Susan's Place Transgender Resources

Title:  HHS to Prohibit Hospitals From Performing Sex-Change Surgery on Kids

Link To: Article[/b] (https://childrenshealthdefense.org/defender/hhs-prohibit-hospitals-from-performing-sex-change-surgery-kids/?utm_source=cc&utm_medium=email&utm_campaign=defender&utm_id=20251219%5Bb)
Author:   Suzanne Burdick, Ph.D.
Date: 19 December 2025

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Brief summary of the article
The article reports that U.S. health officials plan to ban gender-affirming medical procedures for minors, cut Medicare and Medicaid funding for providers who perform them, and issue new federal rules to enforce the policy. Officials argue the treatments harm children, criticize what they describe as a profit-driven industry, reject claims about suicide risk, and announce support for research and care for youths who seek to detransition.

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Main Points of the Article
"Federal health officials are taking action to prohibit hospitals from performing sex-rejecting procedures on children and support the families of children who underwent such procedures and now regret it."

"Sex-rejecting procedures, or 'gender-affirming care,' refers to the use of puberty blockers, cross-sex hormones and/or surgery as a treatment for gender dysphoria."

"Children are falling prey to a 'predatory multi-billion dollar industry,' said U.S.  Health Secretary Robert F.  Kennedy Jr.  Kennedy cited a study that reported profits from sex-rejecting drugs and surgeries surpassed $4.4 billion in 2023."

"Hospitals rake in millions of dollars by convincing boys and girls that a lifetime of off-label prescriptions for estrogen and testosterone blockers, chest reconstruction surgeries and more are the only way to achieve true happiness and belonging in life.  It's wrong.  The Trump administration will not stand by while ideology, misinformation and propaganda push young people into decisions they cannot fully understand and that they can never reverse."

"Hospitals that perform sex-rejecting procedures on minors will no longer be eligible for Medicaid or Medicare funding."

"The 'overwhelming body of evidence' shows 'these procedures hurt, not help children,' Kennedy said."

"[NIH] will do science aimed at helping kids who are 'de-transitioning' or wanting to 'de-transition' back to their original sex and their families."

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Best Wishes Always
Sarah B
Global Moderator

Since it's not happening at all, they are just wasting their time.

That's not what is going on and the headline of this post is somewhat misleading. HHS coined a new term 'sex-rejecting procedure', which according to them includes puberty blockers and hormone therapy. Those things do happen for minors and HHS wants to block them using this policy.

That's not a legitimate source.

https://en.wikipedia.org/wiki/Children%27s_Health_Defense

Hi Everyone

I quoted the CHD article to report how the issue was being framed, not to endorse it as an authority.  Like any outlet, including Wikipedia, it has limitations, which is why the veracity of any article should be checked against multiple sources.  My point was to make people aware of the article itself and readers are free to judge the sources for themselves.

Best Wishes Always
Sarah B
Global Moderator
@Susan @Northern Star Girl @Devlyn @Iztaccihuatl

Introduction

What follows is ordinary statutory and administrative-law analysis. It is not advocacy, not medical guidance, and not commentary on the underlying policy debate. Explaining the limits Congress placed on an agency's authority is basic civics and foundational administrative law.

Based on a review of the governing statutes, relevant case law, and the scope of CMS's delegated authority, there is a fundamental legal defect in the agency's proposal: Congress explicitly prohibited the federal government from using Medicare or Medicaid to control the practice of medicine.

I. Congress Drew a Bright Line in 1965

When Medicare was enacted in 1965, lawmakers were acutely aware of physicians' concerns that federal payment could be used as leverage to dictate clinical decision-making. The American Medical Association had opposed Medicare for years, warning that government reimbursement would inevitably lead to government control over medical judgment. Many physicians feared that participation would place their professional decisions under bureaucratic supervision.

Congress addressed those concerns directly and deliberately by including Section 1801 of the Social Security Act, codified at 42 U.S.C. § 1395. The statute's language is clear, categorical, and unusually broad:

QuoteNothing in this subchapter shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.

This provision was not boilerplate or incidental. It reflected a deliberate legislative compromise: the federal government would finance medical care for the elderly and disabled, but it would not dictate how that care was delivered. Congress placed this prohibition at the very beginning of Title XVIII, before any operational or enforcement provisions, underscoring that it was meant to constrain everything that followed. Medicare was designed as a payment program, not as a mechanism for federal control over clinical practice.

II. What CMS Can Lawfully Do

Within those limits, CMS does possess meaningful regulatory authority. The Social Security Act permits the agency to establish "conditions of participation" for hospitals and other providers that seek reimbursement under Medicare and Medicaid. These conditions are intended to ensure that facilities meet baseline standards of safety, competence, and operational reliability.

Historically, conditions of participation have addressed matters such as recordkeeping, staffing qualifications, infection control, emergency preparedness, and facility operations. They regulate how care is delivered in an institutional setting, not which medical treatments physicians may offer to their patients. Their purpose is to ensure that hospitals are capable of providing care safely, not to substitute federal judgment for clinical judgment.

The Supreme Court reaffirmed this distinction in *Biden v. Missouri* (2022), when it upheld CMS's COVID-19 vaccination requirement for healthcare workers. The Court emphasized that the mandate fit within the agency's authority because it directly addressed patient safety within healthcare facilities. It did not dictate the content of medical treatment or prohibit physicians from providing particular forms of care. Even in that context, the Court recognized that CMS's authority is limited and tethered to safety and operational concerns.

Justice Thomas, in dissent, warned explicitly that the agency's power to impose health-and-safety requirements should not be manipulated into a general authority to control medical practice. That warning is directly implicated by the proposal at issue.

III. What CMS Cannot Lawfully Do

The proposed rule crosses the boundary Congress drew. CMS is not imposing a safety protocol or an operational standard. Instead, it seeks to prohibit an entire category of medical treatment by threatening to terminate all Medicare and Medicaid funding for hospitals that provide it.

This is not how conditions of participation have ever functioned. Traditional conditions ask whether a facility is safe, competently managed, and capable of delivering care. The proposed rule asks whether a facility offers a treatment the current administration disfavors. That shift transforms a quality-control mechanism into a tool of substantive medical regulation.

CMS has never been granted authority to decide which treatments physicians may offer. Doing so constitutes supervision and control over the practice of medicine—the very power Congress expressly withheld. Conditioning participation in federal payment programs on the abandonment of particular medical treatments is indistinguishable from direct regulation of clinical practice.

IV. The Unprecedented Nature of the Proposal

Legal commentators across ideological lines have recognized how sharply this proposal departs from settled administrative practice. Using Medicare and Medicaid as leverage to ban specific medical treatments represents a dramatic expansion of executive power. If accepted, it would establish a precedent under which any medical service could be targeted through funding threats alone.

Under that framework, future administrations could condition participation in federal programs on whether hospitals provide end-of-life care, contraception, fertility treatments, pain management protocols, or any other form of care that becomes politically disfavored. The practical effect would be to place control over American medicine in the hands of whoever occupies the executive branch at a given moment.

That outcome would invert the structure Congress created. Clinical judgment would become subordinate to political priorities, and professional medical standards would yield to administrative fiat. This is precisely the result Congress sought to prevent when it enacted Section 1801.

V. The Absence of Statutory Authorization

No federal statute prohibits the medical treatments at issue. Congress has not enacted such a ban, despite having considered related legislation. Instead, the administration seeks to accomplish indirectly—through funding pressure—what it lacks authority to impose directly through law.

Administrative agencies may implement statutes; they may not replace them. An agency cannot manufacture authority simply because Congress declined to act. When CMS claims it is operating under its "longstanding authority," it ignores the fact that the foundational statute governing Medicare explicitly limits that authority in this domain.

VI. Judicial Skepticism and Likely Review

Courts have already expressed skepticism toward similar efforts. Federal district courts have issued nationwide and preliminary injunctions blocking related enforcement actions, recognizing that the administration is likely exceeding its statutory bounds. Those rulings reflect a broader judicial unwillingness to allow agencies to circumvent Congress through expansive interpretations of delegated authority.

The proposed rule will face immediate legal challenge. Its defenders will need to explain how a categorical prohibition on medical treatment can be reconciled with a statute that expressly forbids federal control over medical practice. Given the clarity of the statutory text, the legislative history, and decades of consistent administrative practice, that defense will be difficult to sustain.

VII. Conclusion

The legal question presented is straightforward. Medicare and Medicaid are payment programs, not instruments of federal medical governance. Congress drew that line explicitly in 1965, and it remains binding law today.

CMS may regulate how facilities operate to ensure safety and competence. It may not dictate which treatments physicians may provide. The proposed rule attempts to do exactly what Congress forbade: use federal funding to exercise supervision and control over the practice of medicine.

Whatever one's views on the underlying policy debate, the administrative-law analysis is clear. CMS lacks statutory authority for this action. The prohibition Congress enacted six decades ago remains in force, and it bars the agency from proceeding as proposed.

@Susan

Thank you for this. It helps dispel a lot of misinformation being circulated.