Dr. Kade Goepferd watched the Trump administration’s moves on Thursday to ban gender-affirming care for transgender youth with “a mix of sadness and frustration.”

Goepferd, who is the founder of Children’s Minnesota Gender Health Program, says that for the medical community, nothing has changed about the evidence supporting gender-affirming care that could justify the government’s actions.

“There’s a massive propaganda and disinformation campaign that is selectively targeting this small population of already vulnerable kids and their families,” Goepferd says.

“Men are men”

Federal health officials said many times at Thursday’s announcement that their actions were driven by science and evidence, not politics or ideology. They frequently praised a report published by the Department of Health and Human Services in November. It concluded that clinicians who provide medical care to help youth transition have failed their patients and emphasized the benefits of psychotherapy as an alternative.

At times, health officials cast doubt on the idea that a person could be transgender at all.

“Men are men. Men can never become women. Women are women. Women can never become men,” said Acting CDC Director Jim O’Neill. He added that “the blurring of the lines between sexes” represented a “hatred for nature as God designed it.”

Health Secretary Robert F. Kennedy Jr. said doctors and medical groups had “peddled the lie” that these treatments could be good for children, and that those youth were “conditioned to believe that sex can be changed.”

Doctor groups disagree

The American Academy of Pediatrics, the medical group that represents 67,000 pediatricians across the country, pushed back forcefully on those characterizations.

“These policies and proposals misconstrue the current medical consensus and fail to reflect the realities of pediatric care and the needs of children and families,” said AAP President Dr. Susan J. Kressly in a statement. “These rules help no one, do nothing to address health care costs, and unfairly stigmatize a population of young people.”

AAP’s official position on this medical care is that it is safe and effective for the young people who need it. That view is shared by the American Medical Association, the Endocrine Society, among other medical organizations.

In a statement Thursday, the American Psychological Association wrote: “APA is deeply concerned about recent federal actions that not only challenge the scientific understanding of gender identity but also potentially jeopardize the human rights, psychological health, and well-being of transgender and nonbinary individuals.”

The most significant proposal released by HHS would withhold all Medicare and Medicaid funding from hospitals — a big portion of their budgets — if they provided gender-affirming care to those under age 18.

The Children’s Hospital Association said that rule — if finalized — would set a dangerous precedent. “Today’s proposed conditions make it possible for all kinds of specialized health care treatments to be withheld based on government-mandated rules,” wrote CEO Matthew Cook. “Millions of families could lose access to the care they need.”

After a 60-day comment period, the rules could be finalized and then take effect.

Attorneys general in New York and California have said they will fight these rules and protect the rights of trans people to get care in their states. The ACLU has vowed to sue, and more legal challenges are expected.

“I don’t want to be lost”

According to a CDC survey, about 3% of teenagers aged 13-17 identify as transgender, approximately 700,000 people. A poll from health research organization KFF found that less than a third of transgender people took medication related to their identity and 16% had had surgery.

For young people, medical options most commonly include puberty blockers and hormones. Surgery is very rare for minors. “This is health care that evolves over time, is individualized, tailored to a patient’s needs, often after years of relationship with a trusted health care team,” says Goepferd.

NPR spoke to a transgender 15-year old in California this week about the moves Trump administration officials were making to restrict care. “They think what I’m feeling is a phase and that my family should just wait it out and that it’s better I’m unhappy and never receive care,” he says. NPR agreed not to name him because of fears for his safety.

He says it can be difficult for those who are not transgender to understand that experience, but that, as far as he can tell, these health officials “are not interested in understanding trans people.”

He describes the long and deliberate process he made with his parents and doctors before he began taking testosterone. “The decision to not start gender-affirming care is often just as permanent as a decision to start it,” he says. “Not starting [hormone therapy], for some people, it feels like ruining our body, because there are certain changes we can never have.”

Now, after six months on testosterone, he feels like he’s on the right path, and is worried about the prospect of losing access to his medication if HHS’s efforts to shut down care nationally succeed. “It feels like someone’s throwing me into the bush just off the path I’m on, and that’s kind of terrifying,” he says. “I don’t want to be lost. I want to keep going where I’m going.”

“Deep moral distress”

More than half of states already ban gender-affirming care for young people after a frenzy of laws passed since 2021 in Republican-led states. This week, Republicans in the House led efforts to pass two federal bills that would restrict access to care, including one that could put doctors who provide the care in prison for up to ten years. It’s unclear if the bills will be voted on in the Senate.

Although nothing has officially changed in states where the care is still legal, these efforts to enact national restrictions have doctors and health systems in those states bracing for the possibility that their clinics will have to close down.

Dr. Kade Goepferd takes care of transgender and gender diverse young people at Children’s Minnesota hospital.
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“There’s a deep moral distress when you know that there is care that you can provide to young people that will measurably improve their health and the quality of their life, and you’re being restricted from doing that,” Goepferd of Children’s Minnesota says. “And there’s a moral distress in feeling like — as a hospital or a health care system — you have to restrict care that you’re providing to one population to remain financially viable to provide health care for other kids.”

Is there such a thing as an “off year” for U.S. elections? The elections in 2025 were not nearly as all-encompassing as last year’s presidential race, nor as chaotic as what is expected from next year’s midterms. But hundreds of elections were held in dozens of states, including local contests, mayoral races, special congressional elections and two highly anticipated governor’s races.

Many of the elections were seen as early tests of how lasting President Trump’s 2024 gains might be and as a preview of what might happen in 2026.

Here are five takeaways from the 2025 election cycle.

In Elections Seen as Referendums on Trump, Democrats Won Big

Democrats did well in nearly all of this year’s elections, continuing a pattern that has played out across off-year elections for the last two decades: The party that wins the White House routinely loses ground in the next round of elections.

Elections in these years are often viewed as referendums on the president’s performance. And Mr. Trump’s approval ratings, after months of holding steady, took a dip in November.

A notable shift came in New Jersey, where the majority-Hispanic townships that swung toward Mr. Trump in 2024 swung back to Democrats in the 2025 governor’s race. That contributed significantly to the victory of Representative Mikie Sherrill, the Democratic candidate, over Jack Ciattarelli, the Trump-backed Republican.

The leftward swing was viewed by many political commentators as a reaction to Mr. Trump. If that is the case, it remains to be seen how much of it will carry over into 2026.

Progressive and Moderate Democrats Are Both Claiming Victories

Democratic strategists continue to debate whether the party should embrace progressive candidates or more moderate ones. And in 2025, the election results had both sides feeling emboldened.

In New York City, Zohran Mamdani, a democratic socialist who struggled to garner support from the Democratic Party, defeated former Gov. Andrew Cuomo by nine points. A similar story played out in Jersey City, where James Solomon, a progressive, crushed former Gov. James McGreevey of New Jersey in a mayoral runoff. Progressives also prevailed in cities like Detroit and Seattle.

Centrist Democrats, meanwhile, came away with arguably the two biggest wins of the year against Trump-endorsed Republicans. Abigail Spanberger and Ms. Sherrill, both Democrats, outperformed their polling estimates and decisively won the high-profile governor’s races in Virginia and New Jersey.

The debate will continue among Democrats as several 2026 primaries have prominent progressive and moderate candidates going head to head.

In Texas, Representative Jasmine Crockett, a progressive, entered the primary race for a U.S. Senate seat against the more moderate James Talarico. A similar situation has developed in Maine, where Graham Platner has pitched himself as a more progressive alternative to Janet Mills in the party’s attempt to unseat Senator Susan Collins, a Republican. Other progressives, like Julie Gonzales in Colorado and Brad Lander in New York, are challenging incumbent Democrats in primary races.

A Record 14 Women Will Serve as Governors in 2026

Virginians elected Ms. Spanberger as their first female governor. In New Jersey, Ms. Sherrill became the second woman to secure the position. Both women significantly outperformed Vice President Kamala Harris’s margins from the 2024 presidential race, improving on her results by almost 10 points.

Female candidates also did well down the ballot. Eileen Higgins will be the first female mayor in Miami after defeating Emilio González, who had the support of Mr. Trump. And, in Seattle, Katie Wilson defeated the incumbent mayor, Bruce Harrell.

Come 2026, a record 14 women — 10 Democrats and four Republicans — will serve as governors, with six of them expected to run for re-election next year. (More than a dozen states have yet to elect a female governor.)

In New York, it is likely that both candidates will be women: Representative Elise Stefanik, a Republican, began a campaign last month against the incumbent, Kathy Hochul.

Special Elections Are Still Very Special (for Democrats)

Despite not flipping any House seats, Democrats outperformed Ms. Harris’s 2024 results in every House special election this cycle. Their wins, however, offer limited insight into what might happen in 2026.

Special elections, which happen outside of regular election cycles to fill vacated seats, draw fewer voters than those in midterm or presidential years. Special election voters tend to be older and highly engaged politically, and they are more likely to be college educated. That has given Democrats a distinct advantage in recent years, and 2025 was no exception.

Democratic strength in special elections extended to lower-profile races held this year. In Virginia, Democrats secured 64 out of 100 seats in the House of Delegates. In Georgia, Democrats won two seats on the Georgia Public Service Commission, the first time the party won a non-federal statewide office since 2006. Pennsylvania Democrats swept the major Bucks County contests, electing a Democratic district attorney for the first time. And, in Mississippi, Democrats broke the Republican supermajority in the State Senate.

Odd-Numbered Years Are Still Very Odd (for Election Polls)

Polling in off-year election cycles is challenging because it’s hard to know who will turn out to vote. This year, the polls significantly overestimated the Republicans in the Virginia and New Jersey governor’s races, which both had particularly high turnout for an off year. In 2021, polls had the opposite problem, as they overestimated Democrats.

Polling misses don’t necessarily carry over from cycle to cycle: Despite the leftward bias of the polls in 2021, they performed very well in 2022. After each election, pollsters look at the result and evaluate their performance, and then note where they went wrong. Analysis from groups like the American Association for Public Opinion Research frequently indicates that errors come from an incorrect sense of who shows up to vote. Pollsters then try to adjust for this error in the next election cycle.

The errors of 2025 may prove largely irrelevant, however, as the midterm elections will feature a larger, very different pool of voters with a new set of races, and a new host of lessons for pollsters to learn.

Off years are weird, and the polling errors they produce often are as well.

MOSCOW — Russian President Vladimir Putin said Friday that Moscow’s troops were advancing across the battlefield in Ukraine, voicing confidence that the Kremlin’s military goals would be achieved.

Speaking at his highly orchestrated year-end news conference, Putin declared that Russian forces have “fully seized strategic initiative” and would make more gains by the year’s end.

Russia’s larger, better-equipped army has made slow but steady progress in Ukraine in recent months.

The annual live news conference is combined with a nationwide call-in show that offers Russians across the country the opportunity to ask questions of Putin, who has led the country for 25 years. Putin has used it to cement his power and air his views on domestic and global affairs.

This year, observers are watching for Putin’s remarks on Ukraine and the U.S.-backed peace plan there.

U.S. President Donald Trump has unleashed an extensive diplomatic push to end nearly four years of fighting after Russia sent troops into Ukraine in February 2022, but Washington’s efforts have run into sharply conflicting demands by Moscow and Kyiv.

Putin reaffirmed that Moscow was ready for a peaceful settlement that would address the “root causes” of the conflict, a reference to the Kremlin’s tough conditions for a deal.

Earlier this week, Putin warned this week that Moscow would seek to extend its gains in Ukraine if Kyiv and its Western allies reject the Kremlin’s demands.

The Russian leader wants all the areas in four key regions captured by his forces, as well as the Crimean Peninsula, which was illegally annexed in 2014, to be recognized as Russian territory. He also has insisted that Ukraine withdraw from some areas in eastern Ukraine that Moscow’s forces haven’t captured yet — demands Kyiv has rejected.