On January 28, 2025, President Donald Trump signed an executive order that will block federal funding and support for medical procedures related to gender transitions for minors under the age of 19. The order specifically targets procedures involving puberty blockers, sex hormones, and surgeries, stating that the United States government will no longer fund or assist in these medical interventions for children.
The executive order reinforces the administration’s policy that the federal government will not sponsor, support, or promote gender transition procedures for minors. It directs the Secretary of Health and Human Services (HHS) to take necessary actions to eliminate the use of gender-affirming care for minors, which could include restrictions on programs such as Medicare, Medicaid, and the Affordable Care Act. HHS is also instructed to withdraw its guidance on gender-affirming care and related patient privacy matters.
While gender-affirming care can include various medical and psychological services for individuals transitioning to a gender different from the one assigned at birth, it is generally considered appropriate only for adults, with most medical professionals not recommending surgical interventions for minors before they reach puberty. Major medical associations, including the American Medical Association and the American Academy of Pediatrics, have consistently endorsed gender-affirming care as a clinically appropriate and evidence-based practice for both children and adults.
In his announcement, President Trump condemned gender-affirming procedures, accusing medical professionals of “maiming and sterilizing” children under the false pretense that such irreversible interventions could change a child’s sex. He further directed federal agencies to abandon policies that follow the World Professional Association for Transgender Health (WPATH) guidelines, which have been regarded as the global standard by experts in gender-affirming care.
The executive order also outlines actions to exclude coverage for gender-affirming procedures for minors from federal health plans, including the Federal Employee Health Benefits plan and TRICARE, the military’s healthcare program. It also mandates an investigation into states that protect access to these procedures and a review of U.S. laws related to the criminalization of female genital mutilation on minors.
The move follows a broader trend of states passing laws restricting access to gender-affirming healthcare for transgender minors, with 26 states enacting such bans. This executive order aligns with a global debate over gender-affirming care, particularly after the controversial Cass Review in the UK, which questioned the use of puberty blockers in minors. Despite ongoing debates, this executive order represents a significant shift in U.S. policy regarding transgender healthcare for minors.
