Children's Hospital Funding Extended Through 2030, But With New Ban on Gender-Affirming Care

The aptly named Children’s Hospital GME Support Reauthorization Act of 2025 does two big things at once: it keeps a critical funding stream flowing for pediatric medical training, but it attaches a major new condition that could significantly change how some hospitals operate.

The Good News: Securing the Pediatric Pipeline

First, let's talk about the money. This bill extends the federal program that supports Graduate Medical Education (GME) at children’s hospitals all the way through the end of fiscal year 2030. This program is essential because it helps fund the residency programs that train the next generation of pediatric specialists—the doctors who treat everything from childhood cancer to broken bones. If you have kids, this is the program that ensures there’s a trained pediatrician available when you need one. On top of the extension, the bill actually increases the funding allocations for fiscal years 2026 through 2030, setting aside $124 million and $261 million in two separate pots. For children's hospitals, which often operate on tighter margins than general hospitals, this continued, increased funding provides crucial financial stability for their training programs.

The Catch: A Ban on 'Specified Procedures and Drugs'

Here’s where the policy gets complicated. Section 2 introduces a major restriction: any children’s hospital that provides “specified procedures and drugs” to minors (under 18) will lose all of this federal GME funding for the following fiscal year. Think of it as an all-or-nothing penalty. The bill defines these restricted services very specifically, focusing on medical interventions related to gender transition.

These “specified procedures and drugs” include nearly all surgeries intended to change a minor’s body to align with a sex other than the one indicated at birth (like hysterectomies, orchiectomies, or various facial/chest surgeries for this purpose). It also covers administering puberty blockers (like GnRH analogues) to delay normal puberty, or giving high doses of cross-sex hormones (estrogen or testosterone) for transition purposes. If a hospital performs even one of these procedures on a minor, it risks losing millions in federal GME funding the next year.

Real-World Impact on Access

For most hospitals, losing this GME funding would be catastrophic for their residency programs. This means that children’s hospitals currently offering these services face a stark choice: either stop offering specified gender-affirming care entirely or forfeit all federal support for training pediatric doctors. This provision, which kicks in for the 2026 fiscal year (based on a look-back period starting September 1, 2025), is designed to create a powerful incentive for hospitals to cease providing these specific services to minors.

For a family seeking gender-affirming care for a minor, this could mean that even major pediatric centers—which are often the only places with the expertise to provide complex care—will no longer offer it. Access could become severely limited, requiring travel across state lines or long distances, even if the family and doctors agree the treatment is medically necessary.

Where Exceptions Apply

The bill does carve out some important exceptions, showing an attempt to target the policy precisely. The payment restriction does not apply if the procedures or drugs are used to treat certain pre-existing medical conditions, provided there is parental consent. For example, hospitals can still use puberty blockers to treat precocious puberty (when a child starts puberty too early) or perform procedures to correct a verifiable genetic disorder of sex development (like certain chromosomal or hormonal issues). Additionally, the restriction is waived for procedures needed to address an immediate danger of death or loss of a major bodily function. Crucially, the bill also confirms that providing mental or behavioral health services for gender dysphoria is not restricted, as long as those services don't involve the specified procedures or drugs.