2026年8月11日 下午6:43 美国东部时间 / 美联社报道
特朗普政府宣布，医疗补助计划将停止为未成年跨性别者支付性别确认手术和激素治疗费用，州儿童健康保险计划也不会为19岁以下群体支付此类治疗费用。
此次公告是特朗普去年重返白宫以来，其政府针对跨性别者推出的一系列政策中的最新一项。
该政策将于10月13日生效。
目前尚不清楚当前有多少纳税人资金用于跨性别青少年的性别确认治疗。美国医疗保险与医疗补助服务中心周二未回应有关该政策的置评请求。
全美至少已有27个州禁止为18岁以下人群提供性别确认医疗服务。即便在未颁布此类禁令的州，许多大型医院也已停止提供部分相关治疗。针对未成年人的性别确认手术极为罕见，青春期阻滞剂和激素治疗更为常见。
根据该政策，医疗补助计划和儿童健康保险计划将继续为未成年跨性别者支付心理健康治疗费用，但将逐步取消对青春期阻滞剂以及用于促使第二性征发育的激素治疗的覆盖，2027年4月前已接受此类治疗的人群除外。
特朗普周二在社交媒体发帖称，他已指示美国医疗保险与医疗补助服务中心署长穆罕默德·奥兹医生推进这一政策调整。
特朗普在帖文中称：“我们不会让无辜的孩子接受这些残忍的手术和治疗手段，这些做法会对他们稚嫩的身体造成难以想象且不可逆的伤害。”
LGBTQ+青年权益倡导者对此持不同看法。
GLBTQ法律辩护与倡导组织法律总监乔希·罗文格表示，该规则“在父母为子女做出最佳医疗决策的道路上设置了障碍”，并将面临法律挑战。
“特朗普政府通过此类行动恐吓跨性别青年及其家庭，这种行为必须停止，”人权运动主席凯利·罗宾逊在一份声明中说道。
人权运动已就政府禁止联邦雇员福利计划覆盖性别确认医疗服务的举措提起诉讼。
美国医学协会及其他多数主流医学组织支持跨性别者获得性别确认医疗服务，但美国整形外科医生协会今年早些时候表示，该协会发现“证据不足”，无法证明针对存在性别烦躁——即个人出生时被指派的性别与其性别认同不匹配所带来的不安——的未成年人进行胸部、生殖器和面部整形手术的利大于弊。
特朗普政府此前已宣布，将切断为未成年人提供性别确认医疗服务的医院的医疗补助和医疗保险资金，同时禁止跨性别运动员参加女子和女子组体育赛事，并限制民众在护照上选择男性、女性或X作为性别标识。
政府去年还发布了一份报告，主张仅为跨性别青年提供心理治疗，而非更广泛的性别确认医疗服务。
多数此类政策调整都面临法律挑战。美国最高法院维持了政府的护照性别标识政策，同时允许各州实施体育赛事禁令。一家下级法院驳回了政府称此类治疗不安全且无效的声明。针对针对医院的政策的诉讼仍在审理中。
Trump administration bars use of Medicaid funds for some youth transgender care
August 11, 2026 6:43 PM EDT / AP
President Trump’s administration said that Medicaid will stop paying for gender-affirming surgeries and hormone treatments for transgender minors and the state Children’s Health Insurance Program won’t pay for the treatments for those under 19.
The announcement is the latest in a series of policies from the administration aimed at transgender people that began the day Mr.Trump returned to office last year.
The policy is to take effect Oct. 13.
It is not clear how much taxpayer funding is going to cover gender-affirming treatments for transgender youth now. The Centers for Medicare and Medicaid Services did not respond to questions about the policy on Tuesday.
At least 27 states have already banned gender-affirming care for those under 18. Even in states that haven’t, many major hospitals have stopped providing some of the treatments. And gender-affirming surgeries for minors are rare. Puberty blockers and hormone treatments are more common.
The policy calls for Medicaid and CHIP to continue to pay for mental health treatment for transgender minors but phase out coverage of hormone treatments that are used both to block puberty and to produce sex-related physical changes for those already receiving them as of April 2027.
Mr. Trump said in a social media post Tuesday that he directed Dr. Mehmet Oz, the CMS administrator, to make the change.
“We are not going to pay for our innocent children to undergo these barbaric surgeries and practices, which result in unthinkable and irreversible harm to their young bodies,” Mr. Trump said in his post.
Advocates for LGBTQ+ young people look at it differently.
GLBTQ Legal Advocates and Defenders legal director Josh Rovenger said the rule “is putting up barriers between parents and their ability to make the best medical decisions for their children” and would face a legal challenge.
“The Trump administration is terrorizing trans youth and their families with these kinds of actions, and it has to stop,” Human Rights Campaign President Kelley Robinson said in a statement.
HRC is already suing the administration for efforts to bar gender-affirming care coverage under federal employee benefit plans.
The American Medical Association and most other major medical organizations support access to gender-affirming care, though the American Society of Plastic Surgeons said earlier this year that it found “insufficient evidence” that the benefits of chest, genital and facial surgeries on minors experiencing gender dysphoria — or the unease a person may have because their assigned gender and gender identity don’t match — outweigh the risks.
The administration has already announced it would cut off Medicaid and Medicare funding for hospitals that provide gender-affirming care for minors, along with barring transgender athletes from sports competitions for girls and women and blocking people from being able to choose male, female or X to designate their sex on passports.
It also released a report last year urging therapy only for transgender youth and not broader gender-affirming healthcare.
Most of the changes have faced legal challenges. The U.S. Supreme Court let the administration’s passport policy stand and allowed states to enforce the sports bans. A lower court ruled against the administration’s declaration that called the treatments unsafe and ineffective. A challenge over the policy targeting hospitals is still pending.
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