The Trump Administration is quietly banning the federal government's largest health insurance provider from covering gender-affirming care even for adults. The U.S. Office of Personnel Management's Healthcare and Insurance division announced in an internal letter Friday from director D. Shane Stevens that "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 ... regardless of age."The letter, posted on social media by independent journalist Ashley Renee and shared in a blog post by federal benefits law firm Ermer & Suter, said that the Federal Employees Health Benefits and Postal Service Health Benefits programs would be implementing the changes as of 2026. The FEHB provides benefits to more than eight million federal employees, with the PSHB covering an additional two million postal workers. There are currently an estimated 14,000 federal employees who are transgender, according to the Williams Institute. The denial of hormone therapies applies only to trans people who are using them to treat gender dysphoria, with the letter clarifying they must still be prescribed during IVF, for treating endometriosis or fibroids, and for cancer treatment or tumor growth prevention.Exceptions will be available for patients "who are mid-treatment within a surgical and/or hormonal regimen for diagnosed gender dysphoria," and healthcare providers must determine who qualifies for the exception on a "case-by-case basis." Counseling services for gender dysphoria will still be covered, with the letter stating that the "counseling services must be provided by a licensed mental health provider and may include those who provide faith-based counseling."The American Medical Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Academy of Child & Adolescent Psychiatry, the World Medical Association, and the World Health Organization all agree that gender-affirming care is evidence-based and medically necessary not just for adults, but minors as well.