Health insurance plans for federal employees will no longer cover surgical and chemical gender transition procedures, the White House’s Office of Personnel Management (OPM) announced last month. The move expands on an earlier decision to remove coverage for gender transition procedures on minors and steers federal policy away from gender ideology, sparing taxpayers who would rather not pay for the controversial procedures.

“For Plan Year 2026, chemical and surgical modification of an individual’s sex traits through medical interventions (to include ‘gender transition’ services) will no longer be covered under the FEHB [Federal Employees Health Benefits] or PSHB [Postal Service Health Benefits] Programs,” OPM informed health insurance carriers in an August 15 letter (“Carrier Letter 2025-01b”).

Every year, the OPM issues a “Call Letter” to health insurance carriers, which “outlines benefit policy and strategic initiatives of importance,” the OPM described in a letter issued on January 15, 2025, days before the second Trump administration began. The letter directed carriers to “submit their benefit and rate proposals” by the end of May, for “the contract term beginning January 1, 2026.” Under the Biden administration, OPM aimed to complete benefit negotiations by the end of July and rate negotiations by mid-August.

However, the Trump administration ushered in sweeping reforms across the federal government, with no organ more critical to its reform effort than OPM.

On January 31, OPM updated its guidance to health insurance providers in a second letter (“Carrier Letter 2025-01a”) based on President Trump’s executive orders (EOs) “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” and “Protecting Children from Chemical and Surgical Mutilation.”

“Pursuant to the first EO, all federal agencies are tasked with ensuring all federal policies and documents that require an individual’s sex list two options, male and female, and shall not make available third options or request “gender identity,” the letter stated. “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” for “covered individuals under age 19.”

As of August 15, the OPM has now extended the ban on taxpayer funding (through health insurance) of gender transition procedures to all individuals covered by federal health insurance plans, not just minors. “For Plan Year 2026, chemical and surgical modification of an individual's sex traits through medical interventions (to include ‘gender transition’ services) will no longer be covered under the FEHB or PSHB Programs,” OMB wrote. “This exclusion expands upon Carrier Letter 2025-01a and applies regardless of age.”

The letter provides three exceptions — clarifications, rather — regarding the excluded procedures. Under the new policy, health insurance providers must still cover counseling services “provided by a licensed mental health provider.” They “should not exclude coverage” for legitimate uses of the excluded procedures, such as taking certain hormones to treat precocious puberty or certain cancers. And they “must establish an exceptions process … for enrollees who are mid-treatment within a surgical and/or hormonal regimen for diagnosed gender dysphoria,” which should consider those enrollees “on a case-by-case basis.”

The most obvious effect of these policy changes is to make it more difficult for transgender activists to shelter comfortably within the ranks of the federal workforce. If a federal employee wishes to pursue costly, cosmetic alterations to make his or her appearance more like members of the opposite sex, he or she is free to do so, but the government (that is, taxpayers) will no longer pick up the tab. If these procedures are too expensive on a civil servant’s salary, the employee is free to leave the federal workforce for more lucrative private employment.

Every choice in life involves trade-offs; this policy simply invites those who are most enthusiastic to pursue gender transition procedures to do so apart from federal employment.

With these policy changes, the OPM now treats gender transition procedures similarly to abortion, which has been excluded from the FEHB since the Hyde Amendment was first passed in 1995. Both categories are morally controversial procedures, which many Americans would rather end permanently.

Although federal policy falls far short of that distant ideal, it can at least initiate a compromise that respects the conscientious objections of opponents to these procedures. At the very least, federal policy can refrain from requiring that those who find these practices morally abhorrent must fund them with their tax dollars. That is what OPM has done here.