On Tuesday, January 28, Donald Trump signed an executive order that aims to remove access to gender-affirming healthcare for trans youth in the United States.
The order, called ‘Protecting Children from Chemical and Surgical Mutilation’, directs the Federal Health Employee Benefits Plan to stop coverage of gender-affirming care, including puberty blockers, hormone therapies, and gender-affirming surgeries for those aged 19 and under. It also calls on the Department of Justice to investigate medications currently prescribed and to prosecute healthcare providers, citing laws that prohibit “female genital mutilation.”
If enacted, all hospitals, clinics, and medical schools currently supporting providing gender-affirming care in the US would risk losing their federal funding should they continue to do so. The order also aims to end coverage for gender-affirming care under TRICARE, the military’s healthcare system.
Transgender youth already have limited access to gender-affirming care across the US with restrictions in place in 26 states. This order threatens to impose a nationwide ban, with activists and medical professionals condemning move, noting that it perpetuates misinformation.
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Leading medical organisations including the American Academy of Pediatrics, American Psychological Association, and the American Medical Association assert that gender-affirming care is medically necessary and life-saving for transgender youth.
Lambda Legal Chief Legal Officer Jennifer Pizer says the order contradicts nondiscrimination protections granted in the Affordable Care Act.
Legal director of the Lesbian Center for Transgender Rights Shannon Minter said: “The order’s characterization of medical care for transgender minors bears no resemblance to reality. This is an attempt to impose an extreme ideological agenda through hyperbole and fear, not a responsible attempt to address this issue.”
Human Rights Campaign President Kelley Robinson said: “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.”
Pop icon and LGBTQ+ advocate Madonna said: “It’s so sad to watch our new government slowly dismantling all the freedoms we have been fighting for and WON over the years.”
It’s so sad to watch our new Government slowly dismantling all the Freedoms we have been fighting for and WON over the years. 🏳️🌈💔
Don’t give up the Fight! pic.twitter.com/6FiziYa2zM— Madonna (@Madonna) January 28, 2025
Trump’s executive order attacking trans healthcare falsely refers to gender-affirming care as “chemical and surgical mutilation,” and activists have pointed to the blatant discrepancy of this statement. Gender-affirming surgeries are rarely performed on minors, and medications are rarely prescribed.
Activists emphasise that there are plenty of procedures that “mutilate” cisgender children in the US, including infants being surgically altered to “fix” intersex variations, gynecomastia (removing breast tissue in boys), rhinoplasty (altering the shape of the nose), and breast augmentation in teen girls.
This order specifically impacts transgender youth, and it follows a series of dangerous measures targeting diversity, equity and inclusion (DEI) across the country. Trump’s administration is also attempting to eliminate the federal recognition of transgender and non-binary identities, end accommodations for transgender students, reinstate a ban on transgender service members in the military, and require government-issued IDs to reflect the sex assigned at birth.
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It’s important to remember that this order will not come into immediate effect, and will very likely be challenged in court. LGBTQ+ legal organisations including the ACLU and Lambda Legal have already successfully challenged and defeated some of Trump’s anti-trans policies, and, following Trump’s anti-LGBTQ+ orders, the latter has promised to swiftly take action.
Omar Gonzalez-Pagan, Lambda Legal Senior Counsel and Health Care Strategist shared: “This policy by the Trump administration is morally reprehensible and patently unlawful. 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.
“We fought previous attempts by the first Trump administration to restrict health care and we won. We stand ready to fight back against this even more pernicious effort to deny medically necessary health care to our youth.”
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