All of us deserve to access health care without fear or shame, and to decide with our doctors what care is right for us. But for trans people in our community, access to essential health care is under attack. Targeting transgender people is a key part of the president’s broader attempt to seize power and take away our freedoms—he's banking on bullying our communities into compliance with his backwards agenda.
The Trump administration knows it doesn’t have the power to unilaterally ban gender-affirming care, so instead, it is trying to change the rules for receiving Medicaid funding. This move threatens health care access for everyone, unless our communities are willing to abandon trans youth—and that’s not an option.
Although at this time the administration has not yet published its proposed changes to Medicaid and Medicare, we know these threats are coming. Take action now and urge state leaders to protect access to gender-affirming health care services—and read on below to learn more about what is at stake.
The Trump administration plans to weaponize federal funds to eliminate gender-affirming health care for youth nationwide.
Through the widely publicized Project 2025 policy playbook, we knew that the Trump administration planned to do everything in its power to block transgender youth and their families from accessing life-saving health care services. This summer and fall, information became public that revealed that the agencies overseeing health care plan to propose rule changes to Medicare and Medicaid which, once finalized and if allowed to take effect, could significantly affect medical care for transgender youth nationwide.
While the contents of these rules are not yet public, the titles of the proposed rules make clear that they are intended to weaponize federal funding to block the provision of gender-affirming care to minors. The Trump administration hopes it can strongarm health care providers and state governments into abandoning transgender youth and their families—but with thoughtful leadership and bold action, Vermont’s leaders can chart a different path.
What do these changes mean for Vermont?
These regulatory attacks would not change the legality of providing care for transgender youth. They are intended to threaten any provider or healthcare organization that participates in Medicare or Medicaid with loss of that federal funding if they care for transgender youth. This is a significant threat, but it does not make this care illegal.
While the potential rule changes appear to be yet another attempt to erase transgender people from public life, Vermont’s responsibility to provide access to affordable gender-affirming health care would not change. Our laws still require that Vermont Medicaid and private insurers cover gender-affirming care, and still make it illegal for health care providers to discriminate against transgender patients in deciding what care to offer.
However, if the rules successfully block federal funds from being used to cover gender-affirming care for minors, Vermont Medicaid would still cover those services--but the funding for those services would have to come from the State. To ensure that access to care is maintained, it’s up to our state leaders to find creative alternatives.
It is also important to note that these changes are based on harmful misinformation about the scientific evidence around care for transgender youth. Decades of research, including a comprehensive systematic review commissioned by the state of Utah earlier this year, show that care for transgender youth is safe, effective, and essential.
Care is a right, not a privilege.
Trans youth are valued members of our community who are deserving of inclusion, care, and celebration. It’s on all of us to condemn these dangerous and bigoted attacks and affirm that the rights, dignity, and humanity of trans youth are not up for debate. Patients and providers deserve to seek, access, and deliver gender-affirming health care without fear or shame. With trans rights under attack nationally and in Vermont, standing up for these critical freedoms has never been more important.
We find ourselves at a critical moment for trans rights in Vermont and across the country. In response to federal threats, states like New Hampshire have already banned gender affirming care for new patients under the age of eighteen in the state, and we expect many patients to turn to Vermont to access this life-affirming care. We need to ensure that Vermont does not back down to federal threats. Vermont needs to uphold its commitment to provide life-affirming healthcare for all members of our community—and lawmakers need to hear from you.