Trump Signs Order Aimed at Ending Gender-Affirming Care for Anyone Under 19

President Donald Trump signed an executive order on Tuesday that seeks to end gender-affirming medical treatment for children and teenagers under the age of 19. The age threshold covers 18-year-olds as well as minors, a point clarified in a correction to the original coverage published on January 31.

The directive follows other recent actions affecting transgender people. On Monday, Trump signed an order banning transgender troops from serving openly in the military. On his first day in office last week, he signed an order recognizing two sexes, male and female, and targeting what it called gender ideology extremism.

Under Tuesday's order, the federal government will not "fund, sponsor, promote, assist, or support" gender-affirming care for children. The president argues that such care leaves young people with costly medical bills and regret later in life, since some procedures may affect their ability to conceive. The care in question includes puberty blockers, hormones and surgeries.

Some coverage for pediatric gender-affirming care will be excluded from Medicaid, Medicare and the benefits packages offered to federal and U.S. Postal Service employees. The order also directs that any laws relying on guidance from the World Professional Association for Transgender Health be eliminated or changed. Institutions that receive federal research and education grants must stop providing gender-affirming care to children.

Trump also criticized health care workers who perform the procedures, saying, "This dangerous trend will be a stain on our Nation's history, and it must end." Although the order centers on pediatric care, it instructs federal and state attorneys general to work together to enforce laws "against female genital mutilation across all American States and Territories" more broadly.

LGBTQ advocacy and civil rights groups strongly condemned the move, saying it targets and discriminates against trans youth, among the most vulnerable people in the country. Omar Gonzalez-Pagan, senior counsel and health care strategist for Lambda Legal, said the administration's "disdain and animosity towards transgender people and other minorities appears to know no bounds." He added that the order could put thousands of vulnerable young lives at risk and called it "an outrageous overreach of government power."

Gonzalez-Pagan also warned of the long-term effects on families, saying the order condemns transgender youth to "extreme and unnecessary pain and suffering" and leaves parents facing "agonized futility." He noted it denies them medically recommended care that is readily available to their cisgender peers.

The Human Rights Campaign also criticized the administration for inserting itself into personal medical decisions. HRC President Kelley Robinson said everyone deserves the freedom to make deeply personal health care decisions for themselves and their families, regardless of income, zip code or health coverage. She called the order "a brazen attempt to put politicians in between people and their doctors," and said it blocks access to evidence-based care supported by every major medical association in the country.

The order sets deadlines for follow-up. The secretary of Health and Human Services has 90 days to evaluate research on how best to help children experiencing discomfort with the gender assigned to them at birth, and agency leaders have 60 days to submit progress reports on the order.