HHS proposes rule barring hospitals from performing gender transition surgeries or hormone treatments on minors to participate in federal programs. Ties to Trump order, Catholic teachings.
Newsroom (19/12/2025 Gaudium Press) The U.S. Department of Health and Human Services on December 18 announced proposed regulatory actions that would effectively prohibit hospitals from performing surgical or medical gender reassignment procedures on minors identifying as transgender as a condition of participating in Medicare and Medicaid programs.
The Centers for Medicare & Medicaid Services, an agency within HHS, issued the proposed rule, which would bar facilities from providing gender transition surgeries or hormonal treatments to minors experiencing gender dysphoria. Given that nearly all U.S. hospitals participate in these federal programs, the regulation, if finalized, could significantly restrict access to such interventions nationwide.
The proposal is not yet binding and must undergo the standard federal rulemaking process, including a period for public comment. Observers widely anticipate legal challenges once the rule advances.
HHS Secretary Robert F. Kennedy Jr., speaking at a December 18 press conference, described what is often termed “gender-affirming care” as having “inflicted lasting, physical and psychological damage on vulnerable young people.”
The department stated that the actions are intended to implement an executive order issued by President Donald Trump aimed at prohibiting these procedures for individuals under 18.
Advocates for restricting such interventions argue that they protect minors from making irreversible decisions during childhood that may lead to regret in adulthood. Opponents contend that denying access to these treatments could exacerbate mental health challenges or elevate risks of self-harm among affected youth.
The announcement aligns with recent developments in Catholic health care guidance. In November, the U.S. Conference of Catholic Bishops approved substantial revisions to the Ethical and Religious Directives for Catholic Health Care Services, incorporating explicit prohibitions against procedures described as “gender-affirming care.”
These updates draw heavily from Dignitas Infinita, a 2024 Vatican declaration on human dignity issued by the Dicastery for the Doctrine of the Faith. The document reaffirms church teaching on sexual difference, calling it “the greatest possible difference that exists between living beings” and the source of the ongoing miracle of new human life.
A March 2023 statement from the bishops’ Committee on Doctrine had already articulated opposition to “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.” It argued that interventions failing to respect the unity of body and soul, including sexually differentiated embodiment, ultimately harm rather than help the human person.
Currently, 26 states and Puerto Rico maintain bans or restrictions on these procedures for minors, according to tracking by the Movement Advancement Project, an organization focused on LGBTQ+ policy.
A 2022 analysis by the UCLA Williams Institute estimated that approximately 1.6 million people in the United States identify as transgender, including roughly 300,000 adolescents aged 13 to 17. Separately, a study published in JAMA Pediatrics documented 926 commercially insured U.S. adolescents with gender-related diagnoses who received puberty blockers between 2018 and 2022, with none younger than 12. The research did not encompass minors covered by Medicaid.
The HHS announcement emerged amid separate controversies involving the department. Critics recently highlighted cuts to millions in grants to the American Academy of Pediatrics following the organization’s opposition to Secretary Kennedy’s adjustments to federal vaccine policy. Additionally, some pro-life advocates have expressed concern over the Food and Drug Administration’s recent approval of a new generic version of mifepristone, a medication commonly used in early abortion procedures. The FDA operates under HHS oversight.
- Raju Hasmukh with files from OSV News
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