Oppose HHS Attacks on Evidence-Based Gender-Affirming Care

I am writing to urge you to oppose the Trump Administration's dangerous attempt to eliminate gender-affirming care for transgender youth through regulatory overreach that ignores medical evidence and threatens healthcare providers with exclusion from Medicare and Medicaid. The Department of Health and Human Services recently released a proposed rule from the Centers for Medicare and Medicaid Services that would prohibit hospitals from providing what it calls "sex-rejecting procedures" to children as a condition of Medicaid participation. Simultaneously, HHS released a 12-page memo threatening to withdraw federal funds from hospitals offering hormone replacement therapy and puberty blockers to young transgender people. These actions bypass normal rulemaking processes and rely on fear rather than science. This approach dismisses established medical organizations like the World Professional Association for Transgender Health and the Endocrine Society, both of which endorse evidence-based interventions for treating gender dysphoria in young people. Instead, the administration relies on controversial sources while ignoring decades of peer-reviewed research supporting these treatments. The threatened exclusions from federal health programs represent what industry compliance guides call the "death penalty" for healthcare providers, typically reserved for institutions committing serious crimes like Medicaid fraud. As Khadijah M. Silver, Supervising Attorney for Civil Rights at Lawyers for Good Government, noted, this declaration abuses a policy document intended for national public health emergencies, not standard-of-care medicine that patients need. There is no federal law banning gender-affirming care for transgender youth. This enforcement strategy creates uncertainty that could force hospitals to deny medically necessary care to vulnerable young people, segregating access to only those who can afford private payment. I urge you to publicly oppose these regulatory attacks, support legal challenges to this overreach, and protect the ability of doctors to provide evidence-based care to their patients without political interference.