Right now, the House Foreign Affairs Committee is putting together a wide-ranging State Department Reauthorization bill that will codify the folding of what is left of the U.S. Agency of International Development (USAID) into the State Department. All signals are that most of the President’s Emergency Plan for AIDS Relief (PEPFAR) will be retained, at least in some capacity. But somehow, orphans and vulnerable children have fallen off the priority list again.

HIV is an insidious disease, particularly when it comes to children and babies. Its impacts extend well beyond the biomedical, often leaving society’s youngest without parents, without education, and even without food. When parents or caregivers become debilitated or die, children are at grave risk of falling into poverty, suffering abuse, and contracting HIV and dying themselves.

The Trump Administration’s dismantling of USAID and freezing of much of U.S. foreign assistance has placed the lives of millions of children, who previously were safe, in great jeopardy — and even led to the deaths of some.

At the beginning of the AIDS epidemic, a bipartisan group of U.S. lawmakers was educated to understand the tragic impacts it would have on children. They knew from practitioners that treating HIV alone wasn’t enough; the epidemic’s socio-economic consequences, especially on children, had to be addressed, too. That is why they very intentionally built protections into the AIDS, TB, and Malaria authorization bill that created PEPFAR in 2003 to direct 10% of all HIV funding to orphans and vulnerable children (OVC). These resources supported community-based programming — ensuring children were able to attend school, eat nutritious food, travel to clinics for testing and treatment, and receive psychosocial support to address the stigma and discrimination they experienced. These programs also trained OVC caregivers in positive parenting and provided livelihood support, enabling them to expand microbusinesses and better provide for their children.

PEPFAR’s OVC programs also played a key role in identifying HIV positive children, getting them tested, and ensuring adherence to treatment regimens. These functions are still urgently needed. Children continue to be left behind in the global HIV response: just over half of all children living with HIV (57%) are on life-saving treatment versus roughly 77% of adults. And while children make up only 3% of people living with HIV, they account for 12% of AIDS-related deaths.

The OVC set aside was a remarkable achievement, representing the first time that the holistic needs of children were addressed in one program. But the set aside also did much more, which was not anticipated at the time: it provided an antidote to child labor and sex trafficking — evils that perennially thrive in conditions of marginalization and poverty. OVC programs succeeded by strengthening the family and caregivers around the child. PEPFAR prevented 8.2 million children from becoming orphaned in the first place, and its parenting programs have been shown to reduce physical, verbal, and sexual abuse of children by up to 57%. PEPFAR’s OVC work on behalf of adolescent girls reduced their experiences of sexual violence by 65% in Malawi and 68% in Kenya. According to new modeling of high-prevalence countries using Population-Based HIV Impact Assessment (PHIA) surveys, over the past decade alone, OVC programs prevented the sex trafficking of 8,500 children, reduced the number of child marriages by close to 7,000, and cut the cases of physical and emotional violence against children by nearly 55,000. PEPFAR did all this by keeping girls in school, training parents, educating young boys and girls about what to watch out fo,r and changing social norms around what is and is not acceptable. These types of activities are time- and labor-intensive, but they change the behavior of communities over the long term and are critical in ensuring UNAIDS’ 95-95-95 goals. They also produce a strong return on investment.

Over the past two decades, PEPFAR has supported over 13 million orphans and vulnerable children and their caregivers with holistic interventions addressing the social and economic devastation of AIDS. It has also protected 10.3 million girls from sexual abuse.  When children remain in school, especially girls, they can generate income, support their families, and contribute to the economy as adults. PEPFAR’s OVC programs have produced a $4 return on economic productivity gains for every $1 spent on programming.

One of the more complicated aspects of the OVC set aside is that, unlike most other aspects of PEPFAR’s policy framework, it expires. The OVC set-aside requires that Congress preserve it, adding it back each time the program is reauthorized. Although it has historically enjoyed bipartisan support and has been included in each reauthorization, recent political attacks on foreign assistance have cast doubt on its future.

And sadly, OVC programs are all gone as of January of this year. The programs supported by the OVC set aside did not receive the waiver from Secretary of State Marco Rubio for “life-saving humanitarian assistance” as other medical components of PEPFAR did. As a result, programs were abruptly cut off and 6.6 million orphans, vulnerable children and caregivers were completely abandoned.

Right now, in countries that were receiving PEPFAR’s OVC support, children are not getting food or being connected to medical care. Because education is not free in many countries, when a family is not able to pay school fees (something the OVC set aside did), children are often forced to work, many times on the street. In some places, when conditions are dire, it is not uncommon for children to be trafficked — “sold” into domestic servitude or married off as young children, where they are without protection from physical and sexual abuse.

But we know how to prevent this. PEPFAR has saved and protected millions of babies and young children, ensuring they have the safeguards and support they need to thrive.

And there is not a moment to lose. Experts estimate that 10% of children in sub-Saharan Africa are orphaned from all causes, and this loss of a parent is associated with education loss, child abuse, and child sexual exploitation, with consequent elevated risks of HIV infection. The dangers for children are acute: 20% of girls experience rape or sexual assault and a child younger than 15 years is estimated to die from AIDS every 7 minutes.

We call on Congress to reauthorize PEPFAR as a part of the State Department Reauthorization bill and to include the 10% set aside for orphans and vulnerable children as a part of the underlying statute so that it does not expire at the end of each authorization. In addition, we call on the Administration to re-hire staff and fully fund OVC programs as it folds PEPFAR into the State Department. Without the 10% set aside for OVC that Republican and Democratic members of Congress came together to intentionally create two decades ago, millions of children will be at great peril.

The post Congress: Don’t Forget the Orphans & Vulnerable Children appeared first on First Focus on Children.

What happened?

On May 27th, 2025, Health and Human Services Secretary Robert F. Kennedy Jr., along with National Institutes of Health (NIH) Director Jay Bhattacharya and Food and Drug Administration (FDA) Commissioner Marty Makary announced that the Trump Administration had removed COVID-19 vaccines from the childhood immunization schedule and from the recommended schedule for pregnant women.

Earlier in May, Makary and FDA’s director of the Center for Biologics Evaluation and Research Vinayak Prasad released an FDA policy position restricting COVID-19 vaccines to adults 65 and older and those at high risk for severe COVID-19.

Combined, these actions will put children and their families at increased risk of COVID-19 and other health complications as COVID-19 vaccines become more difficult and more expensive to get.

The weak and misleading “evidence” provided by Kennedy and others in the Trump Administration does not make a sufficient case for withholding COVID-19 vaccines from children. Research continues to show that the benefits of vaccinating children far outweigh the few risks. With this position, Kennedy and others — none of whom are trained in infectious diseases or vaccinology — unnecessarily put America’s children at increased risk for COVID-19, long COVID, Multisystem Inflammatory Syndrome (MIS-C), and other  other complications.

What is the immediate effect of this position?

This measure eliminates the recommendation that children receive at least one dose of the most current COVID-19 vaccine after 6 months of age. At the same time, FDA plans to require unnecessarily and unusually strict testing for already approved COVID-19 vaccines for people aged 6 months to 64 years with no other risk factors for severe COVID-19.

Together, these actions mean that many children will go unvaccinated and that insurance companies may no longer cover the vaccine, which costs roughly $140 per vaccine. In addition, even families who can afford the vaccine may not be able to get it without a prescription from a doctor. These obstacles to protecting children come at the same time Congress and the Administration are attacking Medicaid, which provides health insurance to 37 million children.  

In addition, the use of weak, false, and purposefully misleading evidence contributes exponentially to existing vaccine hesitancy and works to further destroy public trust in vital public health agencies, such as the FDA and the Centers for Disease Control and Prevention (CDC).

What could happen next?

Now that Secretary Kennedy has removed the COVID-19 vaccine from the CDC’s childhood vaccine schedule, he may instruct the FDA to revoke the Emergency Use Authorizations (EUAs) for the pediatric COVID-19 vaccines altogether. If the EUAs are revoked, COVID-19 vaccines may become unavailable for children while vaccine manufacturers attempt to get the vaccines re-approved by the FDA. These actions would make it essentially impossible for children to obtain vaccines against COVID-19 in the United States.

Not Recommended vs. No Access: Twisting the research to fit the policy

Kennedy and others have repeatedly claimed that “most countries have stopped recommending [the COVID-19 vaccine] for children” and “all other high-income nations confine vaccine recommendations to older adults (typically those older than 65 years of age), or those at high risk for severe Covid-19.” But this is a disingenuous reading of these policies. In fact, “most countries” — which appears to mean the 12 countries identified in the FDA’s position paper on the issue — do continue to recommend an initial COVID-19 vaccine for all people, of all ages, including babies and children. They have, however, cut back on recommending yearly boosters for children. It is obvious the Administration understands this distinction because it is clearly stated in the documents they offer as evidence. It is purposefully misleading then to produce this list as evidence to limit all vaccination for persons under 65 and without risk factors for severe COVID-19.

The 12 countries that the FDA lists derived their booster recommendations from the World Health Organization’s (WHO) COVID-19 vaccine guidance, which states that all persons should receive at least one dose of the COVID-19 vaccine in their lifetime and that previously vaccinated persons as young as 50 years old with comorbidities, pregnant persons, health workers, and individuals with compromised immune systems or increased risk factors for severe COVID-19 should receive additional doses of the vaccine routinely, either per pregnancy or every six to 12 months.

By removing COVID-19 vaccines from the childhood immunization schedule and placing other restrictions on them, Kennedy effectively prevents children and their families from accessing the vaccines at all, which is fundamentally at odds with WHO’s guidance that “everyone, everywhere should have access to COVID-19 vaccines.” Even though FDA’s Prasad and Makary have said they reject the view that “the American people are not sophisticated enough to understand age- and risk-based recommendations,” they apparently accept the idea that American children should not be protected from COVID-19 and that American families should not even be allowed to choose whether they want additional yearly protection.

Everyone, everywhere, should have access to COVID-19 vaccines.

World Health Organization Guidance

No vaccines means higher risk to children

If children and their families are no longer able to be vaccinated against COVID-19 they risk COVID-19 infection, long COVID, and MIS-C. The latest COVID-19 variant, Omicron, has an R0 value of 9.5, meaning one person infected with COVID-19 is expected to infect between nine and 10 other people. This rating means COVID-19 is nearly nine times more infectious than flu and would require 89% of the U.S. population to achieve herd immunity, a form of indirect protection where enough people in the U.S. are immune to a given disease that it makes the disease harder to transmit. Herd Immunity is the only way to protect unvaccinated people in the U.S., especially those who cannot receive the vaccine due to compromised immune systems, allergies, or other complications. By Prasad and Makary’s own admission, only 30-60% of Americans would be eligible to access the COVID-19 vaccine, far below herd immunity and thus jeopardizing the health of millions of Americans. Unvaccinated children and their families could face various risks, including: 

• Increased risk of COVID-19
  • Without access to vaccines, children are at increased risk of COVID-19 infection.
  • From 2020 to 2022, COVID-19 was the 7th leading cause of death for 1-17 year olds in America, killing an estimated 1086 children. Although they have a lower risk of severe illness and hospitalization, children are just as likely as adults to be infected. Children also can spread the virus and, in some studies, have been shown to play an outsized role in spreading COVID-19.
  • Babies under 1 year old, especially those prematurely born, are at heightened risk of severe illness. The only way for babies under 6 months old to be protected from COVID-19 is for their families and those around them to be vaccinated, especially their pregnant parent. WHO thus recommends that pregnant persons receive another dose of the COVID-19 vaccine during their pregnancy, which the FDA’s framework does not allow and CDC no longer recommends.
  • Newborns are protected through transferred immunity from their pregnant parent getting vaccinated, which is why pregnant people are advised to get flu shots, TDAP vaccines, and other vaccines to protect the health of newborns.
• Increased risk of long COVID
  • Even if children recover from a COVID-19 infection that caused mild or no symptoms, they are still at risk of long COVID, also calledpost-COVID condition or PCC. Long COVID is a condition that continues to cause symptoms even  after the person recovers from the COVID-19 infection. Long COVID can last anywhere from 3 months to many years. Researchers have identified up to 200 symptoms of long COVID, notably fatigue, brain fog, and anxiety, and long COVID can negatively affect a child’s ability to play or perform well at school. There is no cure for long COVID, so vaccines remain the best way to protect children from the condition. Currently, over 1 million children in the U.S. have had long COVID, with 80% experiencing activity limitations.
• Increased risk of MIS-C
  • Multisystem Inflammatory Syndrome in children (MIS-C), is a rare but serious condition that can affect children infected with COVID-19. A child with MIS-C may have a fever and severe inflammation in multiple parts of their body, including their heart, lungs, and brain. The only way to protect against MIS-C is to be vaccinated against COVID-19. Many things remain unknown about MIS-C, but experts have observed that it can affect children of all ages, and  especially school-age children around 8 to 9 years old. MIS-C can be treated if detected early enough, but without treatment children can suffer permanent damage to the heart, kidneys, and other organs.
• Becoming incubators for deadlier and more infectious strains of COVID-19
  • Every time a virus infects someone it replicates and has a chance to mutate, making it easier to spread from person to person and/or deadlier. For example, on the same day as Secretary Kennedy’s announcement, researchers detected a new strain of COVID, variant NB.1.8.1, in the U.S. The more a virus is allowed to spread, the more chances it has to mutate.
  • As COVID-19 has mutated, it has become exponentially better at spreading from person to person. If we refuse to protect children in the U.S. and let more and more children and families go unvaccinated, we allow COVID-19 to spread and mutate into more infectious and deadlier variants.
• Kennedy’s disinformation campaign makes vaccine hesitancy worse
  • Even if these dangerous policies are eventually reversed, the damage to the public’s confidence in public health agencies like the CDC and FDA may be longer lasting. The disinformation and false claims about the safety and effectiveness of COVID-19 vaccines by Kennedy and others can make hesitancy around the COVID-19 vaccines and other vaccines much worse.
  • Prasad and Makary mention public trust in vaccination has declined, referencing an article that explicitly refutes Secretary Kennedy’s false vaccine claims and blames the Trump Administration for fueling anti-vaccine sentiment. Prasad and Makary make the bewildering claim that COVID-19 vaccination requirements, not their or Secretary Kennedy’s years of anti-vaccine disinformation, is the cause for lower vaccination rates in the U.S. The truth is much more straightforward: disinformation is the number one driver of COVID-19 vaccine hesitancy as well as hesitancy to take a variety of other vaccines.
  • COVID-19 vaccines are safe and effective. The benefits for getting vaccinated far outweigh the risk of side effects.

Conclusion

Secretary Kennedy’s decision to remove COVID-19 vaccines from the childhood immunization schedule, in combination with the FDA’s decision to restrict access to the latest COVID-19 vaccines, is anti-scientific, short-sighted, and will put children and their families at unnecessary risk while potentially letting COVID-19 mutate and run wild in the U.S. COVID-19 vaccines are safe, effective, and lifesaving, and these decisions will make it essentially impossible for most people in the United States to be protected from COVID-19. This decision will also further erode public trust in vaccines and public health institutions at the same time that outbreaks of vaccine-preventable diseases, like measles, continue to ravage the country. Instead of accepting scientific consensus, agreeing with what other countries and WHO actually recommend, or trusting parents and doctors to make informed decisions about children’s health, Secretary Kennedy has unilaterally imposed his own false anti-vaccine rhetoric onto America’s children. American children and their families will suffer decades of lasting harm if these decisions stand.

The post Trump Administration’s removal of COVID-19 from recommended childhood vaccines endangers children, families, and confidence in all vaccinations appeared first on First Focus on Children.

For many school districts, the BSCA grants made it possible to hire more counselors, social workers, and psychologists. In some rural and underserved communities, these funds allowed schools to triple their mental health staff, providing students with vital support for anxiety, depression, trauma, and everyday stress. These professionals often serve as the first — and sometimes only — point of contact for children in need.

With the abrupt end of this funding, schools across the country are now facing the painful prospect of laying off staff and scaling back mental health programs that serve kids and teens. These cuts will mean longer waits for help, fewer trusted adults for students to turn to, and a return to the days when many children’s mental health needs went unnoticed and unmet.

This setback comes at a time when children’s mental health needs are at an all-time high. Nearly one in five children, ages 3-17 struggle with mental, emotional, developmental, or behavioral disorders. Only about half of these children receive treatment. Suicide remains one of the leading causes of death among teenagers, with 20% of high school students reporting they seriously considered suicide in 2023.

School-based mental health services are critical to identifying issues early and providing timely intervention. When these services are cut, students — especially those in rural or low-income areas — are left with even fewer options for support.

As if the loss of school-based mental health funding weren’t enough, Congressional leaders are also proposing hundreds of billions of dollars in cuts to Medicaid and CHIP. The more than 37 million children these programs insure include those from families with low incomes, those in foster care, and those living in rural communities. Medicaid and CHIP don’t just cover doctor visits, they are essential for funding school-based physical and mental health services.

Medicaid and CHIP provide billions of dollars each year to school districts, enabling them to offer a wide range of services directly on campus. These funds allow schools to:

• Hire and retain counselors, social workers, and psychologists who provide mental and behavioral health care to students.
• Offer preventive and primary care through school-based clinics, including routine screenings and immunizations.
• Support students with disabilities by funding therapies and specialized services required under federal law.
• Expand access to care for all eligible students, not just those with disabilities, in many states.

For many families, especially those in rural or underserved communities, school-based health services funded by Medicaid and CHIP are the most accessible or even the only source of care. Students are far more likely to receive mental health support when it is available at school, reducing barriers related to transportation, cost, and stigma.

If Congress moves forward with cuts to Medicaid and CHIP, schools could lose the ability to provide these critical services. These service losses would disproportionately affect children who rely on school-based care, leading to increased unmet physical and mental health needs, higher absenteeism, and more children struggling academically and emotionally without the support they need. States would be forced to cut services, restrict eligibility, or reduce provider payments, further straining an already fragile system and deepening health disparities for kids.

The combined effect of losing both dedicated school mental health grant funding and the foundational support of Medicaid and CHIP would be nothing short of devastating. It would put at risk the progress made in recent years to reduce stigma, increase awareness, and improve access to mental health care for kids and teens. As we observe Mental Health Awareness Month, policymakers must commit to ensuring that every child has the support they need to thrive, not just survive. They can start by demanding that the Administration reinstate the $1 billion in bipartisan grants Congress passed for school mental health services and by also refusing to cut Medicaid and CHIP.

The post Cuts to School Mental Health Funding and Threats to Medicaid/CHIP: A Growing Crisis for Children appeared first on First Focus on Children.

Last week, I testified before the House Judiciary Subcommittee on the Constitution and Limited Government to speak about the crisis children in America face and urge Congress to act. But while I talked about rising child poverty, hunger, homelessness, and struggles obtaining health care, the Subcommittee majority was, sadly, more interested in stoking culture wars than solving problems for children and youth.

Maybe the majority called the hearing to distract from what the full House of Representatives was doing to threaten the health, education, development, safety, and well-being of children through the budget process. On April 9, 2025, votes were pending in the House on a parliamentary vote to move the budget forward to a final vote on passage of the budget proposal.

Those two votes set into motion the process by which Congress may cut up to $880 billion in cuts to Medicaid and the Children’s Health Insurance Program (CHIP), $330 billion in cuts to SNAP or food stamps, and $230 billion in cuts to education, including school meals – all of which would have significant negative and disproportionate consequences on tens of millions of children across the country.

Consequently, I was grateful for the invitation to testify from Democratic Committee members Jaime Raskin (D-MD) and Mary Gay Scanlon (D-PA), who serve as Ranking Members of the full House Judiciary Committee and Subcommittee on the Constitution and Limited Government, respectively. They asked me to speak to the “status of children” in this country and how we might best address their needs, concerns, and interests.

This hearing followed one in the Subcommittee a few weeks earlier on birthright citizenship in which the Subcommittee majority failed to acknowledge that President Trump’s Executive Order 14160, which seeks to gut birthright citizenship, targets one group of people for harm: BABIES.

My testimony and opening statement made the following points:

• Children face many growing threats: these include rising infant and child mortality, rising child poverty, increasing uninsured rates, a children’s mental health crisis, the reemergence of vaccine-preventable diseases (e.g., measles and pertussis), increases in homelessness and hunger, a child care crisis, increases in child abuse deaths, the on-going threat of school shootings, and the growing fear of children living in immigrant households all threaten kids.
• Our failure to care for and support children leads to poor outcomes: the failure of other systems to care for and support children is more likely to lead to problems that come before the House Judiciary Committee, including juvenile interactions with the justice system and child exploitation.
• Money matters: evidence clearly shows that investing in children has the highest rate of return of just about any federal spending for our nation’s future. For example, research by economists Nathaniel Hendren and Ben Sprung-Keyser finds that investments in children produce the highest return on investment of any category of federal spending examined.
• The Trump Administration, in just a short period of time, is failing our kids: actions by the Administration on the budget, through its executive orders, and its dismantling of government departments and agencies, have repeatedly failed kids or, even worse, targeted them for harm.
• The American people strongly support making investments in kids: on issue after issue, the American people have demonstrated that they support making investments in kids and oppose policies that would harm them in any way.
• Children have fundamental rights too: these rights and voices should be recognized and defended, but unfortunately, they are often ignored or dismissed.

What El Paso Taught Me About Why Kids Need Advocates

In speaking to the House Judiciary Subcommittee, I emphasized that I didn’t come as a lawyer, or a doctor, but as a child advocate informed by growing up in El Paso, Texas, as the child of educators and seeing firsthand the struggles that children face, including poverty, the lack of health care, underinvestment in education, and societal injustice that take root and hurt kids.

From my parents and others in my family who were educators, I learned how poverty, health care, hunger, homelessness, domestic violence, and child abuse all play major roles in a child’s education and life opportunities.

I explained:

Children are not asking for luxury. They are not lobbying for tax shelters or asking for loopholes. Their needs are focused on their health, education, development, safety, and well-being. They and their families are asking for stability, safety, and a fair chance for an opportunity to thrive.

These are the building blocks of childhood, and yet across our country, those foundations are cracking — sometimes collapsing completely.

Children’s Issues Should Be Bipartisan

Throughout its 20-year history, First Focus on Children has worked on a bipartisan basis with Democrats and Republicans alike to champion children’s health care, nutrition, education, and safety. These aren’t red issues or blue ones. They are children’s issues.

Helping children should never be a partisan issue. It hasn’t been for most of my career—and it shouldn’t be now.

Unfortunately, instead of working across the aisle to address the growing needs of America’s children, what unfolded during the hearing and on the floor of the House was something else entirely.

The House voted later that evening 216-215 (Roll Call #94) to proceed with the budget vote and 216-214 (Roll Call #100) the next morning in favor of the Republican leadership’s budget proposal that could lead to hundreds of billions in cuts to investments, programs, and services to children at the very time they are facing enormous challenges. This budget proposal is, quite frankly, an “assault” on children.

What the Committee Chose to Spotlight Instead

The Subcommittee hearing title was “Ending Lawfare Against Whistleblowers Who Protect Children,” but I remain unsure what the true purpose of the hearing was. Based on the hearing title, I would have hoped that the Subcommittee would have tackled cases involving children, such as:

• The U.S. Women’s Gymnastics Team
• The Boy Scouts
• Kids for Cash
• The Catholic Church
• Jerry Sandusky/Penn State
• The Mormon Church
• Jeffrey Epstein scandal
• Southern Baptist Convention
• Book Bans/Censorship
• The Troubled Teen Industry
• Child Welfare Failings
• Juvenile Prisons
• Child Labor
• Child Trafficking
• Migrant Children
• Attacks on LGBTQ Youth

In many of these cases, if adults had listened to the kids themselves, abuse and harm could have been averted and children protected, but the voices of young people were repeatedly ignored.

This was, once again, often true in this hearing. The topic involved Dr. Eithan Haim, who opposes gender-affirming care and sent partially redacted medical records of children’s appointments without their consent to right-wing blogger Christopher Rufo. This action led the Department of Justice to charge the physician with violating the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule.

I leave it to others to decide whether this particular case violated HIPAA, but it was important that Rep. Pramila Jayapal (D-WA) raised and spoke eloquently about the concerns of children and their parents with respect to medical privacy rights.

In an exchange with Dr. Haim, Rep. Jayapal also explained why adolescents and their parents should not have their medical records released without their consent.

The Congresswoman concluded with a passionate argument as to why we needed to protect the privacy rights of adolescent transgender kids.

What About Texas Child Protective Services?

One of the bombshells that went largely ignored from Dr. Haim’s testimony was that Texas Child Protective Services (CPS) was failing to protect children who were hospitalized at Texas Children’s Hospital due to child abuse.

Dr. Haim testified that he did not bother to call Texas Child Protective Services (CPS) to report his concerns because the agency never “actually protected children” in cases that he witnessed involving “dozens of children who suffered unfathomable abuse such as intentional starvation, cigarette burns, finger amputations, etc.” He said he would see the “abusers” in the room making medical decisions for those they harmed.

If protecting children was the goal of this hearing, Dr. Haim raises disturbing claims about the failure of Texas CPS to protect children from horrific cases of medical abuse. His testimony should prompt a follow-up investigation and hearing focused on the failure of CPS to protect children in the Chairman’s State of Texas.

What say you, Chairman Roy?

Turning a Hearing That Should Have Been About Kids into a Culture War

Instead, much of the time of the Subcommittee Republicans was focused on dismissing gender dysphoria and attacking gender-affirming care. Several Republican members on the Subcommittee argued in favor of government stepping into the role of banning or regulating such care, despite numerous medical societies having created evidence-based guidelines related to such care, and adolescents and their parents seeking out and consenting to such treatment.

In Texas, Governor Greg Abbott and Attorney General Ken Paxton have equated gender-affirming care with abuse and have asked Texas CPS to investigate parents and families for gender-affirming care.

We disagree.

At First Focus on Children, we joined an amicus brief before the Texas Supreme Court in 2022 that opposed efforts to label gender-affirming care as child abuse. Our position follows established standards of medical practice and defends the medical rights of young people and their parents, in partnership with their doctors, to receive gender-affirming care. The amicus brief reads:

Gender-affirming care is not child abuse… By definition, care that is recommended and appropriate pursuant to standards of care that are widely agreed upon by professionals who treat child abuse cannot be child abuse. Gender dysphoria is real. And gender-affirming care to treat gender dysphoria is appropriate under the established standards of care and practice.

Rep. Becca Balint (D-VT) made this point and explained how such care is evidence-based and has saved lives.

These attacks on such care are not just rhetorical – they have real-world consequences. When states criminalize gender-affirming care, families are forced to flee, kids are denied medical support, and a chilling effect ripples through pediatric practices and children’s hospitals.

For example, Congress is holding up extension of the pediatric graduate medical education (GME) reauthorization bill over gender-affirming care. This threatens the medical education of pediatric residents for all pediatric medical care, including pediatric oncology, endocrinology, cardiology, diabetes, pulmonology, neurology, orthopedics, prosthetics, rheumatology, nephrology, and neonatal and perinatal medicine. If funding is threatened, life-saving medical care delivered in children’s hospitals all across this country would be put at risk.

The doctors, nurses, and medical staff at children’s hospitals are heroes who save the lives of children every single day. Congress has a moral responsibility to protect and support all children, including the funding that supports their care.

Turning Attention Back to the Challenges Facing Children

Rep. Balint urged the Subcommittee to turn its attention to the major challenges that children are facing in this country, including the votes the House was preparing to make on the federal budget later that evening and the next morning.

Rep. Balint discussed with me the myriad of challenges facing our nation’s children, including infant and child mortality, child poverty, hunger, homelessness, children’s mental health crisis, and with an important addition from Rep. Raskin, gun violence. We discussed how massive budget cuts being proposed by House leadership would make these matters much worse for children.

The data speaks for itself:

• Infant and child mortality are rising for the first time in decades.
• Child poverty has more than doubled since pandemic-era relief was cut.
• Millions of children have lost health coverage as Medicaid protections ended.
• Mental health crises continue to soar, with rates of anxiety, depression, and suicide among youth climbing year after year.

These are not abstract problems. These are children with names, faces, and dreams being derailed and harmed by policy failures and budget cuts.

After the Recess

After a break for members to cast votes on the House floor, the hearing resumed and took some disturbing turns, such as Rep. Harriet Hageman (R-WY) declaring there is “zero” benefit from gender-affirming care. She wishes for government to outlaw it and, ironically, to overturn the decision-making authority of parents and adolescents with their doctors.

The American Academy of Pediatrics, the Academic Pediatric Association, the American Academy of Child and Adolescent Psychiatry, the American Academy of Family Physicians, the American Academy of Nursing, the American College of Obstetricians and Gynecologists, the American College of Osteopathic Pediatricians, the American College of Physicians, the American Pediatric Society, the Association of American Medical Colleges, Association of Medical School Pediatric Department Chairs, the Endocrine Society, the National Association of Pediatric Nurse Practitioners, the Pediatric Endocrine Society, the Society for Adolescent Health and Medicine, and the Society of Pediatric Nurses, who know the real evidence and science, disagree.

In an amicus brief they filed in February, they explicitly state “gender-affirming medical care for people under nineteen, which as this brief describes, is critical, medically necessary, evidence-based care for gender dysphoria.”

They add:

…gender dysphoria can result in debilitating anxiety, depression, and self-harm, and is associated with suicidality. As such, the effective treatment of gender dysphoria saves lives.

Finally, Chairman Chip Roy (R-TX) tried to play a game of “gotcha” in which he asked me repeatedly about the role of parents in making decisions about their children’s health care (again, ironic because it is the Subcommittee Republicans and President Trump that seek to deny parents, children, and their doctors the ability to make these decisions).

Three straight times, I repeatedly said either:

We believe that medical decisions should be made by doctors, parents, and children, Doctors, parents, and children should make medical decisions based on best practices.

He then noted, to which I affirmatively and enthusiastically agree, that I have said – more than once – that there are other occasions when health care can and should be delivered without parental consent. Examples include:

• Emergency care
• Other medical circumstances in which the denial of care would threaten the life of children, such as cancer treatment
• Services such as allowing kids to receive band-aids, medical tape for ankle or finger sprains, ice packs, or even a tissue
• Routine medical care to adolescents, testing and treatment for infectious and communicable diseases, counseling, substance abuse treatment, etc.
• Other circumstances, such as a rape kit exam related to sexual abuse by a parent or family member

I also pointed to the majority’s witness, Dr. Haim, who testified that he witnessed numerous cases in which “abusers” were being allowed by Texas CPS to make medical decisions related to “unfathomable abuse such as intentional starvation, cigarette burns, finger amputations, etc.” I added that cases involving child abuse by parents are a good example of when to leave parents out of decision-making.

Here is that exchange with Chairman Roy.

Unfortunately, the video misses me thanking Chairman Roy for putting my Substack posts and my letter to the House Judiciary Committee on these issues into the Committee record. I was appreciative that he did so – not because we agreed on the issue, but because he was making my point and that truth for children should be reflected in the Subcommittee record.

Here are the Substack posts that he put into the transcript”

• How a ‘Parental Rights’ Bill Threatens the Health, Education, and Safety of Children
• Gov. DeSantis Should Veto Florida’s Tragically Flawed So-Called ‘Parents’ Bill of Rights’

I wish he had added:

• The Dark Side of Parental Rights Laws: Risks to Child and Adolescent Health
• Childism, Under the Guise of Parental Rights, Is Detrimental to Children
• Judge Barrett, What Is Right for Children?

In the end, parental consent is the norm.

However, we diverge concerning those circumstances in which parental consent may be unavailable, unnecessary, places the child at danger or high risk, or results in the denial of medically necessary care or treatment.

While some feel that the health of children, their bodies, and their lives are at the sole discretion and control of parents in all or almost all circumstances, even in cases where children would die due to medical neglect.

I do not.

As Samantha Godwin explains:

When evaluating the extent of parents’ legal rights, we should not merely consider how ideal parents exercise their power to provide the effective care and guidance children need. The extent of what the law enables imperfect parents to do to their children must also be taken into account. The issue is not only what role we hope that parents play in their children’s lives, but how the powers actually granted might be used and abused for better or worse. Thinking only in terms of how the best parents conduct themselves is a mistake; it is also necessary to account for what the worst parents can get away with.

In such cases, I would err on the side of both protecting the health and well-being of children and recognizing that children have fundamental rights too.

Highlighting How the Trump Administration’s Cuts Threaten Children

In her closing, Ranking Member Scanlon returned the focus to the Trump Administration’s proposed massive budget cuts to programs of importance to our nation’s children.

As Rep. Scanlon and I discussed, this isn’t hypothetical. These cuts will devastate children and families.

The Trump Administration has put forth budget proposals that would:

• Slash Medicaid and CHIP by up to $880 billion.
• Impose cuts to child nutrition programs, including SNAP, WIC, and school breakfast and lunch programs, just as food insecurity has risen.
• Gut the Department of Education and scatter its responsibilities across unrelated agencies.
• Devastate the Low-Income Home Energy Assistance Program (LIHEAP).
• Eliminate Head Start.
• Defunding of public health programs that protect children from preventable diseases.

These policies don’t reflect the values of the American people. They reflect the priorities of political ideologues determined to shrink government — even if it means sacrificing children to do it.

Columnist Catherine Rampell further documents the list of attacks on children that the Trump Administration has proposed in a column that ran this morning titled Donald Trump’s war on children: The Administration is divesting from future generations. It will cost America dearly.

The Public Is on the Side of Children

Fortunately, the American people are on the side of children in the debates over the budget – overwhelmingly so.

Here’s what Americans believe:

• 83% support maintaining or expanding Medicaid.
• 72% support expanding the Child Tax Credit to fight child poverty.
• 71% oppose attacks on birthright citizenship.
• By wide margins, they believe the federal government is spending TOO LITTLE rather than TOO MUCH on children’s programs.

These aren’t partisan views. These are deeply held American values. The problem is not the people. It’s the politicians who refuse to listen to them or make children a priority.

We Can and Must Do Better

In my closing remarks, I said:

Despite being citizens who have fundamental rights, children and their voices are often locked out of political arenas and decision-making processes that impact their lives.

It is imperative that when a child cries out for help – whether it is a sick child, an abused child, a hungry child, a homeless child, or a victim of gun violence – adults should listen.

We must build a nation in which every child has a chance to grow up healthy, safe, educated, and supported.

That’s what I went to Congress to say. It’s what I’ll keep saying. And with your help — sharing this Substack post, raising your voice, pushing back against false narratives — we can help change not just the conversation, but the future for our children.

How to Help Children

1. Watch and share the clips: use them to tell others what’s really happening in Congress and the Trump Administration.
2. Contact your representatives: tell them to reject cuts to kids’ programs and defend children’s rights.
3. Support organizations like First Focus on Children: help those of us working every day to make children a national priority.

The post Testifying for Children Before a House Committee That, Far Too Often, Ignores Them appeared first on First Focus on Children.

The Trump Administration has made children a political target, which is not only immoral, it’s costly. Kids can’t vote, and they don’t have political action committees or lobbying power. But investing in children leads to better health outcomes, higher educational attainment, and increased earnings as adults. A study by the National Bureau of Economic Research suggests that every dollar the federal government invests in programs that benefit children yields $10 or more in societal returns.   

The Administration has had Head Start in its sights since it took office, ensnaring the program in the funding freeze announced in January – which was quickly reversed after an uproar from early learning advocates and members of Congress. In late March, the Trump Administration announced plans to cut approximately 10,000 jobs at the U.S. Department of Health and Human Services, including 30-45% of staff at the Administration for Children and Families (ACF), which administers Head Start as well as important programs in child care and child welfare. Five of 10 regional ACF offices have closed since then, eliminating Head Start and other staff in those offices. Regional offices provide near constant communication between HHS and the states and jurisdictions implementing HHS programs. This includes oversight of grantees to ensure the integrity of federal programs, fielding technical assistance and program questions, and ensuring health and safety standards for children are met.  

Head Start currently serves over 775,000 children and their families, including children with disabilities, those in foster care, and children experiencing homelessness. The program has served more than 40 million children and families throughout its history. The Head Start program includes preschool and child care for children ages 3 and 4; care and home visiting through Early Head Start for infants, toddlers, and expectant families; the American Indian and Alaska Native Head Start program; and the Migrant and Seasonal Head Start program. Services under Head Start are provided in a variety of settings, including home visiting, center-based, and family child care, giving families many choices. In fact, Head Start prioritizes the inclusion of parents as partners in decisions and operations. The program produces both short- and long-term positive results for kids and families.   

Eliminating Head Start would decimate child care and other family services for hundreds of thousands of families that rely on it and increase inequity in early learning. There is already an early learning and child care crisis in this country, with child care being least affordable and accessible for Black, Hispanic, and low-income working parents. Under current funding levels, Head Start is only able to serve 33% of eligible families, Early Head Start serves 11%, and the Child Care and Development Block Grant (CCDBG) serves 15% of families who qualify.  

Costs for care are astronomical and would climb even higher by eliminating Head Start. In 2023, the cost to a family of child care for two children in a center was more than annual mortgage payments in 45 states and the District of Columbia. The cost of child care for an infant at a center was more than in-state tuition at a public university in 39 states and D.C. CCDBG, which is only able to offer child care assistance to a fraction of eligible families, would be unable to absorb families that formerly received Head Start services. Eliminating Head Start would leave countless families without an option for care for their children, putting their job security and our national economy at risk. Instead of solving the child care crisis, eliminating Head Start would exacerbate it. Without Head Start, families that depend on these services may be unable to afford the high expense of alternatives and be forced out of the workforce.   

The child care sector still has not recovered from the COVID-19 pandemic and has not been able to permanently increase wages and benefits to attract and keep teachers. Lawmakers provided approximately $50 billion in emergency funding to the sector during the pandemic, all of which has since expired. In states that have not addressed this shortfall, the share of families who need child care and do not have it increased from 17.8% to 23.1%. States used this pandemic-era funding to eliminate copays for families, increase compensation for early learning teachers, reduce waiting lists, and expand child care assistance eligibility. These funds also increased women’s participation in the workforce.  

Increased investments in early learning programs have proven effective. Research has shown they produce positive results for children and their families. Eliminating programs that currently serve low-income families is not progress. The President’s plan would inexplicably attempt to address our crisis in child care access and affordability by eliminating existing child care slots and limiting parent choice. We urge Congress to fulfill its responsibility to fund national priorities and continue its support for Head Start and vital early childhood programs in this country.  

The post Trump Administration’s Plan to Eliminate Head Start Threatens Child Care, Families, and Economy appeared first on First Focus on Children.