US President Donald Trump issued an executive order on Tuesday directing federal agencies to restrict access to gender-affirming medical care for transgender youth under age 19 and block federal funding for such treatments.
The order requires federal health programs to exclude coverage for gender-affirming surgeries and hormone treatments for minors beginning in 2026. Key provisions include directing the Department of Health and Human Services (HHS) to review and rescind its 2022 guidance on gender-affirming care; requiring medical institutions receiving federal research grants to halt providing these treatments to minors; instructing the Justice Department to prioritize investigations into potential consumer fraud related to long-term effects of these treatments; and calling for new protections for employees wishing to report on noncompliance by their colleagues.
The order also directs HHS to conduct a literature review on treatment options for transgender minors — which it refers to as “children who assert gender dysphoria, rapid-onset gender dysphoria, or other identity-based confusion” — within 90 days and tasks the Justice Department with working with Congress on legislation to create a private right of action for affected individuals.
Implementation timelines vary by agency, with initial progress reports due within 60 days.
The executive order comes amid an ongoing national debate over transgender rights and healthcare access. According to the Human Rights Campaign, transgender Americans face significant barriers to healthcare, with 22% lacking health insurance coverage and 29% reporting being denied care by medical providers due to their gender identity. Transgender youth in particular face heightened challenges — research indicates that many identify across a broad spectrum of gender identities, and have historically struggled to access appropriate medical care and support services. While public support for transgender rights grew from 25% to 62% between 2014 and 2019, transgender Americans continue to face disproportionate rates of poverty, discrimination in housing and employment, and difficulty obtaining accurate identity documents that match their gender identity.
The issues of gender-affirming care and treatment options for transgender youth featured prominently in the 2024 election season, with Trump-aligned Republicans largely disavowing the necessity of such care.
