Trump executive order targets transgender care

Sandhya Raman and Jessie Hellmann, CQ-Roll Call on Jan 28, 2025

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WASHINGTON — President Donald Trump issued a wide-ranging executive order on Tuesday directing the Department of Health and Human Services and other federal agencies to examine policies related to gender-affirming care for children and teens.

The executive order — which would affect adolescents’ ability to get gender-affirming care through various insurance programs — follows a separate Pentagon directive calling for a change for transgender troops issued Monday. That order is already the subject of litigation.

The order defines “child” as an individual under 19 years of age, meaning access to care could even be impacted for people who otherwise are considered adults.

“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 memo reads.

Trump campaigned heavily on the issue of transgender care during the 2024 campaign, running ads attacking Democratic rival Kamala Harris as being for “they/them.”

The 2024 GOP platform also prioritized limited access for gender-affirming care, vowing to “ban Taxpayer funding for sex change surgeries, and stop Taxpayer-funded Schools from promoting gender transition.”

Trump’s executive order directs HHS to rescind guidance related to gender-affirming care and to reexamine and increase data collection on the issue.

It calls for defunding education and research at medical schools and universities related to transgender care for kids and teens. It also directs HHS to reexamine what other regulatory and subregulatory actions are needed across agencies to align with the executive order, including looking at essential health benefits requirements and Medicare and Medicaid conditions of participation.

The Biden administration took several steps to expand access to care for trans people, including approving a request from Colorado to make gender-affirming care an essential health benefit.

The document directs TRICARE to begin rulemaking to ensure gender-affirming care is excluded from adolescent coverage benefits.

TRICARE currently covers hormone therapy for gender dysphoria, but generally doesn’t cover surgery, according to the TRICARE website.

The fiscal 2025 defense authorization law signed by former President Joe Biden last year also included a ban on gender-affirming care for minors.

The document calls on changing relevant provisions in Federal Employees Health Benefits and Postal Service Health Benefits plans for 2026 Plan Year so that coverage can exclude pediatric gender-affirming care and to adjust the premiums in both plans accordingly.

The document also calls on the Justice Department to coordinate enforcement strategies across state lines, interpreting the 1980 Parental Kidnapping Prevention Act to enforce actions against so-called sanctuary states for youth gender-affirming care and to work with Congress to enact a private right of action for affected youth or their parents.

Trump also directs the heads of the mentioned agencies to meet and submit a report on coordinated implementation within 60 days.

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