Doctors say Medicaid change to gender-affirming care will harm vulnerable youth

EMILY FENG, HOST:

President Trump celebrated moves his administration made this week to restrict healthcare for transgender youth. That includes a new Medicaid policy, a report and a short documentary. And in a post on Truth Social, Trump boasted, quote, "please remember this when you're casting your vote in the midterm elections in November," end quote. NPR's Selena Simmons-Duffin has more.

SELENA SIMMONS-DUFFIN, BYLINE: The first action on transgender youth came on Tuesday, when the Department of Health and Human Services issued a final rule to block federal dollars from paying for gender-affirming care for young people who are enrolled in Medicaid or the Children's Health Insurance Program. Dr. Mehmet Oz, the administrator of the Centers for Medicare and Medicaid Services, made a social media video about it.

(SOUNDBITE OF ARCHIVED RECORDING)

MEHMET OZ: When the harms of sex-rejecting procedures are so serious, and the evidence is weak, the government cannot keep signing these checks.

SIMMONS-DUFFIN: The rule is a big deal, says Katie Keith of Georgetown Law. She calls it unprecedented.

KATIE KEITH: I'm not aware of any other times that the federal government has prohibited federal funds in this way for a specific patient population with a particular diagnosis.

SIMMONS-DUFFIN: Then on Thursday, the administration released a report called Wolves in White Coats that featured the stories of young people who had detransitioned and accused doctors and hospitals of being driven by greed. Administration officials then cited that report when they referred dozens of healthcare providers to the HHS inspector general for investigation over billing codes. Vice President JD Vance and other officials made a video about that.

(SOUNDBITE OF ARCHIVED RECORDING)

JD VANCE: These allegations are crazy, and they demand investigation.

SIMMONS-DUFFIN: Finally, also on Thursday, HHS released a 12-minute documentary - also called "Wolves In White Coats" - narrated by assistant secretary for health, Dr. Brian Christine.

(SOUNDBITE OF DOCUMENTARY, "WOLVES IN WHITE COATS")

BRIAN CHRISTINE: Every year, American families are misled by activists, physicians and mental health practitioners into making the biggest mistake of their child's life.

SIMMONS-DUFFIN: After all this came out, NPR spoke to the mother of a transgender teenager who's on Medicaid in California. She asked NPR not to use her voice on air because she fears her family could be targeted or her children could be taken away by the federal administration. She asked to be called by her initials, A.W.

She tells NPR the narrative about doctors driven by greed, forcing families to make decisions couldn't be further from her experience. She says her child's care has been slow and thoughtful, and the idea that doctors are driven by profit is, quote, "laughable because the population is so small." Lindsey Dawson makes the same point. She's director of LGBTQ health policy at the nonpartisan health policy organization KFF.

LINDSEY DAWSON: It's very unlikely that providers are engaging this work solely to generate revenue.

SIMMONS-DUFFIN: When it comes to the new Medicaid rule, Dawson says some Democratic states are vowing to make up the cost the federal government won't be paying anymore, including California, where A.W. lives. But A.W. is still worried. She says, quote, "it's heartbreaking and devastating to have your child used as basically a political football," unquote. Jennifer Levi, senior attorney with GLAD Law, expects the rule to face legal challenges.

JENNIFER LEVI: This has to be seen in the broader context of this long ongoing attack on the transgender community.

SIMMONS-DUFFIN: So far, she says, the Trump administration has had a lot of losses on this issue in court, which may be why - in addition to making policy - the administration is also making videos.

Selena Simmons-Duffin, NPR News.

(SOUNDBITE OF PARACHUTE DAY'S "THANK YOU NOTES") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR's programming is the audio record.