“Procedures that reject gender identity deprive young people of their potential,” critics argue.

The proposed federal changes could jeopardize access to medical treatments and surgeries for transgender youth in nearly two dozen states where such care is currently legal and supported by Medicaid, which is funded by both federal and state resources.

These proposals stand in opposition to the guidance of numerous leading U.S. medical organizations. Advocates for transgender children have strongly criticized the administration’s stance on gender-affirming care, warning that these new measures could endanger lives.

“It’s deeply concerning to see so many federal lawmakers attempting to deny transgender and nonbinary youth the healthcare they require,” expressed Rodrigo Heng-Lehtinen of The Trevor Project, a non-profit focused on suicide prevention for LGBTQ+ youth. Heng-Lehtinen condemned the proposals as a “one-size-fits-all mandate from the federal government,” insisting that such decisions should remain between a doctor and patient.

If implemented, these rules could significantly impact youth gender-affirming care in states where it is still legal.

Medicaid programs in slightly less than half of states currently cover gender-affirming care.

At least 27 states have adopted laws restricting or banning the care. The Supreme Court’s recent decision upholding Tennessee’s ban means most other state laws are likely to remain in place.

The proposals announced by Kennedy and his deputies are not final or legally binding. The federal government must go through a lengthy rulemaking process, including periods of public comment and document rewrites, before the restrictions becoming permanent. They are also likely to face legal challenges.

But the proposed rules will likely further intimidate health care providers from offering gender-affirming care to children and many hospitals have already ceased such care in anticipation of federal action.

Nearly all US hospitals participate in the Medicare and Medicaid programs, the federal government’s largest health plans that cover seniors, people with disabilities and low-income Americans. Losing access to those payments would imperil most U.S. hospitals and medical providers.

The same funding restrictions would apply to a smaller health program, the State Children’s Health Insurance Program, when it comes to care for people under the age of 19, according to a federal notice posted on Thursday morning.

Kennedy also announced that the HHS Office of Civil Rights would propose a rule excluding gender dysphoria from the definition of a disability.

In a related move, the Food and Drug Administration issued warning letters to a dozen companies that market chest-binding vests and other equipment used by people with gender dysphoria.

Manufacturers include GenderBender LLC of Carson, California and TomboyX of Seattle. The FDA letters state that chest binders can only be legally marketed for FDA-approved medical uses, such as recovery after mastectomy surgery.

Moves contradict advice from medical organisations and transgender advocates

Dr Mehmet Oz, the administrator of the Centres for Medicare and Medicaid Services, on Thursday called transgender treatments “a Band-Aid on a much deeper pathology,” and suggested children with gender dysphoria are “confused, lost and need help.”

Polling shows many Americans agree with the administration’s view of the issue. An Associated Press-NORC Centre for Public Affairs Research survey conducted in May found that about half of US adults approved of how Trump was handling transgender issues.

Chloe Cole, a conservative activist known for speaking about her gender-transition reversal, spoke at the news conference to express appreciation. She said cries for help from her and others in her situation “have finally been heard”.

But the approach contradicts the recommendations of most major US medical organisations, including the American Medical Association, which has urged states not to restrict care for gender dysphoria.

“In an effort to strongarm hospitals into participating in the administration’s anti-LGBTQ agenda, the Trump Administration is forcing health care systems to choose between providing lifesaving care for LGBTQ+ young people and accepting crucial federal funding,” Dr. Jamila Perritt, a Washington-based OB/GYN and president and CEO of Physicians for Reproductive Health, said in a statement.

“This is a lose-lose situation where lives are inevitably on the line. “

Actions build on a larger effort to restrict transgender rights

The announcements build on a wave of actions President Donald Trump, his administration and Republicans in Congress have taken to target the rights of transgender people nationwide.

On his first day in office, Trump signed an executive order that declared the federal government would recognise only two immutable sexes: male and female. He also has signed orders aimed at cutting off federal support for gender transitions for people under age 19 and barring transgender athletes from participating in girls’ and women’s sports.

On Wednesday, a bill that would open transgender health care providers to prison time if they treat people under the age of 18 passed the US House and heads to the Senate. Another bill under consideration in the House on Thursday aims to ban Medicaid coverage for gender-affirming care for children.

Young people who persistently identify as a gender that differs from their sex assigned at birth are first evaluated by a team of professionals. Some may try a social transition, involving changing a hairstyle or pronouns. Some may later also receive hormone-blocking drugs that delay puberty, followed by testosterone or estrogen to bring about the desired physical changes in patients. Surgery is rare for minors.