CMS tells states Medicaid funds cannot be used for gender-affirming care

The Centers for Medicare and Medicaid Services (CMS) is urging states to not use Medicaid funds for gender-affirming care for minors, specifically gender reassignment surgeries or hormone treatments.  

“As a doctor and now CMS Administrator, my top priority is protecting children and upholding the law,” Mehmet Oz, the recently confirmed agency head, said in a statement Friday.  

“Medicaid dollars are not to be used for gender reassignment surgeries or hormone treatments in minors—procedures that can cause permanent, irreversible harm, including sterilization," he continued. "We have a duty to ensure medical care is lawful, necessary, and truly in the best interests of patients.” 

The CMS sent a letter to state Medicaid agencies Friday notifying them of their responsibility to make sure program payments are “consistent with quality of care” and that covered services are in the best interest of the patient.  

The letter, signed by CMS Deputy Administrator and Director Drew Snyder, claims both surgery and hormone treatments lack evidence to support that they offer long-term benefits for transgender minors and that these interventions can cause "long-term and irreparable harm."

It adds that some developed countries like the United Kingdom, Sweden and Finland have issued restrictions on the use of puberty blockers and hormone treatments on children.  

However, every major medical association in the U.S. supports gender-affirming care, including gender reassignment surgery and hormone treatments, for transgender adults and minors. 

The American Medical Association also supports public and private health insurance coverage for the gender-affirming care to treat gender dysphoria and opposes the “denial of health insurance based on sexual orientation or gender identity.”  

At least 10 states — Kentucky, Arizona, Idaho, Missouri, Florida, Nebraska, Ohio, South Carolina, Tennessee and Texas — have introduced legislation to prohibit Medicaid coverage of gender-affirming care for adults and minors, according to nonprofit think tank the Movement Advancement Project.