Yesterday was a confusing news day. Let’s try and make some sense of it.
As you may or may not know, Donald Trump’s Justice Department has been on a terror spree for the last year or so, threatening countless hospitals with cuts to federal funding if they continue providing transgender youth with safe, proven, lifesaving healthcare. 27 states have formally banned the treatment of gender dysphoria in trans youth, and the Justice Department hopes to intimidate hospitals into refusing to treat their patients in the remaining 23 states… to shocking effect.
We’ve been reporting on this for a while, covering some of the hospitals that have been hit with subpoenas, and reporting on the ways in which the Justice Department—once a prestigious destination for hotshot lawyers looking to pad their career with good, respectable work—has had its reputation obliterated in a single year so that it could be weaponized to harm trans Americans and innocent migrants.
Now, shockingly, we’re seeing some reprieve. Sort of. Maybe.
It all starts with an NPR article published July 13 and written by Selena Simmons-Duffin. NPR reported that The Department of Health and Human Services, run by Robert F. Kennedy, Jr., seems unlikely to finalize the proposed rule that would legitimize previous memos and Executive Orders blocking gender-affirming care for minors. Because of NPR’s reputation, this was taken as gospel almost immediately, with Human Rights Campaign’s lavishly compensated president Kelley Robinson saying, in a statement, “It takes an avalanche of outrage to stop this administration from doing harm to innocent people, and together, we the people delivered to protect transgender youth across the country. Together, we have stopped Donald Trump and RFK Jr., this time, from imposing their malignant will in every doctor’s office and home when it comes to what is the right and appropriate treatment for trans people – decisions that should be left up to medical professionals, the patients themselves, and their loved ones.”
Hear, hear. Thank you, HRC, for saving us all.
Unfortunately, the very next day HHS commented on X, formerly known as Twitter, to declare that they have not walked back their plans to destroy hospitals that treat their patients:
“The Department has not withdrawn or reversed course on the Medicare and Medicaid Programs; Hospital Condition of Participation: Prohibiting Sex-Rejecting Procedures for Children rule. HHS and CMS continue to follow statutory requirements by reviewing comments, and we intend to issue a final rule. HHS remains committed to protecting children from potentially lifelong, irreversible, and harmful sex‑rejecting interventions.”
So… uh… what? What does that mean? Is the rule going into effect or not?
Well, NPR has since helpfully updated their article! Under a new subhead, “a departure from the normal process,” they explain that normally HHS would propose a rule, accept public comment for 60 days, then finalize the rule so that it could take effect. However, per the president’s Unified Agenda, the rule’s “final action” date has been listed as December 2028, right before Trump leaves office. This leaves the rule in regulatory limbo: it isn’t outright canceled, and could be revived and pursued at some point between now and the end of Trump’s presidency, but it has been deprioritized.
Speaking to NPR, Katie Keith, director of the Health Policy and the Law Initiative at Georgetown University, says that the rule remains effective for the Trump administration as a potential deterrent: “By not withdrawing the rule, CMS can keep the threat of doing so alive and continue to discourage providers from offering the care — even if the rule is never finalized.”
Keither also told NPR that she believes HHS’ waffling “should give hospitals more confidence to either resume or continue offering the care … I would argue that they should have been doing this all along anyway.”
It seems likely that HHS may back off of trans healthcare on this front, lacking confidence that they can defend the rule in court (given what appears to be a blatant violation of laws pertaining to Medicare/Medicaid), but make no mistake: Even if they don’t finalize and enforce this rule, they will continue to attack gender-affirming care in any way they can.
Whether or not this is a victory—and I would argue it is, at the very least, good news—we can’t stop fighting now, or ever. The Trump administration is not done assaulting the rights of trans Americans.
