Dr. Oz tells states not to use Medicaid money on gender-affirming care for children

In one of his first messages since becoming director of the Centers for Medicare & Medicaid Services, Dr. Mehmet Oz is telling states that Medicaid funds are not to be used for gender-affirming care for children.

In a statement Friday, Oz said that states shouldn’t use Medicaid dollars for gender reassignment surgeries or hormone treatments in minors. He said such procedures “can cause permanent, irreversible harm.”

“CMS will not support services that violate this standard or place vulnerable children at risk. It is a CMS responsibility to steward Medicaid dollars and ensure resources focus on protecting our most vulnerable,” Oz said.

Psychotherapy should be “the first line of treatment,” Oz said.

“This isn’t about politics or stigma,” Oz said in the statement. “It’s about protecting people from decisions they may not fully understand, and consequences they can’t undo.”

The CMS sent a letter to state Medicaid agencies outlining the policy.

The CMS directive probably shouldn’t come as a shock to states or health systems. Shortly after returning to the White House in January, President Trump issued an executive order that blocks gender transition care for those under 19, and Trump said he would prohibit federal funds from going to providers offering such services.

The American Academy of Pediatrics has defended gender-affirming care and said elected officials should not move to block such care. In a 2023 statement, the academy said, “The AAP opposes any laws or regulations that discriminate against transgender and gender-diverse individuals, or that interfere in the doctor-patient relationship.”

The American Medical Association has also urged governors to block state laws that would prohibit gender-affirming care.

“Decisions about medical care belong within the sanctity of the patient-physician relationship,” the AMA wrote in a 2021 letter to the National Governors Association.

Many efforts to prohibit gender-affirming care to minors are playing out at the state level, with states passing measures to prohibit such treatment.

More than half of the states have passed measures prohibiting gender-affirming care, and nearly 40% of the nation’s transgender youth between the ages of 13 and 17 are living in states that have passed bans on gender-affirming care, according to the Human Rights Campaign.

Liana Douillet Guzmán, CEO of FOLX Health, a digital health service provider offering care for LGBTQIA+ patients, told Chief Healthcare Executive® in a January interview that she was gravely concerned about the prospect of restrictions on gender-affirming care. She said she knows parents “who are furiously figuring out how they can retain their children's medical care.”

The Senate voted to confirm Oz as CMS administrator earlier this month. When Oz was looking to secure the nomination, Sen. Josh Hawley, a Missouri Republican, sent questions to Oz about his support for transgender issues and an episode of his TV show in which he hosted transgender advocates. But Hawley eventually supported Oz for the CMS post, and the senator said on X that Oz “disavows his previous support for trans surgeries & drugs for minor children.”

A heart surgeon, Oz gained fame through appearances on Oprah Winfrey’s show and hosted his own long-running daytime talk show for years.

Hospitals and healthcare leaders have been pressing the Trump administration and Congress to preserve funding for Medicaid.