Berliner Tageblatt - Trump health chief seeks to bar trans youth from gender-affirming care

The series of sweeping proposals announced by US health chief Robert F. Kennedy Jr. and other officials would cut off vital federal funding from hospitals that provide pediatric gender transition services -- including puberty blockers, hormone therapies and surgical interventions -- even in states where they are legal.

In announcing his proposals -- which are not final and must go through lengthy review and public comment -- Kennedy called gender-affirming care "malpractice" based on "junk science driven by ideological pursuits."

His health department this year released a report largely written by critics of gender transition that emphasized risks of gender-affirming care and urged counseling before interventions -- a document that proved central to Thursday's announcement.

The proposed measures would prohibit reimbursements for minors' gender-affirming care from Medicaid, the federal program that provides health care coverage to low-income children and adults.

Even more limiting, it would revoke all funding from both Medicaid and Medicare -- the health care program for elderly adults and disabled people -- from any hospital that provides such care.

Such a move would place extreme financial hardship on facilities if they continued to provide such health services.

It puts medical providers in an "extremely precarious position," said Michael Ulrich, a Boston University professor of public health and law.

"I'm not sure there's a provider that exists that doesn't rely substantially on federal money," he told AFP.

- 'Life-saving' care -

The American Civil Liberties Union vowed a legal battle, calling the proposals "cruel" as well as "unconstitutional, saying they target "a vulnerable population for political gain."

The American Academy of Pediatrics -- which just abruptly lost federal funds in the millions including for initiatives to prevent infant death, according to a Washington Post report -- called Thursday's actions and rhetoric "harmful."

"These rules help no one, do nothing to address health care costs, and unfairly stigmatize a population of young people," the organization's president said in a statement.

The LGBTQ advocacy organization Human Rights Campaign said the proposals would "force providers into an impossible choice: stop providing health care to trans youth in order to protect federal funding for every other patient."

Zoe Taylor, a family doctor in the western US state of Washington, called gender-affirming health care "life-saving."

The physician, a fellow with the advocacy organization Physicians for Reproductive Health, said in her practice she's seen "youth thrive once their gender dysphoria is treated."

"Treating trans kids with gender-affirming care prevents and treats other mental health issues that come from society's reaction to trans youth, and also to their own gender dysphoria," she told AFP.

The proposals are an intrusion on the relationship between patients, their families and physicians, she said.

- 'Extremely dangerous' -

Throughout the first year of his second term, President Donald Trump has demonized any recognition of gender diversity and placed strong focus on attacking transgender people.

But the push to withhold broader federal health funding from any provider who offers transgender care scaled up Trump's crusade dramatically.

And it came one day after a split House of Representatives narrowly passed a bill that would criminalize providing gender-affirming medical care to trans minors.

Transgender people are a small proportion of the population, but lawyer Ulrich said the issue is both "extremely bad for transgender youth" and could "open the door" for other controversial government health care decisions.

"I don't think that enough people recognize the extent to which this is the federal government saying, 'We have the authority to declare to hospitals throughout the country what kind of health care they can and cannot provide,'" he said.

"It's an extremely, extremely dangerous proposition for the future."

C.Meier--BTB