HHS proposes new regulatory actions to prohibit gender transition procedures for minors

WASHINGTON (OSV News) — The U.S. Department of Health and Human Services Dec. 18 announced new regulatory actions that would effectively ban certain types of medical or surgical gender reassignment procedures for minors who identify as transgender.

HHS and the Centers for Medicare & Medicaid Services issued a proposed regulation to bar hospitals from performing gender transition surgeries or providing hormonal treatments for minors experiencing gender dysphoria as a condition of participation in Medicare and Medicaid programs. Almost all hospitals in the U.S. participate in these programs.

However, the regulations are not yet final or legally binding — they must first undergo a rulemaking process, including public comment. They are also expected to face legal challenges.

HHS Secretary Robert F. Kennedy Jr. said at a Dec. 18 press conference that “so-called ‘gender affirming care’ has inflicted lasting, physical and psychological damage on vulnerable young people.”

HHS said the proposed regulatory actions were designed to carry out President Donald Trump’s executive order that sought to prohibit these procedures for minors.

Supporters of banning gender transition surgeries or hormonal treatments for minors who identify as transgender say such restrictions will prevent them from making irreversible decisions as children that they may come to regret as adults. Critics of such bans argue that preventing those interventions could cause other harm to minors, such as mental health issues or increase the risk of physical self-harm.

The U.S. bishops approved in November an updated version of their guiding document on Catholic health care, with substantial revisions that include explicit prohibitions against so-called “gender-affirming care.”

The proposed revisions of the “Ethical and Religious Directives for Catholic Health Care Services,” build on “Dignitas Infinita,” the 2024 declaration on human dignity published by the Vatican’s Dicastery for the Doctrine of the Faith.

“Dignitas Infinita” reaffirmed church teaching on gender, describing sexual difference as “the greatest possible difference that exists between living beings,” which in humans “becomes the source of that miracle that never ceases to surprise us: the arrival of new human beings in the world.”

In guidance on health care policy and practices released in March 2023, the U.S. Conference of Catholic Bishops’ Committee on Doctrine stated the church’s opposition to interventions that “involve the use of surgical or chemical techniques that aim to exchange the sex characteristics of a patient’s body for those of the opposite sex or for simulations thereof.”

“Any technological intervention that does not accord with the fundamental order of the human person as a unity of body and soul, including the sexual difference inscribed in the body, ultimately does not help but, rather, harms the human person,” the document states.

A 2022 study by the UCLA Williams Institute found there are approximately 1.6 million people in the U.S. who identify as transgender, including about 300,000 youth (those 13-17 years old) who identify as transgender.

A recent JAMA Pediatrics study found 926 U.S. adolescents with commercial insurance and a gender-related diagnosis received puberty blockers from 2018 through 2022, and none of them were under the age of 12. The study did not include minors covered by Medicaid.

Twenty-six states and Puerto Rico already ban or restrict such procedures, according to data from the Movement Advancement Project, an LGBTQ+ policy group.

The announcement came as HHS faced criticism for cutting millions of dollars in grants to the American Academy of Pediatrics after that group criticized Kennedy’s changes to federal vaccine policy.

HHS has also recently faced criticism from some pro-life activists for the Food and Drug Administration‘s recent approval of a new generic form of mifepristone, a pill commonly, but not exclusively, used for early abortion. FDA falls under HHS purview.

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