The Trump Administration Cuts Federal Funding for Gender Affirming Care for TGI Youth

Here is What TGI Youth in Medi-Cal Need to Know

The finalized CMS rule published August 11, 2026 prevents federal Medicaid (Medi-Cal in California) funding for gender-affirming medical care, including hormonal therapy, puberty blockers, and surgical care, for Medicaid beneficiaries under 18. The rule is set to take effect on October 13, 2026.

Medi-Cal is California’s Medicaid system. Depending on what county you live in, Medi-Cal may be referred to as a different name. View the complete list of providers through this directory.

It is important to highlight what this rule does not do:

1. This rule does not ban hospitals from providing these services.
2. This rule does not prohibit providers from delivering care.
3. This rule does not prevent states from providing coverage for care outside of Medi-Cal or with
   state-only funds.
4. This rule does not prevent non-federal funding to cover the cost of care, including private
   insurance or paying out of pocket.
5. This rule does not affect the legality of care, however, impacts the funding that pays for this
   care for young people in Medi-Cal.
6. This rule does not affect federal funding for other services that TGI youth in Medi-Cal currently
   receive, such as mental health services.

Important to note: The rule includes a 6-month transition window that will allow for federal funding for hormones only for existing hormone-therapy patients up to 6 months post-effective date of the rule.

Gender-affirming care is still legal, safe, and protected in CA

Under California law, individuals are guaranteed access to medically necessary gender-affirming health care without discrimination. California is obligated to continue covering gender-affirming care. State agencies are working to finalize a plan for how Medi-Cal enrolled families will be able to continue to get their care covered.

California has taken a number of steps to protect families accessing gender-affirming care. California also protects against the release of medical information if the information is requested to comply with another state’s law banning gender-affirming care. California’s Foster Youth Bill of Rights affirms that foster youth have the right to access this necessary gender-affirming care.

Gender-affirming care is safe, effective, and supported by nearly all major medical organizations in the United States. This rule is counter to the best practice medicine and jeopardizes trans youth’s access to the care they need. California’s Attorney General filed a lawsuit to try to stop this rule from going into effect on September 2, 2026.

The following services will not be eligible for federal reimbursement under the finalized CMS rule (effective 10/13/2026):

1. Medi-Cal will not cover puberty blockers, hormone therapy, or surgery for trans youth under 18.
2. There is a “continuation of use” period for trans youth who have begun hormone therapy prior to October 13, 2026. This means that their medications could be covered up to 6 months after the rule’s effective date (i.e. 10/13/26 – 4/12/27).

Providers, patients, and families should continue access to care, and stay updated on developing laws and guidelines.

What TGI youth in Medi-Cal and their families can do now

If care hasn’t begun

It is not too late to get care covered. If you have a child that might be ready to begin care, get an appointment scheduled for a check up as soon as possible or before October 13, 2026.

If care is underway or ongoing

1. Communicate with your provider to make sure all labs are up to date and all prescriptions have as
   many refills available as possible.
2. Get copies of your medical record. Every hospital or clinic is going to have their own policies for
   patients to get copies of their medical records. Your healthcare team should be able to give you the
   information that you need to get your records through their website, patient portal, or in-person.

Resources

1. The state of California has set aside funding to help people who will be impacted by this rule, however, it will take some time for that funding system to be set up. If you need help paying for your care in the meantime reach out to these resources:
   1. RESPCT Fund – RESPCT
2. Legal support and education organizations
   1. Health Consumer Alliance
3. Care Navigation
   1. TransFamily Support Services
4. Other State resources can be found through:
   1. California LGBTQ Health and Human Services Network

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