In a major policy shift with potential ripple effects for healthcare debates globally, US Health Secretary Robert F. Kennedy Jr. unveiled sweeping proposals on Thursday, 18 December 2025, aimed at severely limiting gender-affirming medical care for minors.
New Rules Target Funding and Disability Status
Kennedy's announced measures are twofold and carry significant financial weight. The first set of rules would bar hospitals that provide gender-affirming treatments to young people from participating in the massive Medicare and Medicaid programmes. Furthermore, Medicaid and the Children's Health Insurance Program (CHIP) would be prevented from covering the costs of such care.
"So called gender affirming care has inflicted lasting physical and psychological damage on vulnerable young people," Kennedy stated. He went further, asserting, "This is not medicine, it is malpractice."
Redefining 'Disability' and Following Trump's Order
The second major proposal involves a change in how transgender individuals are classified within the healthcare system. Kennedy confirmed that the Department of Health and Human Services (HHS) will block Medicare from funding what he termed "sex-rejecting procedures."
Concurrently, he proposed a rule to remove gender dysphoria as a qualifying disability status. This move aligns with an earlier executive order from President Donald Trump, which sought to reverse policies established under previous Democratic administrations.
Kennedy said he personally signed a declaration stating that "sex-rejecting procedures are neither safe nor effective treatment for children with gender dysphoria."
Widespread Consequences for US Healthcare
The practical impact of these proposals could be vast, given the scale of the programmes involved. Nearly every hospital in the United States participates in Medicare, which serves people aged 65 and older, as well as those with disabilities. The threat of exclusion from this programme could force widespread compliance.
Perhaps more critically for child healthcare, more than half of all children in the US rely on Medicaid and CHIP for their health coverage. Removing financial support for gender-affirming care would place it out of reach for a large portion of the population, fundamentally altering access for transgender youth across the country.
