Submit Your Comment on Gender-Affirming Care

This proposed rule—“Medicaid Program; Prohibition on Federal Medicaid and Children’s Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children”—would prevent federal funds from being used to pay for transition-related health care for youth covered by a state’s Medicaid or Children’s Health Insurance Program (CHIP), and states generally rely on combining federal funding to match the state funds that cover the costs of providing those treatments and supportive services.

Comments are due February 17, 2026.

This proposed rule—“Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children”—seeks to require hospitals to cease providing transition-related care to individuals younger than 18 in order to maintain their federal Medicaid funding. Comments are due February 17, 2026.

• Visit the webpage for both proposed rules on the Federal Register.
  • Prohibition on Federal Medicaid and Children’s Health Insurance Program Funding… 
  • Medicare and Medicaid Programs; Hospital Condition of Participation…
• Click on the “Submit a Public Comment” button beneath the rule title.
• Type your comment. You may also attach it as a Word document or PDF.
• Enter your email address if you choose to provide it. You can also select the checkbox to opt to receive email confirmation of your submission and a tracking number, but it is not required.
• Select whether you are an individual or an organization, or whether you want to submit your comment anonymously. We strongly recommend submitting your comment anonymously; see more in the next section regarding mitigating risk
• REGARDLESS: All comments are made viewable to the public even if you select “anonymous.” If you select “individual” or “organization,” the content of the comment and your name will be made viewable to the public.
• Select the box that says, “I read and understand the statement above.”
• Review your comment and click “Submit comment.” You may also preview your comment if you would like.

When submitting a comment to the Federal Government, it is important to keep a few things in mind in order to mitigate risks to you and your loved ones.

First and foremost, we recommend that you submit your comment anonymously. See guidelines for submitting your comments anonymously in the section above.

Other things to consider:

• Some example of information that would be helpful to share in your submission include:
  • Any barriers you or your loved ones faced in accessing this care;
  • The positive effects and benefits of this care for you or your loved one;
  • The safety and efficacy of transition-related care for transgender youth;
  • Information about the negative impacts of limiting access to health care for trans youth, especially through the types of policies proposed in these rules; and
  • Concerns about the impact of health care restrictions for transgender youth and low-income families who rely on Medicaid or Children’s Health Insurance Program (CHIP) insurance coverage.

De-identify yourself and your family members by speaking generally about ages, locations, and the specifics of the clinical care environment. For example, instead of writing, “I am a 22 year-old transgender woman who has been receiving care from my local Planned Parenthood in St. Louis, MO since I was 12 years old,” consider writing, “I am a young trans person living in the Midwest who has received care at a community health center for over a decade.” This reduces risk of exposure for both you and your provider. We have provided short examples of this in the form where you’ll write your comment. Ensure that you write your OWN comment rooted in your own experience; our examples are just that.

Do not share the names of your providers, nor any identifying information about them.

There are risks. People can access the comments you submit via public records requests. People should NOT share personally identifying information in their submissions.