New proposed federal rules from the Trump administration aim to make it nearly impossible for transgender youth to receive gender-affirming care in the United States.

One proposed rule within the Department of Health and Human Services (HHS) would prohibit any medical organization that promotes or provides such care from receiving federal Medicaid funding . It would also forbid the reimbursement of funds through the Children’s Health Insurance Program (CHIP) if gender-affirming care was provided to patients under the age of 19. A second proposed rule would forbid any Medicaid and Medicare funding from going to hospitals that provide gender-affirming care for trans youth.

The rules have not been officially published yet — an anonymous source within the department shared them with NPR

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