Overview 

On January 28, 2025, President Trump issued an executive order relating to the provision of health care for transgender people throughout the U.S. The order includes many falsehoods about gender-affirming care, ignoring the fact that this care is supported by every major medical association, including the American Medical Association, American Psychological Association, and others. The order directs agencies across the federal government to take action to prevent gender-affirming care in many avenues, including by removing coverage for gender-affirming care from federal health insurance policies, modifying requirements under the Affordable Care Act, and preventing hospitals or other medical providers who accept Medicare or Medicaid, or who receive federal funding for research or education, from providing gender-affirming care of any kind to people under the age of 19. It is important to note that executive actions do NOT have the authority to override the United States Constitution, federal statutes, or established legal precedent.

None of the provisions in this order have an immediate impact on the ability to receive or provide care. Further administrative action, including the promulgation of regulations and the issuance of significant administrative guidance, are necessary in order for implementation to occur.  

High-Level Analysis

• Denies transgender people under the age of 19 access to the same medications commonly prescribed for thousands of adolescents to treat a range of medical issues, including puberty blockers and hormones. It also bans surgery;
• Directs the Department of Health and Human Services (HHS) and the Office of Management and Budget (OMB) to go through administrative rulemaking and other agency actions to effectively prevent any provider who receives Medicaid and Medicare, or who receives federal research or education funding, from offering gender-affirming care to any individuals under 19, even if the patient is paying out of pocket or with private insurance;
• Directs HHS to revise its regulations implementing the Affordable Care Act, including Section 1557’s non-discrimination requirements, to limit access to gender-affirming care for people under age 19;
• Strips coverage for transgender health care for people under age 19 from federal employees’ benefit plans going forward, as well as for the adolescent dependents of active duty service members and military retirees covered under TRICARE;
• Calls for data collection and review of existing research, including on puberty blockers, with skewed instructions designed to reach an outcome of rejecting and/or minimizing research that demonstrates positive outcomes of gender-affirming care for adolescents;
• Directs the U.S. Attorney General to work to protect people who report on others who provide gender-affirming care; to investigate entities under consumer fraud laws for claiming that gender-affirming care is effective; to enforce female genital mutilation laws (falsely implying there is a connection between this and transition-related care); and propose legislation making it easier to sue a provider of transgender health care for medical harm;
• It also directs the Attorney General to take action against states who it alleges have laws that take custody from parents who don’t support their child’s transition. No such laws exist; and
• Requires that agencies issue a report on these efforts and future actions to be taken in line with the President’s policy.