federal government

The American Academy of Pediatrics sued the U.S. Department of Health and Human Services on Wednesday, seeking to block nearly $12 million in cuts to the group.

Earlier this month, the federal government “abruptly terminated” grants to the group, the lawsuit says.

The funding supported numerous public health programs, including efforts to prevent sudden unexpected infant death, strengthen pediatric care in rural communities and support teens facing substance use and mental health challenges.

“AAP does not have other sources of grant funding to replace the federal awards, and without the necessary funds it must immediately terminate its work on its dozens of programs that save children’s lives every day,” says the lawsuit, filed in the U.S. District Court for the District of Columbia. “Within a few weeks, AAP will have to begin laying off employees dedicated to this critically important work.”

The suit alleges Health and Human Services made the cuts in retaliation for the doctors’ group speaking out against the Trump administration’s positions and actions.

The doctors’ group has been vocal about its support for pediatric vaccines and has publicly opposed the agency’s positions. Health Secretary Robert F. Kennedy Jr. — who helped lead the anti-vaccine movement for years — is seeking to broadly remake federal policies on vaccines. Earlier this year, the pediatrics group released its own recommendations on COVID-19 vaccines, which substantially diverged from the government’s recommendations.

The group also supports access to gender-affirming care and has publicly criticized Health and Human Services positions on the topic, saying it opposes what it calls the government’s infringements on the doctor-patient relationship.

“The Department of Health and Human Services is using federal funding as a political weapon to punish protected speech, trying to silence one of the nation’s most trusted voices for children’s well-being by cutting off critical public health funding in retaliation for speaking the truth,” Skye Perryman, president and chief executive officer of Democracy Forward, said in a statement. Perryman’s organization is representing the doctors’ group in the case.

A spokesman for Health and Human Services could not immediately be reached for comment.

Mark Del Monte, CEO and executive vice president of the 67,000-member doctors’ group, said the organization depends on its relationship with the federal government.

“We need this partnership to advance policies that prioritize children’s health. These vital child health programs fund services like hearing screenings for newborns and safe sleep campaigns to prevent sudden unexpected infant death,” he said in a statement. “We are forced to take legal action today so that these programs can continue to make communities safer and healthier.” 

Ungar writes for the Associated Press.

WASHINGTON — The U.S. Department of Health and Human Services on Thursday unveiled a series of regulatory actions designed to effectively ban gender-affirming care for minors, building on broader Trump administration restrictions on transgender Americans.

The sweeping proposals — the most significant moves this administration has taken so far to restrict the use of puberty blockers, hormone therapy and surgical interventions for transgender children — include cutting off federal Medicaid and Medicare funding from hospitals that provide gender-affirming care to children and prohibiting federal Medicaid dollars from being used to fund such procedures.

“This is not medicine, it is malpractice,” Health Secretary Robert F. Kennedy Jr. said of gender-affirming procedures on children in a news conference on Thursday. “Sex-rejecting procedures rob children of their futures.”

Kennedy also announced Thursday that the HHS Office of Civil Rights will 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.

Proposed rules would threaten youth gender-affirming care in states where it remains 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.

Thursday’s announcements would imperil access in nearly two dozen states where drug treatments and surgical procedures remain legal and funded by Medicaid, which includes federal and state dollars.

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 U.S. hospitals participate in the Medicare and Medicaid programs, the federal government’s largest health plans that cover seniors, the disabled 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 when it comes to care for people under the age of 19, the State Children’s Health Insurance Program, according to a federal notice posted Thursday morning.

Moves contradict advice from medical organizations and transgender advocates

Dr. Mehmet Oz, the administrator of the Centers 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 Center for Public Affairs Research survey conducted earlier this year found that about half of U.S. 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 U.S. medical organizations, including the American Medical Association, which has urged states not to restrict care for gender dysphoria.

Advocates for transgender children strongly refuted the administration’s claims about gender-affirming care and said Thursday’s moves would put lives at risk.

“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. “

Rodrigo Heng-Lehtinen, senior vice president at The Trevor Project, a nonprofit suicide prevention organization for LBGTQ+ youth, called the changes a “one-size-fits-all mandate from the federal government” on a decision that should be between a doctor and patient.

“The multitude of efforts we are seeing from federal legislators to strip transgender and nonbinary youth of the health care they need is deeply troubling,” he said.

Actions build on a larger effort to restrict transgender rights

The announcements build on a wave of actions President 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 recognize 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 U.S. 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.

Swenson, Perrone and Shastri write for the Associated Press. Shastri reported from Milwaukee. AP writer Geoff Mulvihill contributed to this report.