Gender-Affirming Care: HHS Increases Provider Scrutiny
- The centers for Medicare & Medicaid Services (CMS) is intensifying its oversight of hospitals that offer gender-affirming care to children.
- Mehmet Oz has given a select group of hospitals 30 days to respond to the probe.
- In letters sent Wednesday, the CMS requested hospitals provide complete financial data for all pediatric sex trait modifications paid for by the government.Regulators also seek details on informed...
CMS and HHS are heightening their scrutiny of gender-affirming care for children, demanding financial data and protocol updates from hospitals. This aggressive stance, covered by News Directory 3, signals a potential shift in access to vital services for transgender youth. Federal regulators, including CMS Administrator Dr. Mehmet Oz and HHS Secretary Robert F. Kennedy Jr., are pressing for detailed facts and changes, sparking debate. Critics decry these actions as politically motivated, fearing they could restrict access to essential treatments.The push for updated protocols and increased oversight follows a controversial HHS literature review. Will more hospitals cease offering gender-affirming care? Discover what’s next as this story unfolds.
CMS, HHS Increase Scrutiny of Gender-Affirming Care for Children
Updated May 30, 2025
The centers for Medicare & Medicaid Services (CMS) is intensifying its oversight of hospitals that offer gender-affirming care to children. The agency is requesting detailed financial information and clinical protocols related to these services. This move marks an escalation of efforts to restrict healthcare for the transgender community.
CMS Administrator Dr. Mehmet Oz has given a select group of hospitals 30 days to respond to the probe. He stated he would not ignore procedures lacking a “solid foundation of evidence.”
In letters sent Wednesday, the CMS requested hospitals provide complete financial data for all pediatric sex trait modifications paid for by the government.Regulators also seek details on informed consent policies for youth gender-affirming care procedures, documentation of adverse events, and plans to update care guidance.
Simultaneously,Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. urged healthcare providers and medical boards to update treatment protocols for youth with gender dysphoria. Kennedy emphasized protecting children from harm.
Both the CMS and HHS letters reference a controversial literature review published by HHS earlier this month. The review claims gender-affirming care offers little benefit and carries long-term risks. Academics, pediatricians, and medical groups have contested the review’s findings, citing concerns about anonymous authorship and political influence.
Despite HHS stating the review was “not a clinical practice guideline,” the government is now asking hospitals to audit and modify their policies accordingly.
Kennedy advocated for psychotherapy as a primary treatment for youth gender dysphoria, rather than puberty blockers, hormone therapy, or surgery. Oz requested documentation on how hospitals plan to align their care protocols with the review.
Kellan Baker, executive director of the Institute for Health Research and Policy at Whitman-Walker, views these actions as an attempt to strong-arm hospitals away from best practices.Baker called the request “a blatant attempt to intimidate providers into betraying their professional obligation to care for their patients.”
arjee Restar, a social and legal epidemiologist at Yale university, expressed concern about the probe’s potential impact on services. “This letter sends a regulatory signal that could discourage hospitals from continuing or expanding gender-affirming care,” Restar said. “Subjecting care that is evidence-based to punitive oversight risks undoing years of clinical and public health progress.”
The Trump administration has been targeting pediatric gender-affirming care since January. Several providers, including Children’s Healthcare of atlanta, Penn State Health, UPMC, and Lurie Children’s Hospital of Chicago, have ceased offering such services.
Penn Medicine announced Thursday it would halt gender-affirming surgeries for those under 19,citing federal guidance.
“This is a challenging decision that we certainly know impacts patients and families who place their trust in our care teams,” said PJ Brennan, Penn Medicine’s chief medical officer. “we remain deeply committed to ensuring a respectful and welcoming habitat for all members of the communities we serve and providing thorough medical and behavioral health care and psychosocial support for LGBTQ+ individuals while complying with federal government requirements.”
Experts are frustrated by what they see as attacks on gender-affirming care and a decline in access to scientifically validated treatments.
“It’s scientifically inappropriate for a federal agency to base clinical oversight on an anonymous, non-peer-reviewed document,” Restar said. “Existing peer-reviewed studies consistently show that gender-affirming care improves mental health and reduces suicidality in trans youth. That’s the evidence CMS should be drawing from.”
Organizations like the American Medical Association, American Psychological Association, and the American Academy of Pediatrics have independently endorsed gender-affirming care as viable treatments.
AAP President Susan Kressly expressed dismay when HHS released its review, stating the document “misrepresents the current medical consensus and fails to reflect the realities of pediatric care.”
Recently, Utah commissioned a literature review on the subject, finding evidence that youth gender-affirming care services reduced suicidality and psychological and social harms for patients.
The authors of the Utah review noted, “The conventional wisdom among non-experts has long been that there are limited data” on pediatric care. “Though, results from our exhaustive literature searches have lead us to the opposite conclusion.”
What’s next
The coming weeks will reveal how hospitals respond to the CMS demands and whether more institutions will curtail gender-affirming care services in light of federal pressure. The long-term impact on access to care for transgender youth remains uncertain.