat Subscribe to our newsletter to stay ahead of the latest LGBTQ+ political news and insights. Subscribe to our Newsletter today This would be a de facto national ban, wrotetrans activist and civil rights attorneyAlejandra Caraballo via Bluesky. There would still be providers in blue states that dont take federal funding but the large interdisciplinary teams of just a few years ago would be nearly impossible to maintain. The result is that the care that remains would largely be underground with worse support and likely outcomes.Theyll never be able to fully ban this care, Caraballo added. There will always be providers willing to provide it like abortion. Even without access to providers, many trans youth will simply go DIY [do-it-yourself] like trans folks have done for decades. Theyre not actually banning this care, theyre making it less safe. The administrations toxic war on gender-affirming careThough there is no federal law banning gender-affirming care, the current presidential administration has sought to eradicate the practice through a Januaryexecutive order(that has since beenblocked by several courts). The order instructed the DOJ to extend the time that patients and parents can sue gender-affirming doctors and to use laws against false advertising to prosecute any entity that may be misleading the public about the long-term effects of gender-affirming care (GAC).In April, Bondi issued a memo to DOJ employees, telling them to investigate and prosecute cases of minors accessing gender-affirming care as female genital mutilation (FGM), even though hospitals dont conduct such female genital surgeries. The memothreatened to jail doctors for 10 yearsif they provide gender-affirming care to young trans people. The following June, the DOJsent subpoenas to 20 medical providerswho offer GAC to trans youth, demanding patients Social Security numbers, emails, home addresses, and information on the care they received, as well as other sensitive information dating back to January 2020. A federal judge blocked the subpoenain one instance and accused the DOJ of going on a bad faith fishing expedition to interfere with states rights to protect GAC within its borders, to harass and intimidate providers from offering such care, and to dissuade patients from seeking such care.Fewer than 3,000 teens nationwide receive puberty blockers or hormone replacement therapy,according to a 2025 JAMA analysisof private insurance data. Gender-affirming care is supported by all major medical associations in the U.S., including the American Medical Association, the Endocrine Society, and the American Academy of Pediatrics, as safe and life-saving for young people with gender dysphoria.One doctor interviewed byThe Washington Postcalled the federal governments crusade against gender-affirming care a toxic plan that will force some patients to detransition, potentially forcing them into adverse psychological and physical effects, including increased anxiety, depression, and the development of unwanted physical changes.Subscribe to theLGBTQ Nation newsletterand be the first to know about the latest headlines shaping LGBTQ+ communities worldwide.