(ZENIT News / Washington, 12.24.2025).- The U.S. federal government is preparing to redraw the boundaries of pediatric medicine in one of the most contested areas of contemporary healthcare. On December 18, the Department of Health and Human Services (HHS), under the leadership of Robert F. Kennedy Jr., announced forthcoming regulatory actions aimed at ending medical procedures intended to alter a child’s sex. The rationale offered by the department is unambiguous: such interventions expose minors to irreversible harm.
At the center of the initiative is a shift in how federal health programs will define acceptable standards of care. HHS intends to make participation in Medicare and Medicaid contingent on hospitals refraining from providing sex-change-related treatments to minors. In practical terms, this condition would affect the vast majority of U.S. hospitals, given their dependence on public funding streams. Facilities that wish to remain within these programs would be barred from administering puberty blockers, cross-sex hormones, or surgical procedures designed to modify a child’s body to align with an asserted gender identity different from biological sex.
The department’s announcement frames the issue not as one of politics or identity, but of child protection and medical responsibility. According to the policy outline, the federal government seeks to avoid complicity—direct or indirect—in practices that may permanently compromise a young person’s physical development. Cited risks include infertility, impaired sexual function, reduced bone density, and potential effects on neurological development, outcomes the department characterizes as both severe and irreversible.
Implementation of the policy would proceed through the Centers for Medicare and Medicaid Services (CMS), which plans to issue additional proposed rules prohibiting Medicaid funding for these procedures in individuals under 18. A parallel restriction would apply to the Children’s Health Insurance Program (CHIP), extending the age threshold to 19. Together, these measures would effectively close federal funding channels for pediatric gender-transition treatments.
Kennedy described the initiative as a moral and governmental obligation. He said the administration, acting at the direction of President Donald Trump, intends to use every available tool to stop what he called dangerous and irreversible practices affecting children. The administration’s stated objective is to safeguard the most vulnerable, asserting that minors deserve protection rather than experimental medical interventions.
CMS Administrator Dr. Mehmet Oz reinforced that message, arguing that the proposed rules clarify long-standing responsibilities within federal health programs. In his view, hospitals participating in Medicare and Medicaid must adhere to evidence-based care standards and avoid unproven procedures that carry life-altering risks for children. The proposed regulations, he said, align federal policy with a duty to prioritize safety and long-term health outcomes.
The announcement follows closely on the release of an HHS-sponsored review titled Treatment for Pediatric Gender Dysphoria: Review of the Evidence and Best Practices. That report examines existing medical literature and insurance claims data, concluding that the evidence supporting pediatric gender-transition treatments is weak while the associated risks are substantial. According to claims data referenced in the report, nearly 14,000 minors underwent such procedures between 2019 and 2023.
Christine, the department’s deputy general counsel, underscored the ethical implications of those findings. She said that medical professionals have an obligation to rely on sound evidence and to refrain from interventions that could burden young patients with lifelong consequences. From the department’s perspective, puberty is a natural developmental process, not a pathology requiring pharmaceutical or surgical correction.
Beyond hospital-based care, HHS also announced enforcement actions through the Food and Drug Administration. The FDA is issuing warning letters to a dozen manufacturers and retailers accused of illegally marketing chest binders to minors as treatments for gender dysphoria. While such compression garments are classified as low-risk medical devices when used for post-mastectomy recovery, federal regulators argue that promoting them to healthy minors for gender-related purposes violates existing regulations.
HHS is also moving to revise civil rights regulations by clarifying the definition of disability. The proposed change would exclude gender dysphoria not rooted in a physical impairment, a step the department says is necessary to prevent anti-discrimination laws from being interpreted as mandates for gender-transition procedures.
Support for the administration’s approach has come from several advocacy and ethics organizations. Stanley Goldfarb, president of Do No Harm, described the proposed hospital regulations as a critical safeguard against what he termed a harmful gender ideology. He argued that public funds should not underwrite medical practices that permanently alter children’s bodies, noting that a number of so-called gender clinics have already closed as concerns about long-term risks have gained public attention.
Mary Rice Hasson, who directs the Person and Identity Project at the Ethics and Public Policy Center, also praised the initiative. She said the proposed rules send a clear signal to states and healthcare professionals that such interventions are unethical and dangerous. In her view, medical claims that promise a child escape from biological reality are fundamentally misleading, offering only the illusion of change while damaging otherwise healthy bodies.
Religious leaders have echoed these concerns, particularly within the Catholic Church. Earlier this year, Bishop Robert Barron, chair of the U.S. bishops’ committee on laity, marriage, family life, and youth, welcomed President Trump’s executive action addressing these procedures. He warned that attempts to change a child’s sex are rooted in a flawed understanding of human nature and have already left many young people with lasting regrets, including infertility and lifelong dependence on hormone therapies.
Barron argued that it is unacceptable to steer children toward invasive medical interventions rather than providing care that affirms their dignity and integrates their physical and psychological well-being. His remarks reflect a broader religious critique that sees the issue not only as a medical debate, but as a question of anthropology and moral responsibility.
The administration’s announcement signals a decisive shift in federal health policy—one that places the weight of public funding and regulatory authority behind a clear position: when it comes to children, the government intends to err on the side of restraint, caution, and long-term protection.
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