President Donald Trump announced new restrictions on gender-related health care on Tuesday, releasing an executive order that aims to prevent federal funds from being spent on gender transitions for children and teens younger than 19.
The order directs health insurance programs run by the federal government, including Medicaid, to stop covering transition-related care, and warns medical schools and hospitals that they could lose access to federal funding if they continue providing such care to young people.
“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 order says.
The new executive order ramps up a nationwide battle over gender-related care for minors, which is already restricted or banned in around half of U.S. states.
It will likely affect ongoing lawsuits over those state-level policies, including a current Supreme Court case, and it will face new lawsuits, as well.
“We will not allow this dangerous, sweeping, and unconstitutional order to stand,” said Chase Strangio, co-director of the ACLU’s LGBT & HIV Project, in a statement on Tuesday.
Strangio defended gender-related health care for children and teens in front of the Supreme Court in December.
Executive order on gender-related care
The new order, titled “Protecting children from chemical and surgical mutilation,” describes medical transitions for minors as a “dangerous trend (that) will be a stain on our Nation’s history.”
The text says that the purpose of the funding restrictions is to protect children from making medical decisions they will come to regret and to fight back against the “radical and false claim that adults can change a child’s sex.”
The order specifically takes aim at the use of puberty blockers, sex hormones and surgical intervention on children and teens under age 19 who want their physical appearance to align with a sex that differs from the one they were assigned at birth.
“Today, it was my great honor to sign an Executive Order banning the chemical castration and medical mutilation of innocent children in the United States of America,” Trump wrote about the order on Truth Social. “My Order directs Agencies to use every available means to cut off Federal financial participation in institutions which seek to provide these barbaric medical procedures, that should have never been allowed to take place!”
Legal challenges
The ACLU, Lambda Legal and other civil rights organizations have vowed to fight the new executive order in court.
Based on their statements, it seems clear that they will make claims related to the Constitution’s equal protection clause and argue that transgender children and teens seeking gender-related health care are being treated differently than their peers who need the same types of treatments for other medical reasons, such as early onset puberty.
The groups may also argue that the order unlawfully interferes with parents' rights to direct the medical care for their children.
“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, senior counsel and health care strategist for Lambda Legal, in a statement.
“We fought previous attempts by the first Trump administration to restrict health care and we won. We stand ready to fight back against this even more pernicious effort to deny medically necessary health care to our youth.”
Supreme Court case on gender-related care
Similar arguments are at the center of the ongoing Supreme Court case over a Tennessee law preventing transgender children and teens under age 18 from accessing certain types of gender-related care.
The families seeking to overturn the law, who are represented by the ACLU, say that the policy promotes unlawful sex discrimination because it treats minors seeking treatments like hormone therapy differently depending on their sex classification at birth.
Elizabeth Prelogar, the U.S. solicitor general during the Biden administration, also argued against the Tennessee law during oral arguments in December.
Before Tuesday’s executive order, it was assumed that the federal government would likely switch sides in the case after Trump took office. Now, that’s pretty much guaranteed.
Such a move could delay the Supreme Court’s ruling, which was previously expected by the end of June, as the Deseret News previously reported.
The new executive order may also prompt changes to Tennessee’s policy on gender-related health care for minors, as well as similar policies in other states, although state-level laws typically threaten health care providers with legal action, rather than loss of funding.