Attorney General William Tong sent a letter to the Federal Department of Health and Human Services (HHS) criticizing two proposed rules relating to medical treatment for transgender youth.
One of these proposed rules, if implemented, would withhold Medicaid and Medicare funds from any hospitals that provide “transgender healthcare” to people under the age of 19. The other prohibits Medicaid and Children’s Health Insurance Program (CHIP) plans from using federal funding for these programs.
“These are extreme measures rooted in a hate-filled political agenda that would decimate our healthcare system. HHS and (the Centers for Medicare and Medicaid Services) are displacing legitimate medical expertise and parental choice with MAGA ideology and debunked fake pseudoscience,” Tong said in a press release that was published on Feb. 18, one day after the letter was sent. “We’re fighting on every front to protect doctors and families and access to lifesaving healthcare.”
Tong co-wrote this letter with attorneys general from New York, Massachusetts, and Illinois. Sixteen other attorneys general co-signed the letter.
Connecticut state law defines gender-affirming health care services, or transgender healthcare, as “all medical care relating to the treatment of gender dysphoria, as described in the most recent edition of the American Psychiatric Association’s ‘Diagnostic and Statistical Manual of Mental Disorders (DSM).”
The most recent edition of the DSM was published in 2022. Since then, there have been significant studies and publications about transgender healthcare for minors.
In 2024, the National Health Service in the United Kingdom published the Cass Review, which found that there was very little evidence to support common transgender healthcare policies for minors, including social affirmation, the use of puberty-blockers, cross-sex hormones, and surgeries. A year later, the HHS published a study affirming these findings.
When asked over email if Tong supported any federal restrictions on gender-affirming care for minors, and if he had any concerns about Connecticut’s transgender healthcare policies, the Office of the Attorney General Chief of Communications and Policy Elizabeth Benton wrote, “Healthcare questions should be decided by patients in consultation with their doctors, not politicians or lawyers.”
On February 3, the American Society of Plastic Surgery (ASPS) issued a statement explicitly recommending that “surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.”
ASPS made the statement a few days after a 22-year-old woman, Fox Varian, who previously identified as transgender, was awarded $2 million in a medical malpractice lawsuit over a double-mastectomy she received when she was 16 years old.
The ASPS’s statement cites the Cass Review and the 2025 HHS report.
“These reviews have not resolved earlier uncertainties regarding treatment benefit; in some areas, they have contributed to a clearer understanding of potential harms, while also highlighting the limitations of the available evidence, including gaps in documenting long-term physical, psychological, and psychosocial outcomes,” ASPS’s statement said.
Tong criticized the HHS report in his press release.
“The HHS report has been discredited as methodologically flawed because it was anonymously published without peer review and issued at the direction of the president to support his goal of ending transgender health care,” the press release states. “Additionally, the proposed rules will bear significant costs to transgender youth, their families and their healthcare providers, which HHS does not account for.”
When the study was first released in May 2025, it had not undergone peer review. However, a peer review was completed in November.
“Attorney General Tong and the coalition assert in their comment letters that the proposed rules intrude on the states’ rights to regulate medicine within their borders, violate the Spending Clause and Equal Protection Clause, and contradict various statutes including the Social Security Act, the Affordable Care Act, the Administrative Procedure Act, and vital nondiscrimination laws,” the press release states.
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