House HHS Appropriations Bill Would Devastate Trans Adult Healthcare Nationwide

The bill would bar federal funding for any "social, psychological, behavioral, or medical intervention" to treat gender dysphoria.

Photo by Louis Velazquez on Unsplash

Today, Washington Bureau Chief Eric Michael Garcia at The Independent uncovered provisions in the newly released HHS appropriations bill that would bar federal funding for gender-affirming care nationwide. The measure, described by some as an anti-transgender “Hyde Amendment,” represents a dramatic expansion of a failed effort from earlier this year in Trump’s “Big Beautiful Bill,” his sweeping tax-and-spending package. This new language would prohibit federal dollars from being used for transgender healthcare at any age, extending even to “social, psychological, behavioral, or medical interventions.” Read broadly, the provision could shutter entire hospital programs that serve transgender patients and, at minimum, severely disrupt care for adults who rely on Medicaid, Medicare, and other federally funded services.

“None of the funds made available by this Act may be used for any social, psychological, behavioral, or medical intervention performed for the purposes of intentionally changing the body of an individual (including by disrupting the body’s development, inhibiting its natural functions, or modifying its appearance) to no longer correspond to the individual’s biological sex,” reads the provision.

The provisions would immediately strip Medicaid and Medicare coverage for gender-affirming care if passed by both chambers of Congress and signed into law. But their impact could stretch far beyond that narrow reading. President Trump, who has repeatedly shown a willingness to expand executive authority, could wield the language as yet another weapon in his ongoing campaign of federal funding threats. Armed with this budgetary provision, his administration could pressure hospitals and clinics—just as it has already done with youth gender care providers—by threatening to pull federal dollars unless they comply with sweeping anti-trans policies.

Earlier this year, Trump wielded Medicaid and Medicare funds as a weapon to scare hospitals into halting youth gender-affirming care—without even having the backing of a statutory provision like the one now moving through Congress. His administration reportedly threatened to cut off all Medicaid and Medicare reimbursements for any procedure at hospitals that continued providing such care to minors. Faced with the possibility of losing their largest source of federal funding, roughly half of youth gender clinics across the country shut down their programs, choosing to comply rather than fight in court. The result has been a devastating collapse in access to care for transgender youth nationwide.

Also earlier this year, Republicans attempted to push through a similar Medicaid and Medicare funding ban—this time targeting both youth and adults—by slipping it into Trump’s flagship “Big Beautiful Bill.” That effort was struck down by the Senate Parliamentarian, who ruled the provision out of order under reconciliation rules. But appropriations bills are not subject to the same guardrails.

Importantly, the funding ban would cover all forms of gender-affirming care, including “social” or “psychological” interventions. That language sweeps far beyond medical treatment and could place adult psychological support, therapy, and counseling directly in the crosshairs, along with any federally funded effort deemed “social” in nature. In practice, “social” care often refers to basic steps like updating names in official systems, changing gender markers, or affirming identity in institutional settings. Under this provision, the Trump administration could interpret even those routine measures as violations, weaponizing the ban to choke off critical funding for any entity deemed out of compliance.

These are not the only provisions in the appropriations bill targeting transgender people. Another section stipulates that any educational institution receiving federal funding could lose that funding if it allows transgender female students to participate in “athletic programs or activities designated for women or girls.” Such language would function as a de facto national transgender sports ban, forcing schools and universities into compliance. Even more troubling, the vague use of the word “activity” could give the administration sweeping latitude to strong-arm schools into broader restrictions—potentially extending to bathrooms, dorms, and virtually any gendered program or event, even if it may not be fully supported by some readings of the text.

It is important to note that the Senate version of the bill does not currently include this provision. These attacks on transgender healthcare and student rights will only make it into law if seven Senate Democrats break ranks and side with Republicans and the House provisions make it into the final bill rather than allowing the government to shut down. The outcome is far from inevitable—Democrats have the power to hold firm and demand that these poison-pill riders never reach final passage. The government funding deadline just three weeks away.

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