The Trump administration announced last month that it would remove gender-affirming care from the health care services covered under the Federal Employees Health Benefits (FEHB) Program beginning in 2026. The move erodes health care coverage for the more than 8 million people who rely on FEHB, employment-based health insurance for federal employees, retirees, and their family members, and threatens the dignity of transgender recipients.
The proposed changes to FEHB would apply to cover individuals regardless of age and significantly hamper access to medical care, such as hormone therapies and gender-affirming surgeries, for federal workers, their spouses, children, and dependents. While mental health counseling for gender dysphoria would remain covered – and carriers would establish a case‑by‑case exceptions process for individuals already receiving care – these carveouts will not create a uniform or reliable system to ensure continuity of care.
Lambda Legal has condemned the exclusion of gender-affirming care as unlawful and as a violation of sex discrimination protections in federally regulated health plans.
Human Rights Watch and other organizations have documented how bans and barriers to gender-affirming care cause serious harm. A June 2025 Human Rights Watch report described how restrictions on such care for transgender youth led to deteriorating mental health and abrupt interruptions to treatment, violating individuals’ rights to health, nondiscrimination, and personal autonomy. Removing coverage for gender-affirming care from health insurance will force people to either pay out of pocket or forgo required care because of costs, significantly restricting access.
These measures are part of a broader campaign by the Trump administration to roll back rights for transgender people. In January 2025, the administration issued an executive order rejecting the validity of transgender identity in law and policy. It has also targeted gender-affirming care, issuing a January 28 order attempting to ban youth access to care and an April 10 proclamation labeling such care a form of child abuse. In July, the Department of Justice began issuing subpoenas to more than 20 hospitals providing gender-affirming care to youth. With these measures, some clinics have begun to cease or radically reduce these services, particularly for youth.
The administration should immediately abandon efforts to deny gender-affirming care and ensure that all people covered under FEHB have equal access to comprehensive, nondiscriminatory health coverage.
