Alabama Attorney General Steve Marshall is leading a coalition of 24 states urging the federal government to permanently halt Medicare and Medicaid funding for sex-change procedures for minors.

In a letter sent to U.S. Department of Health and Human Services Secretary Kennedy, the coalition asked the Centers for Medicare and Medicaid Services to finalize proposed rules that would restrict federal funding for such procedures under Medicare, Medicaid and the Children’s Health Insurance Program.

The letter addresses two proposed rules that would prevent taxpayer dollars from subsidizing what the attorneys general describe as sex-change procedures for children. The coalition argues that federal health programs should not finance medical interventions for minors related to gender dysphoria.

“Medicaid and Medicare should never have been allowed to use taxpayer dollars to fund radical and dangerous sex-change procedures for children. We support the Trump administration’s proposal to reverse course,” stated Attorney General Marshall. “We know the dangers of these procedures firsthand. Through years of litigation defending Alabama’s law, we uncovered a political and medical scandal involving the leading medical guidelines that recommend using sterilizing hormones and surgeries to ‘treat’ children suffering from gender dysphoria. The guidelines were built on ideology and politics, not science, and have led to untold harm to children and their parents. Children deserve better, and the first step in helping them is to stop funding the harm.”

Marshall’s office said the coalition’s position is rooted in evidence uncovered during litigation over Alabama’s law restricting certain medical treatments for minors experiencing gender dysphoria. According to the letter, court proceedings revealed concerns about the development of the “Standards of Care 8,” or SOC-8, published by the World Professional Association for Transgender Health.

The attorneys general contend that WPATH used SOC-8 to advance political and legal objectives and altered treatment recommendations based on political considerations. The letter further alleges that the organization departed from established best practices for creating medical guidelines and impeded the publication of systematic evidence reviews evaluating the safety and effectiveness of sex-change procedures for minors.

The coalition also points to what it describes as WPATH’s determination that castration could be considered “medically necessary” for males who self-identify as “eunuchs,” citing it as an example of what the states characterize as ideological influence in medical guidance.

Medicare primarily provides health coverage for individuals age 65 and older and certain younger people with disabilities, while Medicaid and the Children’s Health Insurance Program serve low-income families and children. The proposed federal rules would limit the ability of those programs to reimburse for specific treatments for minors related to gender transition.

Joining Marshall in signing the letter are the attorneys general of Alaska, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Montana, Nebraska, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia and Wyoming.

The full letter can be read at www.alabamaag.gov.