The largest employer health benefits program for the federal government announced Friday that it will no longer cover pediatric transition-related treatment, according to a document obtained by HuffPost.
The directive from the U.S. Office of Personnel and Management’s Healthcare and Insurance program comes just days after President Donald Trump signed executive ordersdirecting federally run insurance programs to exclude coverage for gender-affirming care for people under age 19, and defining sex as only either “male or female.”
The executive order on “Protecting Children from Chemical and Surgical Mutilation” has a specific provision directing OPM to update its benefits program to “exclude coverage for pediatric transgender surgeries or hormone treatments” in its guidance to insurance carriers. OPM, the government agency that acts as human resources for the government, has recently become overtaken by billionaire Elon Musk and many of his close allies.
The executive order is expected to affect not only federal workers but agencies across the federal government. It could modify requirements under the Affordable Care Act and bar hospitals that accept Medicare or Medicaid from providing gender-affirming care to patients under 19.
Friday’s directive, which was distributed to health insurance companies that work with the federal government, states that all carriers will now have to comply with the two orders.
Previous Federal Employee Health Benefits programs ― including the current plan, which is active through 2025 ― did include coverage for pediatric gender-affirming care. But the document states that the orders now supersede “any previous Carrier Letter with conflicting information.”
“Pursuant to the second EO, all Carriers for Plan Year 2026 ‘will exclude coverage for pediatric transgender surgeries or hormone treatments’ for the purpose of gender transition,” the document reads. “OPM recognizes that there are some bona fide medical conditions, such as precocious puberty, or therapy subsequent to a traumatic injury, where hormone treatments for individuals under the age of 19 may be lawfully covered by Carriers.”
Gender-affirming care is already difficult for young people to access, and more than half of U.S. states have already enacted bans on such care.
One study showed that surgeries are rarely performed on trans youth, with cisgender male teens accounting for the majority of chest surgeries. Puberty blockers and hormone therapy, which have been recommended by leading health associations to alleviate gender dysphoria, are also seldom prescribed to minors.
The Federal Employee Health Benefits program provides benefits to more than 8 million federal employees and their families, as well as retired employees. This means that children of current and retired federal employees, including postal workers, who use the program for health insurance will no longer be able to receive gender-affirming care under the new mandate.
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Health care providers in Colorado, Virginia, and Washington, D.C., have already paused surgeries and stopped prescribing puberty blockers and hormones for young people in order to comply with Trump’s directive.