Former President Donald Trump signed a sweeping executive order Tuesday aimed at restricting federal support for gender-affirming medical care for individuals under 19. This marks his latest effort to roll back protections for transgender individuals across the country.
“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.
The directive primarily targets treatments such as puberty blockers, hormone replacement therapy, and gender-affirming surgeries. It orders federally funded insurance programs, including TRICARE for military families and Medicaid, to stop covering these services. Additionally, it urges the Department of Justice to take legal action against states that protect access to such care.
Currently, Medicaid in some states covers gender-affirming treatments. However, Trump’s executive order signals an attempt to end such policies, placing hospitals and universities that receive federal funding under scrutiny.
The language of the order—using terms like “maiming,” “sterilizing,” and “mutilation”—contradicts the widely accepted medical approach to transgender healthcare in the U.S. It also dismisses guidelines from the World Professional Association for Transgender Health as “junk science.”
On his Truth Social platform, Trump further condemned gender-affirming treatments, calling them “barbaric medical procedures.”
Despite these claims, major medical organizations, including the American Medical Association and the American Academy of Pediatrics, support access to gender-affirming care. Medical professionals emphasize that young people questioning their gender identity undergo careful evaluation by specialists before receiving any medical interventions. In most cases, minors start with social transitions, such as changing their pronouns or hairstyles. Medical treatments, when provided, are carefully monitored, and surgical procedures for minors are exceedingly rare.
Critics argue that the executive order jeopardizes transgender youth and their families by stripping them of essential medical choices.
“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,” said Kelley Robinson, president of the Human Rights Campaign.
Beyond banning coverage, the order calls for Congress to pass legislation allowing individuals who regret receiving gender-affirming care—or their parents—to sue healthcare providers. Additionally, it directs the Justice Department to investigate states that protect access to such care and challenges custody rights for parents who support their transgender children.
Some states with Democratic leadership have enacted laws shielding medical providers who treat out-of-state transgender patients, but Trump’s order could place those protections under legal threat. Civil rights groups, including Lambda Legal, have vowed to challenge the executive order in court.
Michel Lee Garrett, a transgender woman and mother of a nonbinary teenager, believes these policies aim to erase trans people from public life. While her child has not opted for medical transition, she remains committed to defending their right to choose.
“I’ll always support my child’s needs, regardless of what policies may be in place or what may come … even if it meant trouble for me,” Garrett said.
For 18-year-old Howl Hall, a first-year student at Eastern Washington University, hormone therapy has been life-changing. Hall, who takes testosterone, fears the impact of losing access to his medication.
“I would be alive, but I wouldn’t be living,” Hall said. “I wouldn’t be living my life in a productive way at all. I can guarantee that I would be failing all of my classes if I was even showing up to them.”
Trump’s push to restrict transgender rights extends beyond healthcare. On Monday, he ordered the Pentagon to review policies regarding transgender military service members, signaling a likely return to a ban on their enlistment. The directive argues that identifying as a gender “inconsistent” with one’s biological sex “conflicts with a soldier’s commitment to an honorable, truthful, and disciplined lifestyle.”
A group of active-duty military personnel immediately filed a lawsuit against the policy.
SPARTA Pride, a nonprofit advocacy group for transgender service members, issued a strong rebuttal: “Transgender service members have been serving openly for almost ten years, and currently fill critical roles in every branch and specialty, including infantry, aviation, nuclear engineering, law enforcement, and military intelligence, many requiring years of specialized training and expertise. … The readiness and physical capabilities of transgender service members is not different from that of other service members.”
Just days after taking office, Trump signed another order defining sex strictly as male or female, eliminating federal recognition of transgender, nonbinary, and intersex individuals. As a result, the State Department has halted issuing passports with an “X” gender marker, forcing nonbinary individuals to choose between “male” or “female” on official documents.
These moves reflect promises Trump made during his campaign but are expected to be deeply divisive. Public opinion on transgender healthcare bans remains split. According to AP VoteCast, 52% of voters opposed restricting gender-affirming care for minors, while 47% supported such bans. Among Trump supporters, roughly six in ten favored prohibitions on medical transition for transgender youth.
Civil rights organizations see these executive orders as a direct attack on transgender rights and inclusion in society.
“It’s very clear that this order, in combination with the other orders that we’ve seen over the past week, are meant to not protect anyone in this country, but rather to single-mindedly drive out transgender people of all ages from all walks of civic life,” said Harper Seldin, a staff attorney for the American Civil Liberties Union’s LGBTQ & HIV Project.
Seldin added that the ACLU is assessing which aspects of the order take immediate effect and which require further legal or bureaucratic steps.
Transgender individuals have gained visibility and legal protections in recent years, but they have also become targets for conservative lawmakers. At least 26 states have implemented restrictions or outright bans on gender-affirming care for minors, many of which are now being challenged in court. Tennessee’s ban, for example, is currently awaiting a ruling from the U.S. Supreme Court.
Other measures in Republican-led states have sought to bar transgender women and girls from participating in women’s sports and dictate which bathrooms transgender people can use in schools and public spaces.
“These policies are not serving anyone,” said Shelby Chestnut, executive director of the Transgender Law Center. “They’re only creating confusion and fear for all people.”
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