Yesterday, the Trump Administration finalized its rules barring Medicaid funding from being used for trans healthcare for people who are 18 and younger. This means an end to funding for puberty blockers, hormones, and surgeries related to medical transition.
These rules take effect on Oct. 13.
The rule changes are the latest steps in a campaign which the Trump administration has been waging since its first days back in office: ending trans healthcare, particularly for trans children.
Still, this is a far narrower plan than what the administration initially planned to implement.
This proposal was initially floated alongside a much broader one that would have barred Medicaid funding for any medical facility that provides trans healthcare to people under 19. Seeing as nearly every medical facility in the United States takes medicare funding either directly or indirectly, this would have effectively prevented most clinics from providing this care.
That proposal was halted last month, as seen from an internal memo from within the Department of Health and Human Services.
This current ban is far narrower in scope, as it only stops funding for specific care and procedures instead of targeting any facility that provides them. As Medicaid primarily assists people with lower incomes and limited resources, the new rules will primarily affect children from poorer families, who have less ability to pay for this care through other means.
While this proposal cuts off a key source of funding, the number of trans youth who could access care was already quite low.
In recent years, 27 states passed varying types of bans on youth and young adult transition care, meaning that trans kids in those states will not be any more restricted from care than they are now. The new Medicaid rules will remove another key source of funding.
Also, an unknown number of kids who want to medically transition are prevented from doing so by their own parents, a factor that can be seen regardless of where they live or the finances of their parents.
As it stands, only around 1,000 trans kids in the United States are able to medically transition in a given year, meaning that for the vast majority of trans kids, bodily autonomy is already out of reach.
This is what doctor Drew Updike calls “the banality of cruelty.” This policy isn't bad because it radically changes the landscape of trans healthcare, but because it is yet another “boring government document” making trans life harder.
