Overview

• CMS Administrator Dr. Mehmet Oz issued a directive on April 11, 2025, instructing state Medicaid agencies to cease funding gender-affirming surgeries and hormone treatments for minors.
• The directive claims these procedures can cause permanent, irreversible harm, including sterilization, and cites federal Medicaid rules prohibiting funding for treatments that impair reproductive capacity under age 21.
• The CMS letter, signed by Deputy Administrator Drew Snyder, argues there is insufficient evidence supporting the long-term benefits of gender-affirming care for minors, referencing restrictions in countries like the UK, Sweden, and Finland.
• Major U.S. medical associations, including the American Medical Association, continue to support gender-affirming care as medically necessary, highlighting professional disagreement with the CMS stance.
• Advocacy groups and former officials have criticized the directive as politically motivated, alleging it misuses Medicaid regulations to advance an anti-transgender agenda.