Editorial: Lumps of coal for Trump, RFK Jr.

No one deserves our lump of coal award more than President Donald Trump and his hideous secretary of Health and Human Services, Robert F. Kennedy Jr. Together, the men have waged an all-out assault on transgender people since Trump returned to the White House in January. Unfortunately for Trump, it’s a symbolic honor and not gold-plated.

Trump is, frankly, the most anti-trans president the country has ever seen. And he has gone all in during his second term. His executive orders have barred trans people from serving in the military and prohibited them from using the gender identity with which they align on U.S. passports. In short, the administration wants to erase trans people from existence. They haven’t succeeded, though the fear and frustration they have instilled in the community has only escalated throughout the year.

Perhaps none of the executive orders have been as cruel as the one Trump issued January 28, just over a week into his presidency. Titled, “Protecting Children from Chemical and Surgical Mutilation,” its goal is to completely shut down gender-affirming care for trans youth. Over the past 12 months, the goal of Trump and Kennedy has largely been achieved, as hospitals across the country paused or ended gender-affirming care for their patients under 19. Research has shown that gender-affirming care reduces suicidal ideation and attempts in trans individuals, The Trevor Project has reported. Medical care, along with social transition and family support, often provides the best outcomes.

On December 18, Kennedy’s Department of Health and Human Services announced the latest horrendous development, a series of proposed regulatory actions to carry out Trump’s executive order directing HHS to end the practice of sex-rejecting procedures on children that the agency claimed in a news release expose young people to irreversible harm. “These procedures include pharmaceutical or surgical interventions of specified types that attempt to align a child’s physical appearance or body with an asserted identity different from their sex,” the release noted.

The first proposed rule would prohibit Medicaid funding for medically necessary health care, such as puberty blockers and hormone therapy, for trans youth under 18 and Children’s Hospital Insurance Program funds from covering this care for trans young people under 19. The second proposed rule would bar hospitals that provide this care to trans youth from participating in Medicare and Medicaid.

Gay Congressmember Mark Takano (D-Riverside) is chair of the Congressional Equality Caucus. In a statement, he noted that at the same time Republicans in Congress have so far refused to extend Affordable Care Act subsidies that expire at the end of the year, the administration is targeting trans youth.

“In just a few days, millions of Americans’ health care premiums will skyrocket because of the Republican health care crisis, but the Trump administration’s most pressing priority isn’t to tackle the skyrocketing costs of health care – it’s proposing more rules that rip away the ability of parents to ensure their transgender children get the medical care they need,” Takano stated. “The only people who should be making decisions about a young transgender person’s health are themselves, their parents, and their doctors – not Donald Trump and RFK Jr. These discriminatory, hypocritical, and cruel proposed regulations aim to cut off medically necessary care for transgender children throughout the country – but these proposed rules do not yet have the force of law. I urge health care providers to not pre-comply and instead continue to provide this lifesaving care.”

Shannon Minter, a trans man who is vice president of legal at NCLR, pointed out the brutish nature of the proposals.

“These rules wage an attack on the lowest income Americans’ ability to access health care and cruelly seek to cut off health care for all transgender youth,” he stated, referring to the fact that Medicaid is a joint federal-state program that helps people with limited income cover their medical costs. The feds issue the rules that states must follow; states run the programs.

These proposed rules come at a time when trans youth and their families are rapidly running out of options. For those who are currently in care, the proposed rules are dangerous, as it means treatment would stop once they are adopted. Of course, that is already the case at many hospitals, which earlier this year decided to “obey in advance” and stopped offering gender-affirming care. In the Bay Area, Stanford Health and Kaiser Permanente paused gender-affirming care, as did Children’s Hospital Los Angeles. Sutter Health initially stated it would pause such care, then apparently reversed course, as we reported last week. It’s unclear if that reversal will hold now that CMS has issued the proposed rules.

The California Legislative LGBTQ Caucus called on Americans to see the administration’s move for what it is. “It should be appalling to all Americans that President Trump is willing to risk the health care of millions of Americans in his effort to harm and erase the smallest and most vulnerable groups of young people,” the caucus stated.

It’s important to note that both proposed rules have 60-day comment periods that started December 19.

“NCLR urges families, advocates, medical professionals, health experts and others to submit comments opposing these dangerous rules,” Minter stated.

Comments can be submitted through Regulations.gov or via the Federal Register. Effective comments often include personal examples, quantitative/qualitative data on economic effects, and specific pros/cons, according to advocates.

Coming just before the holidays, these proposals demonstrate that the Trump administration will stop at nothing to demonize trans people.

But the LGBTQ caucus pointed out California has the law on its side.

“To be clear – even if these rules were to go into effect, health care for transgender individuals would remain legal and protected here in California,” it stated. “And rest assured, the California Legislative LGBTQ Caucus will do everything in its power to keep it that way.”

We hope so, though a legal showdown is expected.

Meanwhile, we think people’s attitudes on trans issues are improving. That was on display in the November off-year elections, in which Democrats ran the table. Americans have tired of the administration’s obsession with transgender people. Most people are concerned about rising costs – the affordability crisis that Trump pretends doesn’t exist. Democratic lawmakers and attorneys general need to keep the pressure on the administration so that trans youth can continue to receive the care that they need.