HHS Rescinds Guidance on Gender-Affirming Care for Minors

On Feb. 20, 2025, the U.S. Department of Health and Human Services (HHS) officially rescinded its 2022 guidance regarding gender-affirming care for minors, effective immediately.

This action was taken in response to President Donald Trump’s Executive Order 14187 titled “Protecting Children from Chemical and Surgical Mutilation”.

HHS stated that the 2022 guidance no longer reflects its views and that this rescission aligns civil rights and health privacy enforcement with the policies of the Trump administration.

Key Highlights

• HHS rescinded its 2022 guidance regarding federal civil rights and patient privacy laws in relation to gender-affirming care for minors.
• The rescission was directed by Executive Order 14187.
• This action does not affect final regulations or court decisions, but it signals HHS’ new stance on this issue.

What the 2022 Guidance Stated

The rescinded 2022 guidance previously outlined how federal civil rights and patient privacy laws applied to gender-affirming medical treatments for minors in three key areas:

1. Section 1557 of the Affordable Care Act (ACA)

   • Prohibits discrimination based on race, color, national origin, sex, age, or disability in federally funded health programs.
   • The 2022 guidance stated that discrimination based on gender identity in federally funded health care settings was prohibited under Section 1557.

2. Disability Discrimination Protections

   • The 2022 guidance stated that gender dysphoria may qualify as a disability under Section 504 of the Rehabilitation Act, which prohibits discrimination against individuals with disabilities in federally funded programs.
   • It also suggested that denying medically necessary care based on gender dysphoria may violate Section 504 or Title II of the Americans with Disabilities Act (ADA).

3. Patient Privacy Protections

   • The 2022 guidance emphasized that protected health information (PHI) related to gender-affirming care could not be disclosed without patient authorization.
   • Limited exceptions applied only where disclosure was required by law.

Why HHS Rescinded the Guidance

HHS justified rescinding the 2022 guidance for the following reasons:

• Section 1557 and Gender Identity
  • The legal basis for applying Section 1557 protections to gender identity has been challenged in multiple court cases.
• Gender Dysphoria and Disability Protections
  • HHS stated that gender dysphoria likely does not qualify as a disability under Section 504 of the Rehabilitation Act.
• Patient Privacy Concerns
  • HHS argued that the 2022 patient privacy provisions lacked adequate legal support under HIPAA Privacy and Security Rules.

What’s Next?

• HHS plans to issue new guidance that will protect whistleblowers who take action to enforce compliance with the new policies.
• Further legal challenges or updates in federal regulations may impact how gender-affirming care is addressed in the future.

📄 Read the full HHS Rescission Notice: HHS Notice
📄 Read Executive Order 14187: White House Document