President Donald Trump signed a wide-ranging executive order designed to curb minors' access to gender-affirming medical care. The order, titled "Protecting Children From Chemical and Surgical Mutilation," has imposed harsh new measures that deny federal funding, limit research into the practices, and require federal agencies to revoke the guidance issued by a prominent transgender health organization.

The executive order specifically targets transition-related healthcare, including puberty blockers, hormone therapy, and gender-affirming surgeries, for individuals under the age of 19. Under the new directive:

  • Federal funds will no longer cover such treatments for minors.

  • Medical schools and hospitals receiving federal research and education grants will face restrictions on studying or providing transition-related care.

  • The Health and Human Services (HHS) secretary is tasked with implementing regulations to halt such treatments for minors.

  • Federal agencies are instructed to withdraw guidance from the World Professional Association for Transgender Health (WPATH), an organization that sets widely recognized standards for transgender medical care.

The order uses harsh language in describing gender-affirming medical interventions as "irreversible" procedures that can cause lifelong complications and sterilization. It asserts that more minors will regret these medical choices and further declares that children are being misled into believing they can change their biological sex through medical interventions.

“Across the country today, medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions,” the order asserts.

It further declares, “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 executive order has already sparked outrage from LGBTQ+ advocacy groups. Lambda Legal, a leading LGBTQ+ legal organization, condemned the measure and vowed to fight against it.

This broadside condemns transgender youth to extreme and unnecessary pain and suffering, and their parents to agonized futility in caring for their child — all while denying them access to the same medically recommended health care that is readily available to their cisgender peers,” said Omar Gonzalez-Pagan, an attorney with Lambda Legal.

Critics have suggested that the guidelines lead to unequal healthcare standards, as it does not appear to place similar restrictions on hormone therapy, puberty blockers, or surgeries for non-transgender minors.

How many minors receive transition-related care?

Despite the political outrage surrounding transition care for minors, very few adolescents are reported to have undergone such treatments. According to a report published in JAMA Pediatrics in January, less than 0.1% of insured adolescents in the United States use puberty blockers or gender-affirming hormones.

In addition, current medical policies mandate that a minor must have parental or guardians' consent to receive any transition-related treatment. Policies adopted by WPATH and other primary medical associations recommend that children be put through therapy and social transition, in which they change their clothes, names, and pronouns before requiring any medical treatment.

For those who experience persistent gender dysphoria through puberty, puberty blockers may be prescribed. Hormone therapy may be an option for teenagers, while surgeries—such as double mastectomies—are extremely rare and typically reserved for older adolescents.

Major medical organizations including the American Medical Association, American Academy of Pediatrics, and the American Psychological Association support access to transition-related care and have voiced strong opposition to legislative restrictions. Studies also show that gender-affirming care can make a major improvement in the mental health outcomes of transgender youth and diminish suicide rates.

A key section of the executive order, titled Ending Reliance on Junk Science,”  directly criticizes WPATH, claiming it “lacks scientific integrity.” The order instructs the HHS secretary to conduct a review of existing research on gender dysphoria, particularly focusing on concepts like rapid-onset gender dysphoria—a controversial and widely debated theory suggesting that gender dysphoria can emerge suddenly due to social influence.

“The Secretary of HHS, as appropriate and consistent with applicable law, shall use all available methods to increase the quality of data to guide practices for improving the health of minors with gender dysphoria, rapid-onset gender dysphoria, or other identity-based confusion, or who otherwise seek chemical or surgical mutilation,” the order states.

WPATH has not yet responded to the executive order.

The debate over transition-related medical care is not limited to the U.S. In December, the United Kingdom took a major step by indefinitely banning new prescriptions of puberty blockers for minors diagnosed with gender dysphoria. The decision followed an independent review by England's National Health Service, which found that existing medical evidence for transition-related care in minors was "remarkably weak." However, this study has faced criticism from some researchers and LGBTQ+ activists.

The executive order signed by Trump further complicates an already contentious legal and political landscape. In the last two years, 26 states have enacted laws limiting gender-affirming care for minors. With the new order in place, legal battles are expected to intensify as advocacy groups challenge its implementation in federal court.