US To Ban Sex-altering Procedures On Minors

The United States Department of Health and Human Services (HHS) has announced a series of proposed regulatory actions aimed at implementing President Donald Trump’s Executive Order directing the agency to end sex-rejecting procedures on children, citing concerns over irreversible harm to minors.

In a statement released on Thursday and published on the HHS website, the department said the measures target pharmaceutical and surgical interventions intended to align a child’s physical appearance with an asserted identity different from their biological sex.

As part of the initiative, the Centres for Medicare & Medicaid Services (CMS) will issue a notice of proposed rulemaking to bar hospitals from performing sex-rejecting procedures on children under the age of 18 as a condition for participation in Medicare and Medicaid programmes.

HHS noted that nearly all hospitals in the United States participate in these federal programmes, adding that the action is designed to ensure the government does not contract with institutions that inflict permanent harm on children.

CMS said it was proposing the rule under sections 1861(e)(9), 1871, and 1905(a) of the Social Security Act, which grant the agency authority to establish standards protecting patient health and safety in Medicare and Medicaid participating hospitals.

In addition, CMS will propose a separate rule to prohibit federal Medicaid funding for sex-rejecting procedures on children under 18, as well as Children’s Health Insurance Program (CHIP) funding for individuals under 19.

According to HHS, 27 states currently do not provide Medicaid coverage for such procedures. The department warned that interventions such as puberty blockers, cross-sex hormones, and related surgeries can cause irreversible damage, including infertility, impaired sexual function, reduced bone density, altered brain development, and other long-term physiological effects.

Health and Human Services Secretary Robert F. Kennedy Jr., who signed a declaration based on an HHS peer-reviewed report, said the procedures “do not meet professionally recognised standards of health care.” He added that practitioners who perform sex-rejecting procedures on minors would be deemed non-compliant with those standards.

“Under my leadership, and answering President Trump’s call to action, the federal government will do everything in its power to stop unsafe, irreversible practices that put our children at risk,” Kennedy said. “This administration will protect America’s most vulnerable. Our children deserve better—and we are delivering on that promise.”

CMS Administrator Dr Mehmet Oz also defended the proposal, saying children should be protected from “experimental interventions” that carry life-altering risks without reliable evidence of benefit.

“This proposal seeks to clarify that hospitals participating in our programs cannot conduct these unproven procedures on children,” Oz said, adding that CMS would ensure federal standards reflect the responsibility to safeguard children’s health and safety.

Meanwhile, the U.S. Food and Drug Administration (FDA) announced it is issuing warning letters to 12 manufacturers and retailers for the illegal marketing of breast binders to children for gender dysphoria. The products are typically intended for medical uses such as post-mastectomy recovery.

FDA Commissioner Dr Marty Makary said the agency would take further enforcement actions, including import alerts, seizures, and injunctions, if the practice continues.

HHS also disclosed plans to reverse a Biden-era move to include gender dysphoria in the definition of a disability. Deputy Secretary Jim O’Neill said the previous administration “abused a law” not intended to compel healthcare providers or programmes to support transgender surgeries for minors.

“Our rule would restore regulatory clarity and ensure that organisations receiving federal funds can set evidence-based policies without fear of violating federal civil rights requirements,” O’Neill said.

Assistant Secretary for Health and Head of the U.S. Public Health Service Commissioned Corps, Admiral Brian Christine, said evidence shows sex-rejecting interventions pose serious risks to children and that providers have a duty to offer care grounded in sound medical evidence.

HHS further revealed that claims data indicate nearly 14,000 minors received sex-rejecting procedures between 2019 and 2023. A peer-reviewed study by the department, Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices, underscores the medical risks associated with such interventions.