On January 24, 2025, Kansas Senator Roger Marshall cast the deciding vote to confirm Pete Hegseth as Secretary of Defense, whose Pentagon began discharging transgender service members, and on April 3, 2025 he voted to confirm Mehmet Oz, whose agency barred federal Medicaid funds for gender-affirming care for young people and barred insurers from covering the care as an essential benefit in marketplace plans.
Marshall also voted to confirm Attorney General Pam Bondi, whose Justice Department subpoenaed doctors and clinics that treat transgender youth, Veterans Affairs Secretary Doug Collins, whose department phased out gender-affirming care for veterans, and Personnel Director Scott Kupor, whose office dropped the care from federal employees' health plans. He cast one of the 50 votes for the 2025 law whose Medicaid cuts reach LGBTQ adults, who rely on Medicaid at twice the rate of other adults, in Kansas and every other state. In 2025 Marshall also introduced two bills to end federal funding for gender-affirming care at any age, and his release on one of them counts 276,000 of the 1.3 million transgender adults as enrolled in Medicaid.
Roger Marshall's Confirmation Votes on Transgender Health Care, the Military Ban and Federal Protections
- Marshall Cast the Deciding Vote for the Defense Secretary Who Began Discharging Transgender Troops. On January 24, 2025, Roger Marshall voted to confirm Pete Hegseth as Secretary of Defense; the vote was 50 to 50 and the Vice President broke the tie, so Hegseth would not have been confirmed without Marshall's vote. Hegseth's policy holds that people with a history of gender dysphoria are "incompatible" with U.S. military service. After the Supreme Court let it take effect in May 2025, About 1,000 troops who previously self-identified now have to leave the military, and service members suing over the ban have now received notices starting involuntary separation. In a 2025 Gallup poll, 58% of respondents said they support admitting openly transgender women and men into the U.S. military.
- Marshall Voted to Confirm Mehmet Oz, Whose Agency Cut Off Federal Medicaid Funds for Transgender Youth Care. On April 3, 2025, Marshall voted to confirm Mehmet Oz as administrator of the Centers for Medicare and Medicaid Services, and he was confirmed 53 to 45. In August 2026 Oz's agency finalized a rule ending federal Medicaid and CHIP payment for puberty blockers, hormones and surgery for young people, and KFF counted about 130,000 young trans people with Medicaid or CHIP coverage in states without their own restrictions. In June 2025 the agency had also ruled that insurers are prohibited from covering gender affirming care as an essential health benefit in marketplace plans starting in 2026.
- Marshall Introduced Bills to End Federal Funding for Gender-Affirming Care for Adults and Minors in 2025. On March 12, 2025, Roger Marshall reintroduced the End Taxpayer Funding of Gender Experimentation Act, which prohibits federal funding for gender transition procedures and bars federal healthcare facilities, physicians, and providers from providing such procedures. On May 1, 2025 he introduced the No Subsidies for Gender Transition Procedures Act, which would bar payment for that care covered by Medicaid, Medicare, the Children’s Health Insurance Program, and the Affordable Care Act, and he said it eliminates taxpayer-funded transgender procedures on both minors and adults while urging that it be added to the One Big Beautiful Bill Act. His own office's release on the first bill says that Over 276,000 of the 1.3 million transgender adults are enrolled in Medicaid, the adults whose coverage for this care the bills would end in states that now provide it.
- Marshall Voted to Confirm Pam Bondi and Todd Blanche, Whose Justice Department Subpoenaed Doctors Who Treat Transgender Youth. Roger Marshall voted to confirm Pam Bondi as attorney general on February 4, 2025 and Todd Blanche as deputy attorney general on March 5, 2025. In July 2025 the department issued more than 20 subpoenas to doctors and clinics providing young people with gender-affirming care, KFF reported, and by 2026 at least 40 health care institutions have walked back the provision of gender-affirming care, cutting off patients who had been in treatment.
- Marshall Voted to Confirm Doug Collins, Whose VA Phased Out Care for Transgender Veterans. On February 4, 2025, Marshall voted to confirm Doug Collins as secretary of veterans affairs, and he was confirmed 77 to 23. In March 2025 the VA announced that it would phase out providing gender affirming care for transgender veterans, KFF reported.
- Marshall Voted to Confirm Scott Kupor, Whose Office Dropped Gender-Affirming Care From Federal Employees' Health Plans. On July 9, 2025, Marshall voted to confirm Scott Kupor as director of the Office of Personnel Management, and he was confirmed 49 to 46. Kupor's office removed the coverage from federal employee health plans for 2026, and for 2027 carriers must remove any exceptions process that had protected people already in treatment, according to KFF.
- Marshall Cast One of the 50 Votes for Medicaid Cuts That Fall Hardest on LGBTQ Adults and People With HIV. On July 1, 2025, Marshall voted yes on H.R. 1, which passed 50 to 50 with the Vice President's vote. "LGBTQ+ adults are twice as likely as non-LGBTQ+ adults to use Medicaid as their main insurance," according to the Williams Institute, and "Medicaid is also the primary insurance for Americans living with HIV," The 19th reported in a story republished by the LGBTQ+ outlet them.
- Marshall Voted to Confirm Robert F. Kennedy Jr., Whose Department Shut the LGBTQ Youth Crisis Line for 14 Months. On February 13, 2025, Marshall voted to confirm Robert F. Kennedy Jr. as secretary of health and human services. Kennedy's department ended the 988 crisis line's service for LGBTQ young people in July 2025, a line that had received over 1.5 million contacts since its start. The harm was transient: It was revived over a year later, on September 30, 2026, after pressure from Congress, KFF reported.
What the Federal Limits on LGBTQ Health Care Roger Marshall Backed Mean in Kansas
- Young people on Medicaid. Kansas's own ban on this care for minors is on hold: In May 2026, a judge temporarily blocked the state's ban, the Movement Advancement Project reports. That leaves the August 2026 Medicaid rule from Oz's agency as the limit for Kansas families on Medicaid or CHIP, part of the about 130,000 young trans people with Medicaid or CHIP coverage in states without their own restrictions whose federal coverage for the care ends.
- Insurance for Kansas families. Kansans who buy marketplace coverage can no longer count on it for gender-affirming care, because insurers are prohibited from covering that care as an essential health benefit starting in 2026 under the rule from the agency led by Mehmet Oz, whom Marshall voted to confirm.
Frequently Asked Questions About Roger Marshall on LGBTQ rights
What is Roger Marshall's record on LGBTQ rights under Trump?
Roger Marshall cast the deciding vote to confirm Pete Hegseth, whose Pentagon is discharging transgender troops, and voted to confirm Mehmet Oz, whose agency barred federal Medicaid funds for gender-affirming care for young people. He also voted to confirm Pam Bondi, Doug Collins and Scott Kupor, whose agencies subpoenaed providers, ended the care at the VA and dropped it from federal employee plans.
Did Roger Marshall vote to confirm Pete Hegseth, who banned transgender troops?
Yes. Roger Marshall voted to confirm Pete Hegseth on January 24, 2025, in a 50 to 50 vote decided by the Vice President, so Marshall's vote was needed. Under Hegseth's policy, About 1,000 troops who previously self-identified now have to leave the military.
What bills has Roger Marshall introduced on transgender health care?
Roger Marshall introduced the End Taxpayer Funding of Gender Experimentation Act in March 2025 and the No Subsidies for Gender Transition Procedures Act in May 2025, which he said eliminates taxpayer-funded transgender procedures on both minors and adults. He urged that the second bill be added to the 2025 tax-and-spending law, and the agency led by Mehmet Oz, whom he voted to confirm, later ended federal Medicaid payment for the care for young people.
What happened to gender-affirming care for veterans under the VA secretary Roger Marshall confirmed?
Roger Marshall voted to confirm Doug Collins as VA secretary, and in March 2025 the VA announced that it would phase out providing gender affirming care, keeping only hormone therapy already under way for transgender veterans.
Last updated: 2026-10-25