Southern Queer Newsroom
Over December 17 and 18, 2025, the federal government has intensified its attacks on transgender youth. Warning clouds had been circling for years, as states like Georgia and Tennessee enacted gender-affirming care (GAC) bans for minors. With the U.S. v Skrmetti ruling signing off on Tennessee's bigoted refusal to allow trans youth the same treatments as cisgender kids, conservatives have rushed forward with attempts to punish them for existing.
Conservatives have tried several times to ban Medicaid from covering GAC for trans people, both youth and adults, just this year. Attempts were made to include riders like this in a continuing resolution earlier this year, but were stripped out by the parliamentarian and Senate Minority Leader Schumer. A regressive definition of sex was passed in the most recent National Defense Authorization Act (S 1071) (Sec. 559A) under a section banning trans women from competing in women's sports at military academies. With trans people still banned from service, this doesn't look to have much material impact, but it still carries bad omens for the future.
Two Bans, Both Alike in Indignity
The bill that made headlines was from Georgia Republican Marjorie Taylor Greene. Titled "Protecting Children's Innocence Act" (HR 3492), it would make providing GAC to trans youth a federal felony punishable by up to 10 years in prison. This is a massive escalation of punishment. In Georgia, Senate Bill 140 enforces its gender-affirming for trans minors by allowing the Department of Community Health to determine "sanctions" for providers, up to and including revoking their medical license.
According to reports, this was the deal made by House leadership with Rep. Greene in return for her vote for the National Defense Authorization Act above. Passing this bill will likely be her last major act as a Congresswoman before resigning at the beginning of 2026.
Before the vote on December 17, Democratic Congresswoman Sarah McBride, the only openly trans member of Congress, gave a speech outside the Capitol decrying Republicans as "obsessed with trans people" and opening up about her own childhood.
"I didn't have the courage to come out until I was 21, and that means 21 years of pain. 21 years of unwavering homesickness that only went away when I was able to get the care that I needed." It's a familiar pain to trans people, and one that Republicans insist on forcing the young to go through.
The vote came that evening, and despite some encouraging signs like 9 Republicans voting to send the bill back to committee before many switched their vote, the bill passed 216-211. Three Democrats, including Henry Cuellar of Texas voted in favor of the bill. Four Republicans, including Pennsylvania representative Brian Fitzpatrick, with whom Rep. McBride has worked with several times on legislation, voted against it.
According to the Advocate, Rep. McBride lobbied Republicans to vote against the ban. While not enough votes to kill the bill, especially with three Democrats voting in favor, there was enough dissent early on in the voting to suggest some Republicans were at least partially swayed. That may signal to Democrats that the strategy could work on future extreme legislation, but holds no promise of working, especially on less extreme but still harmful bills.
Texas Republican Dan Crenshaw's bill, "Do No Harm in Medicaid Act" (HR 498), passed the House on December 18, and has received less attention from outlets like Erin in the Morning and the Washington Blade. Lacking the sadistic criminalization of GAC like Greene's bill, HR 498 would ban Medicaid from covering GAC for minors. This is something Republicans have wanted to do for most of session, as back in March, Republicans tried cramming as many anti-trans riders as they could into the continuing resolution. Senate Democrats struck out every single one of those provisions through rules lawyering.
This time, no Republicans balked at voting to pass this bill through the House. In fact, with a vote of 215-201, four Democrats voted in favor, no Republicans voted against, and 17 members were not voting. Of those Democrats who voted yes, three had also voted yes on HR 3492, and they were joined by Marie Gluesenkamp of Washington, co-chair of the conservative Democrat Blue Dog Caucus. 8 Democrats and 9 Republicans were absent.
Because of its extremity, it doesn't seem likely that HR 3492 will get past the Senate, as Republicans would need 60 votes to override a filibuster, which would require at least seven Democrats to vote in favor as long as no Republicans flip like they did in the House. This is made harder with 44 Senators signing a public letter urging Sens. Collins and Murray to oppose any anti-trans rider amendments in future must-past legislation, above the 41 votes needed to block cloture. However, with a larger vote margin and continued attempts both on the state and federal level to ban Medicaid from covering GAC, Crenshaw's bill could make more progress through the Senate or even pass, however unlikely.
Health and Human Services Demands an End to Medicaid Coverage
On Dec. 18, hot off the heels of Greene's bill passing the House, Health and Human Services Secretary Robert Kennedy Jr was joined by fellow vaccine and medicine denier Dr Mehmet Oz and others to announce two new rules from the Centers for Medicare and Medicaid Services (CMS). Together, these two proposed rules—RIN 0938-AV73 and RIN 0938-AV87—attempt to ban hospitals that receive Medicare or Medicaid dollars from providing GAC to minors (AV87) and ban Medicaid dollars and state CHIP (Children's Health Insurance Program) plans from covering GAC for trans youth (AV73).
A notice of proposed rulemaking, RIN 0945-AA27, seeks to propose a rule attempting to remove gender dysphoria as a disability under Section 504 of the Rehabilitation Act of 1973 and Americans with Disabilities Act (ADA). Because this is earlier in the rules making process, this is going to be a future focus of the administration and hopefully for civil rights activists instead of an immediate concern like AV73 and AV87.
During the press conference, RFK and Oz made extreme and false claims about how common gender-affirming surgeries for minors were, how there was a massive industry pushing transition for children who didn't know any better, and invoked the Christian god's "natural plan" for humanity. Chloe Cole, a noted detransitioner and anti-trans activist, used her bad experience of transitioning at a young age to argue no family should get to make that choice about their child again. As ever, the theme of "protecting children" is used to push more violence against them.
It's worth noting how the language used is getting more extreme and dehumanizing. While it's easy to roll one's eyes at Trump's "transgender for everybody" rambles, government officials seemed dead set on exterminating a social evil. Graphic descriptions of surgery are used to disgust the audience. Phrases like "genital mutilation" conjure up images of misogynistic societies and unethical medicine. For these regulations, they've invented a new phrase: "sex rejecting procedures" (SRPs), to artificially separate GAC applied to trans people as opposed to cisgender people.
It's also worth considering how shaky these proposals seem even to a non-expert. According to a former CMS official, these actions attempt to "transform CMS into a medical board," which they said was prohibited under the law. The attempted end-run around Williams v. Kincaid, the lawsuit that protected gender dysphoria as a covered disability, is flagrant and dishonest in its reading of the law.
Williams was a case in the Fourth Circuit Court of Appeals, where the panel decided that gender dysphoria is medically different from "gender identity disorders not resulting from physical impairments" as defined in Sec. 504 and the ADA. The case served as the legal base for the Biden administration's rule that included gender dysphoria as a covered disability under Sec. 504 and the ADA.
The proposed RFK rule (AA27) argues that under the original meaning of gender identity disorder when ADA was ratified, the modern medical categorization of "gender dysphoria" would be included under gender identity disorder and thus exempt from Sec. 504 and the ADA. To back this claim, AA27 cites two dissents—one from the dissenting judge in Williams and one from Justice Alito regarding the denial of cert to Williams—and four district level court cases in jurisdictions not under the Fourth Circuit. They do not cite the majority opinion of the Fourth Circuit panel.
Additionally, the press conference was steeped in religious imagery of a Christian god's perfect designs being warped and twisted by unnatural doctors and activists in a convoluted conspiracy to make more money for plastic surgeons and chest binder manufacturers. This makes it look like the rules are being launched out of disgust and hatred for transgender youth getting the treatment that's medically best for them instead of some "modest concerns." If rules are being created to impose a religious doctrine on citizens, secular and law-abiding courts do not appear likely to let the state pursue this action. That is not a guarantee among Supreme Court justices, who may have final say over these proposed rules.
Fighting In and Out of Court
In the wake of these attacks on trans Americans, civil rights organizations and activists have been loud and public. New York State Attorney General Letitia James and the ACLU have vocally committed to protected healthcare access for trans youth in their state and nationally, with the ACLU already promising to sue the federal government over the proposed rules. Lambda Legal has also condemned the Trump administration's actions and will likely be fighting these rules in court, along with continuing their fights against other discriminatory decisions. Both ACLU and Lambda Legal are accepting donations.
The Trans Youth Emergency Project (TYEP) by Campaign for Southern Equality has been organizing logistical and financial support for families of trans youth for years. They offer help with navigating the maze of laws, lawsuits, and executive orders, finding providers, and awarding travel grants to families affected by trans youth care bans. Statewide queer rights organizations like Transgender Education Network of Texas and Georgia Equality have been major players in state legislatures in the past few years and offer advocacy trainings for trans people and allies who want to testify at their state capitol. Chapters of national organizations like PFLAG may also offer advocacy trainings and other local resources for trans youth and adults in need. All of these groups rely on donations to keep functioning and fighting.
Public comment on AV73 and AV87 lasts for 60 days, or until February 17, 2026. If you would like to comment on either of these, you can do so by following the links above and clicking "Submit a Public Comment." The most effective comments are not copy-pasted from HRC talking points, but personal stories and well-grounded and clear arguments. If you decide to comment, please avoid making any threats or personal attacks so that your comment can receive proper consideration.
These attacks against trans youth are blatantly discriminatory. Exceptions for cis youth who are more likely to receive these sorts of surgical treatments are included in every bill and rule on a state and federal level. In a just society, none of this would stand. Every trans person who lives is a reminder that it won't.