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President Donald J. Trump watches as Robert F. Kennedy Jr., Health and Human Services Secretary, speaks after being sworn in on Thursday, Feb. 13, 2025, in Washington, D.C. / Credit: Jabin Botsford/The Washington Post via Getty Images

Washington, D.C. Newsroom, Dec 18, 2025 / 13:31 pm (CNA).

The Department of Health and Human Services (HHS) proposed regulations today that would seek to end “sex-rejecting procedures” on anyone younger than 18 years old, which includes restrictions on hospitals and retailers.

Under one proposal, the Centers for Medicare & Medicaid Services (CMS) would withhold all funding through Medicare and Medicaid to any hospital that offers surgeries or drugs to minors as a means to make them resemble the opposite sex. The proposed rules would prohibit federal Medicaid funding for “sex-rejecting procedures” on anyone under 18 and prohibit federal Children’s Health Insurance program (CHIP) funding for the procedures on anyone under 19.

This includes surgical operations, such as the removal of healthy genitals to replace them with artificial genitals that resemble the opposite sex and chest procedures that remove the healthy breasts on girls or implant prosthetic breasts on boys.

It also includes hormone treatments that attempt to masculinize girls with testosterone and feminize boys with estrogen and puberty blockers, which delay a child’s natural developments during puberty.

HHS also announced that the Food and Drug Administration (FDA) is issuing warning letters to 12 manufacturers and retailers that they accuse of illegally marketing “breast binders” to girls under the age of 18 as a treatment for gender dysphoria. Breast binders compress breasts as a means to flatten them under their clothing.

The news release said breast binders are Class 1 medical devices meant to help recover from cancer-related mastectomies, and the warning letters will “formally notify the companies of their significant regulatory violations and how they should take prompt corrective action.”

Additionally, HHS is working to clarify the definition of a “disability” in civil rights regulations to exclude “gender dysphoria” that does not result from physical impairments. This ensures that discrimination laws are not interpreted in a way that would require “sex-rejecting procedures,” the statement said.

HHS Secretary Robert F. Kennedy Jr. said in a news conference that “sex-rejecting procedures” on minors are “endangering the very lives that [doctors] are sworn to safeguard.”

“So-called gender-affirming care has inflicted lasting physical and psychological damage on vulnerable young people,” he said. “This is not medicine — it is malpractice.” 

The proposals would conform HHS regulations to President Donald Trump’s Jan. 28 executive order to prohibit the “chemical and surgical mutilation” of children. The order instructed HHS to propose regulations to prevent these procedures on minors.

In a news release, HHS repeatedly referred to the medical interventions as “sex-rejecting procedures” and warned they “cause irreversible damage, including infertility, impaired sexual function, diminished bone density, altered brain development, and other irreversible physiological effects.”

HHS cited its own report from May, which found “deep uncertainty about the purported benefits of these interventions” for treating a minor with gender dysphoria. The report found that “these interventions carry risk of significant harms,” which can include infertility, sexual dysfunction, underdeveloped bone mass, cardiovascular disease, metabolic disorders, psychiatric disorders, and adverse cognitive impacts, among other complications.

Stanley Goldfarb, chairman of Do No Harm, a medical advocacy group, said in a statement that the proposed regulation on hospitals is “another critical step to protect children from harmful gender ideology” and said he supports rules that ensure “American taxpayer dollars do not fund sex-change operations on minors.”

“Many so-called gender clinics have already begun to close as the truth about the risks and long-term harms about these drugs and surgeries on minors have been exposed,” he said. “Now, hospitals that receive taxpayer funds from these federal programs must follow suit.”

Mary Rice Hasson, director of the Person and Identity Project at the Ethics and Public Policy Center (EPPC), said she sees the proposed restriction on hospitals as “excellent.”

“This proposed rule sends a powerful message to states and health care providers: It’s time to stop these unethical and dangerous procedures,” Hasson said. “Puberty is not a disease to be medicated away. All children have the right to grow and develop normally.”

“Sex-rejecting procedures promise the impossible: that a child can escape the reality of being male or female,” she added. “In reality, these sex-rejecting procedures provide only the illusion of ‘changing sex’ by disabling healthy functions and altering the child’s healthy body through drugs and surgery that will cause lifelong harm.”

In January, Bishop Robert Barron, chair of the United States Conference of Catholic Bishops’ (USCCB) Committee on Laity, Marriage, Family Life, and Youth, welcomed Trump’s executive action on these procedures, warning that they are “based on a false understanding of human nature, attempt to change a child’s sex.”

“So many young people who have been victims of this ideological crusade have profound regrets over its life-altering consequences, such as infertility and lifelong dependence on costly hormone therapies that have significant side effects,” Barron said. “It is unacceptable that our children are encouraged to undergo destructive medical interventions instead of receiving access to authentic and bodily-unitive care.”