The U.S. Department of Health and Human Services on Thursday unveiled a series of regulatory actions designed to effectively ban gender-affirming care for minors, building on broader Trump administration restrictions on transgender Americans.

The sweeping proposals — the most significant moves this administration has taken so far to restrict the use of puberty blockers, hormone therapy and surgical interventions for transgender children — include cutting off federal Medicaid and Medicare funding from hospitals that provide gender-affirming care to children and prohibiting federal Medicaid dollars from being used to fund such procedures.