President Trump on Tuesday signed a sweeping executive order meant to broadly restrict access to gender-affirming care for transgender children and teenagers younger than 19, inching closer to fulfilling a key campaign promise to ban treatments that he and his administration have cast as experimental and dangerous, in conflict with major medical associations and transgender health experts.
“Across the country today, medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions,” Tuesday’s order states. “This dangerous trend will be a stain on our Nation’s history, and it must end.”
“Accordingly, 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,” the order states.
Every major medical organization supports gender-affirming care for transgender adults and minors, although not every trans person chooses to medically transition or has access to care.
Trump’s executive order, titled “Protecting Children from Chemical and Surgical Mutilation,” tasks federal agencies with rescinding or amending policies that rely on guidance from the World Professional Association for Transgender Health (WPATH), including the organization’s latest standards of care, released in 2022.
WPATH, a nonprofit professional organization devoted to transgender health care, did not immediately return a request for comment.
Trump’s order tasks the incoming Secretary of Health and Human Services (HHS) with publishing a review of existing literature on best practices “for promoting the health of children who assert gender dysphoria, rapid-onset gender dysphoria, or other identity-based confusion.”
Rapid-onset gender dysphoria, which claims that adolescents identify as transgender because of influence from friends or social media, is not recognized as a valid medical diagnosis by major professional medical organizations. In 2021, 61 professional health care organizations, including the American Psychological Association, signed a letter stating the condition lacks “rigorous empirical support for its existence.”
According to Tuesday’s order, heads of executive departments and agencies that provide research and education grants to medical institutions, including medical schools and hospitals, should take immediate steps to block funding for institutions that continue providing gender-affirming care to minors.
Meredithe McNamara, an assistant professor of pediatrics at Yale University specializing in adolescent medicine, said the provision amounts to “an immediate de facto ban on medical care” for trans youth who receive care at academic medical centers.
“It basically defunds those medical centers if they continue to provide that care,” McNamara said of the order.
“This is a stunning example of how all health care is tied together, and how the most effective way to attack gender-affirming care is to attack the entire health care apparatus as a whole,” she added in an interview. “They’re holding everyone hostage and saying, ‘We’re going to take away everyone’s healthcare unless you systematically deprive just these people.’”
Trump’s executive order additionally directs the HHS Secretary — a position he wants for Robert F. Kennedy, Jr. — to bar access to gender-affirming care for transgender minors through federal programs like Medicaid and Medicare and withdraw the department’s 2022 guidance supporting gender-affirming care. The secretary should issue new guidance, in consultation with the incoming attorney general, “protecting whistleblowers who take action related to ensuring compliance with this order,” according to Tuesday’s order.
The executive order also directs Defense Secretary Pete Hegseth to draft a rule to exclude coverage for gender-affirming care for minors from TRICARE, the military’s health program. Former President Biden in December signed a $895 billion defense policy bill barring TRICARE from covering transition-related care for transgender children of active-duty service members, a provision that military families with transgender kids called a “slap in the face.”
Tuesday’s order similarly tasks the director of the Office of Personnel Management with taking steps to remove coverage for gender-affirming care for trans youth from federal health plans.
It also asks the attorney general to prioritize enforcement of existing federal laws against female genital mutilation, which carry a penalty of up to 10 years in prison. The attorney general should also “prioritize investigations and take appropriate action to end deception of consumers, fraud, and violations of the Food, Drug, and Cosmetic Act” by entities that may be “misleading the public” about the long-term side effects of transition-related care.
Republican state attorneys general have, in recent years, used consumer protection laws to investigate individuals and organizations that provide gender-affirming care to minors. A Senate Finance Committee report released in April claimed that at least four GOP attorneys general — Ken Paxton of Texas, Todd Rokita of Indiana, Jonathan Skrmetti of Tennessee and Andrew Bailey of Missouri — abused their oversight authorities to “further ideological and political goals.”
Trump’s executive order additionally directs the attorney general to work with Congress to “draft, propose, and promote legislation” to enact a private right of action for children, as well as their parents, “whose healthy body parts have been damaged” by medical professionals practicing transgender health care.
The attorney general should also take “appropriate action,” the order states, “to end child-abusive practices by so-called sanctuary States,” including through the potential application of the Parental Kidnapping Prevention Act, a federal law preventing one parent from interfering with another parent’s custody rights.
Conservative organizations celebrated Trump’s executive order Tuesday evening. In a joint statement, Independent Women’s Forum and Independent Women’s Voice said the move restores the “true meaning of ‘care’ for America’s youngest generation.”
Kristina Rasmussen, executive director of Do No Harm, a health policy group that opposes gender-affirming care for minors, said Trump’s order prioritizes “safety, scientific integrity, and family autonomy.”
Omar Gonzalez-Pagan, senior counsel and health care strategist at the LGBTQ civil rights organization Lambda Legal, called the order “morally reprehensible and patently unlawful” and said the group would sue.
“The federal government — particularly, this administration — has no right to insert itself into conversations and decision-making that rightly belongs only to parents, their adolescent children, and their medical providers,” he said.
The executive order comes after Trump signed separate orders declaring that the federal government recognizes only two sexes, male and female, and barring transgender people from serving openly in the military.
