Federal Agencies Propose New Limits on Health Care for Transgender Youth
Fast Facts
On December 18, 2025, the Centers for Medicare and Medicaid Services (CMS) proposed two new federal rules that could limit health care for transgender youth.
The rules would restrict access to gender-affirming medical care like puberty blockers and hormone therapy for people under 18.
No rules have changed yet. These are proposals only and are not in effect.
The public can comment on the proposals through February 17, 2026.
Major medical groups say gender-affirming care is safe, effective, and based on science.
The Story
On December 18, 2025, CMS announced two proposed rules that could make it harder for transgender young people to get gender-affirming health care.
Hospital rule
The first proposal would stop most hospitals that accept Medicare or Medicaid from providing gender-affirming medical care to people under 18. This includes puberty blockers, hormone therapy, and surgery. This would apply even if a young person has private insurance or pays out of pocket. Because most hospitals rely on Medicare and Medicaid funding, very few would be able to keep offering this care. Even though this care is already rare among youth, CMS estimates that about 8,500 young people nationwide could lose access to care they currently receive. The rule does not stop other places—like standalone clinics or doctors’ offices—from providing this care, because the proposal only applies to hospitals.
Medicaid and Children’s Health Insurance Program (CHIP) rule
The second proposal would prevent federal Medicaid and CHIP funds from paying for gender-affirming medical care for minors, no matter where the care is provided. States could choose to use their own money to cover this care, but many families who rely on Medicaid or CHIP may not be able to afford care without insurance help. Currently, Wisconsin is one of 26 states that have Medicaid rules clearly allowing coverage for transgender-related health care. In fact, Wisconsin Medicaid is required by a court order (Flack v. Wisconsin Department of Health Services) to cover gender-affirming care.
These proposals are part of a broader effort by the Trump administration to limit access to gender-affirming care, despite opposition from major medical organizations like the American Academy of Pediatrics. If finalized, the rules would almost certainly face court challenges, which could delay or stop them.
Research shows that gender-affirming care can improve mental health and well-being for transgender youth, while denying care can increase the risk of depression and suicide.
What You Can Do
Stay informed: These rules are not final. Understanding what is being proposed helps protect our community.
Submit a public comment: Anyone can share their concerns with CMS before February 17, 2026. Public comments matter and are part of the decision-making process.
Support transgender youth and families: Check in with people who may be affected and help connect them to trusted resources.
Advocate locally: State leaders may have choices about whether to use state funds to protect access to care. Let them know this issue matters to you.