We’re not yet two weeks into Trump’s second term, but we’ve now seen three major attacks on the trans community in the United States. On day 1, Trump signed an executive order which (among other things) declared that there were only “two sexes.” On Monday, Trump introduced the new version of his trans military ban (which a group of active-duty military personnel sued over on Tuesday). Now we have Trump’s ban on gender-affirming care for trans youth, titled “Protecting Children from Chemical and Surgical Mutilation.” The order isn’t surprising, given how he campaigned on the matter, but that doesn’t make it any less awful.
What you need to know
Trump’s executive order on gender-affirming care for trans youth uses a range of mechanics to move towards its goal. These include rescinding established policies, withholding federal funds, and interpreting laws in certain ways. Much of the gender-affirming care in the United States is based upon guidance from the World Professional Association for Transgender Health (WPATH) and Trump is ordering agencies to “rescind or amend all policies that rely” on that guidance.
Related
A fresh attack on trans youth
Join the frontline of change
Be informed, be inspired, and be part of the conversation that’s shaping a queerer world with our newsletter.
Trump’s gender-affirming care ban is focused on trans youth, but it defines “child” as anyone under 19 years old, meaning that it will apply to 18-year-olds as well. The order seeks to stop TRICARE and Medicaid from covering any form of gender-affirming care for trans youth and remove such care from the benefits packages for all federal employees. The order also moves to remove federal funding for research or education from “medical institutions, including medical schools and hospitals” that pursue gender-affirming care for trans youth.
The order continues, pushing for Attorneys General and other law enforcement to investigate doctors and using the Food, Drug, and Cosmetic Act under the FDA to claim that the public is being mislead about the long-term effects about gender-affirming care. In an effort to leave no stone unturned, the order also seeks to implement the “Parental Kidnapping Prevention Act” to tackle care provided in sanctuary states such as Minnesota.
Related
Trump’s executive order limiting the definition of gender and stopping gender markers from being updated won’t affect existing documents.
How Trump’s order lies about gender-affirming care for trans youth
Gender-affirming care comes in three forms: puberty blockers, hormone replacement therapy (HRT), and surgeries. It’s important to know that the majority of gender-affirming care that trans youth receive is in the form of puberty blockers. These have been in use for over forty years, are regularly prescribed to cis children to combat early onset puberty and precocious puberty, and the effects are fully reversible. Teenagers can choose to start HRT only with the support of family, a medical provider, and a therapist. Surgeries for minors are extremely rare and are limited to top surgery only.
Despite all of this, Trump’s executive order classifies all of these treatments as “chemical and surgical mutilation.” One part of the order goes as far as to say that the Department of Justice will use laws against “female genital mutilation.” Throughout, the order suggests that these treatments constitute “maiming” and “sterilizing” children (none of which is the case) pushing the idea that these people will not be able to “conceive children of their own.” The bill also declares that these children will “soon regret” transitioning: studies show detransition rates are extremely low with those often being driven by social stigma rather than dissatisfaction.
Whether a minor receives gender-affirming care should not be down to the president, but the individual, the family, and the medical recommendations. Major medical organizations such as the American Academy of Pediatrics, the American Medical Association, and the American Psychiatric Association all recommend gender-affirming care and define it as life-saving medical care.
What happens next with the gender-affirming care ban
None of the things stated in Trump’s gender-affirming care ban go into immediate effect. Implementation of the order’s instructions will take between 30 and 90 days, depending on the exact item in the order. Unfortunately, that might not stop some providers from cutting off care more immediately. When orders like this go into place, some will always be wary about crossing a line that isn’t fully drawn yet. In the meantime, medications may still be able to be filled.
A legal challenge to Trump’s gender-affirming care ban is reportedly already in the works from Lambda Legal, who are already working with the Human Rights Campaign to challenge the trans military ban. Omar Gonzalez-Pagan, the senior counsel and health care strategist for Lambda Legal said “In seeking to deny transgender youth the medically sound and well-established health care that they need, this administration could put thousands of vulnerable young lives at risk. It is an outrageous overreach of government power that reveals its cruel absolutism.”
Some of the instructions given in Trump’s order stretch the limits of what can be done by executive order and are also likely to be challenged. There are also suggestions that the order would be in violation of the nondiscrimination clauses of the Affordable Care Act. All of this comes as the Supreme Court of the United States is already considering a case banning gender-affirming care and are expected to give a ruling this summer.
Related
Bishop Mariann Budde made headlines for asking Trump to show compassion. She’s been modeling that behavior herself for a long time.
Sign up for the INTO newsletter and get your twice-weekly dose of stories that shape the queer experience, culture, and lifestyle.
