Donald Trump has issued an executive order that directs federal agencies to rescind policies that support or acknowledge gender-affirming healthcare for transgender Americans.
The sweeping order targets the prescription of puberty blockers, hormone therapies and affirming surgeries for anyone under 19 years old — an age group that includes adult Americans.
“It is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures,” according to the order, which labels gender-affirming care “mutilation.”
The order directs the Department of Health and Human Services to “take all appropriate actions” to end affirming healthcare for people age 19 and younger, including reviewing Medicare and Medicaid and other federal health programs.
It also calls for blocking federal funding to medical schools and institutions that support affirming care.
Trump’s latest action follows a series of executive orders targeting transgender, nonbinary and intersex Americans, including Department of Defense policy that could see the removal of thousands of trans service members, as well as changes throughout the federal government that effectively erase recognition of trans people.
Major medical organizations including the American Academy of Pediatrics, the American Medical Association, American Academy of Child and Adolescent Psychiatry and American Counseling Association, among others, stress that affirming healthcare guidelines are clinically appropriate for trans youth experiencing gender dysphoria.
Medical guidelines generally say that affirming surgeries should only be approved for people ages 18 and older, and they are rarely if ever performed.
In 2020, medically necessary gender-affirming healthcare was available to transgender young people in every state. Within four years, that same healthcare was outlawed in nearly half of states, after hundreds of bills targeting LGBT+ young people flooded statehouses on a wave of anti-trans rhetoric that dominated campaign messaging.
The president and Republican candidates campaigned aggressively against so-called “transgenderism” and “gender ideology,” with Trump promising to “stop” affirming care for trans youth entirely.
“This dangerous trend will be a stain on our Nation’s history, and it must end,” Trump’s executive order says.
LGBT+ advocacy groups had been expecting and bracing for the order following Trump’s nonstop campaign and hundreds of anti-trans proposals in state legislatures across the country.
“Everyone deserves the freedom to make deeply personal health care decisions for themselves and their families — no matter your income, ZIP code, or health coverage,” Human Rights Campaign president Kelley Robinson said in a statement.
“This executive order is a brazen attempt to put politicians in between people and their doctors, preventing them from accessing evidence-based health care supported by every major medical association in the country,” said Robinson, whose group is the largest LGBT+ civil rights group in the country.
“It is deeply unfair to play politics with people’s lives and strip transgender young people, their families, and their providers of the freedom to make necessary health care decisions,” Robinson added. “Questions about this care should be answered by doctors–not politicians–and decisions must rest with families, doctors, and the patient.”
Trump’s latest order also singles out the World Professional Association for Transgender Health and its Standards of Care as lacking “scientific integrity.”
The Department of Justice is tasked with investigating affirming care providers and enforcing laws against “deceptive practices,” according to the order.
Gender-affirming care will also be “excluded” from the Defense Department’s TRICARE program, which provides care for nearly 2 million Americans under 18, according to the order.
The Supreme Court is currently deciding whether laws that bar trans children from medically recommended healthcare qualifies as unconstitutional sex discrimination under the 14th Amendment’s equal protection clause.
During oral arguments in December, conservative justices suggested that they would leave a decision on care standards for trans youth to individual states — echoing similar arguments from their landmark ruling that revoked a constitutional right to abortion care.