| Opinion contributor
RFK Jr moves to restrict gender-affirming care for minors
The Trump administration moved to restrict gender-affirming care for minors, Robert F. Kennedy Jr. announced.
As a nurse practitioner, I believe it’s important to clarify what gender-affirming care for minors actually involves, particularly as Cincinnati Children’s Transgender Health Clinic faces the possibility of closure.
When people hear the term, they often jump straight to “sex change surgery.” That is not reality. For minors, gender-affirming care is most often non-medical: mental health support, careful assessment, family counseling, and guidance around social transition, such as names, pronouns, or clothing. For some adolescents, care may include puberty blockers or hormone therapy after thorough evaluation and with parental consent.
Surgeries for minors are exceedingly rare and are not the standard of care.
Puberty blockers, in particular, are frequently mischaracterized. These medications have been used safely for decades in pediatric care to treat precocious puberty in cisgender children. Their effects are considered fully reversible in the sense that puberty resumes if the medication is stopped. In transgender adolescents, puberty blockers can provide time − time to reduce distress, allow thoughtful decision-making, and give a child space to mature while determining the most appropriate path forward, without the pressure of irreversible physical changes.
Another common misconception is that being transgender is a recent phenomenon. It is not. Gender-diverse people have existed across cultures and throughout hundreds of years in recorded history. What is new is not transgender identity itself, but increased visibility, better medical understanding, and a greater willingness of families and clinicians to address these needs openly rather than forcing children to suffer in silence.
Numerous major medical organizations, including the American Academy of Pediatrics, support gender-affirming care because the evidence consistently shows benefits. Access to this care is associated with lower rates of depression, anxiety, self-harm, and suicide, as well as improved overall quality of life for transgender youth. In clinical practice, these treatments are approached carefully, individually, and guided by established clinical standards.
The proposed federal rules would strip hospitals of all Medicaid, CHIP (Children’s Health Insurance Program), and Medicare funding if they provide this care, forcing institutions into an impossible position. No hospital should have to choose between caring for children with cancer and caring for transgender youth. That dilemma is created by policy, not by medicine.
If clinics close, it won’t be because providers are acting recklessly or without evidence. It will be because political decisions have overridden clinical judgment. Health care decisions belong with patients, families, and the clinicians who care for them, not with politicians using funding threats to dictate medical care.
Maggie Lysaght lives in North Bend, Ohio. She is not affiliated with Cincinnati Children’s Hospital. She said her opinions are her own and she is not speaking on behalf of any organizations.
