CMS Issues Memo Raising Concerns About Gender-Affirming Care for Minors

The Centers for Medicare and Medicaid Services (CMS), a major agency within the Department of Health and Human Services (HHS), has released a memo expressing concerns about certain medical interventions for gender dysphoria in children. The memo, which was obtained by Fox News Digital, emphasizes the agency’s commitment to ensuring that all patients, particularly children, receive care that adheres to the highest standards of evidence-based medicine and scientific integrity.

CMS provides health coverage to over 100 million Americans through Medicare, Medicaid, and the Children’s Health Insurance Program. The memo serves as a reminder to hospitals and medical providers of their responsibility to provide dignified and appropriate care to all patients. It also signals a potential shift in CMS policy, with the agency indicating that it may take steps to align its regulations and provider agreements with what it considers the highest-quality medical evidence in the treatment of children.

The memo highlights the increasing prevalence of medical interventions for gender dysphoria in children in recent years. However, it also raises concerns about the evidence base supporting these treatments, suggesting that they may cause long-term and irreversible harm. CMS states that research used to promote these procedures sometimes contains methodological flaws or demonstrates scientific misconduct.

The agency notes that other developed nations have taken decisive actions to prohibit or significantly limit certain practices, aiming to protect children from harmful and unscientific medical interventions. This comparison suggests that CMS is considering similar measures to safeguard children in the U.S.

The memo specifically mentions potential harms associated with "mutilation," including sterilization, and implies that certain gender-affirming treatments may fall under this category. This characterization of gender-affirming care has been criticized by LGBTQ+ advocates and medical professionals who argue that it misrepresents the nature of these treatments and ignores the potential benefits for transgender and gender-diverse youth.

Dr. Kurt Miceli, medical director at the conservative medical activist group Do No Harm, praised the CMS memo for highlighting medical data from other countries regarding gender-affirming care for children. He expressed support for protecting children from irreversible harms associated with sex-change surgeries or hormonal therapies.

The release of the CMS memo coincides with efforts by the Trump administration to limit or ban gender-affirming care for minors. The administration has sought to weed out what it deems "radical gender ideology" across U.S. institutions. However, these policies have faced legal challenges and have been met with resistance from many hospitals and medical providers.

The memo references studies outlining the effects of gender-transition treatments for kids in England and Finland, as well as research from U.S. medical journals and the Mayo Clinic. It points to data indicating that between 2016 and 2020, nearly 3,700 children between the ages of 12 and 18 underwent surgeries, with over 3,200 having breast or chest surgery and more than 400 undergoing genital surgery. The memo states these resulted in permanent changes to their reproductive organs. It also notes that more than 120,000 children between 6 and 17 were diagnosed with gender dysphoria during that period, with over 17,000 starting treatments like puberty blockers or cross-sex hormones.

The CMS memo states it is informed by a growing body of evidence and protective policies across the world. The agency’s concerns about the long-term effects and potential risks associated with these interventions signal a potential policy shift that could significantly impact access to gender-affirming care for transgender and gender-diverse youth.

The debate surrounding gender-affirming care for minors is complex and highly polarized. Advocates for gender-affirming care argue that these treatments are medically necessary and can significantly improve the mental health and well-being of transgender youth. They point to research showing that transgender youth who receive gender-affirming care have lower rates of depression, anxiety, and suicide.

Critics of gender-affirming care, on the other hand, express concerns about the potential risks and long-term effects of these treatments, particularly for young people whose gender identity may still be developing. They argue that more research is needed to fully understand the potential consequences of these interventions. Some also raise concerns about the role of social contagion and the influence of online communities on young people’s gender identity.

The CMS memo is likely to further fuel this debate and could have significant implications for the future of gender-affirming care for minors in the United States. The agency’s potential policy changes could restrict access to these treatments and create additional barriers for transgender and gender-diverse youth seeking medical care. It also highlights that, especially in our current political climate, even healthcare can be politicized despite the obvious and known impacts.