At the end of 2025, just before the holidays, the federal government released a flurry of anti-transgender proposals. One set of proposals from the Centers for Medicare and Medicaid  Services (CMS) would prohibit healthcare professionals nationwide from receiving any Medicare or Medicaid funding if they provide evidence-based, medically necessary health care services to transgender minors related to their gender identity, like puberty blockers and hormone replacement therapy (HRT).  This care for youth is already banned in Texas through SB 14 (Campbell) which took effect in 2023. Since then families of transgender youth have been forced to leave the state to keep their adolescents safe. Doctors who previously provided care have faced their own “agonizing moral dilemma, stay in Texas and deny care to patients, knowing it will jeopardize their health while breaching professional ethics; or begin the strenuous process of moving their medical license, practice and family elsewhere,” according to Alex Sheldon, executive director of GLMA (previously known as the Gay & Lesbian Medical Association).   Categorical bans on health care for transgender youth have also led to a chilling effect for adult health care. As essential health care