In one of his administration’s most high-profile attacks, President Donald Trump signed an executive order to limit care for trans minors. This decision has elicited firestorm responses from constituents on all sides, including the medical community and legal professions. Specifically, the order stops federal money from going to gender transition surgeries or medications. It explicitly threatens to withhold new grants from hospitals and medical universities that teach or provide this type of care.
The recent developments come amid a convoluted and at times contradictory history of policies addressing gender identity and access to health care. In 2021, the Biden administration released a notice of interpretation that expanded those protections to cover gender identity. The Trump administration scratched that notice in February. This ping-ponging has resulted in healthcare providers and families alike now having to work through an ever-growing complex web.
From 2019 to 2023, estimating as many as 14,000 American children were treated for gender dysphoria. Of those, about 5,700 had surgery while in the program during that period. These figures highlight the growing demand for transition-related care among minors, even as the political and legal environment shifts dramatically.
Attorney General Pam Bondi’s recently released memo. There, she proceeded to announce misguided and morally indefensible new statewide measures to restrict access to all transgender-related care for minors. She asked the Consumer Protection Branch of the DOJ’s Civil Division to initiate investigations into potential violations of the Food, Drug, and Cosmetic Act. This probe specifically targets pharmaceutical manufacturers and distribution companies that facilitate gender transition services for minors.
Bondi’s memo describes this type of care as “radical gender experimentation,” which has put advocates for transgender rights on alert. The clarification memo only refers to gender-affirming surgery. Leading medical associations, such as the American Medical Association and the American Academy of Pediatrics oppose these procedures for children.
“I am putting medical practitioners, hospitals, and clinics on notice: In the United States, it is a felony to perform, attempt to perform, or conspire to perform female genital mutilation (‘FGM’) on any person under the age of 18,” Bondi stated. This declaration is an important first step toward taking a strong stance against these practices that she sees as harmful masquerading as health care.
Medical providers have prescribed puberty blockers since the 1980s to treat children who go through early puberty. Since the 1990s, they’ve used these blockers off-label for transgender adolescents. They claim that these treatments are necessary to avoid suffering from gender dysphoria. Just recently, Bondi’s actions have thrown these age-old practices into question.
This increasing criticism of transition-related care is a microcosm of national attitudes. Today, 27 states have passed laws banning access to gender-affirming treatments for minors. These unprecedented legislative modifications have ignited conversations around the intersection of parental rights, medical ethics, and individual health care decision-making.
The Justice Department’s recent announcement to use laws to prosecute female genital mutilation in investigations complicates ethical obligations for healthcare providers. Opponents contend that calling surgical care for trans minors “mutilation” distorts the nature and purpose of these surgeries. Advocates for transgender rights adamantly argue that these surgeries are very necessary. They have been shown to enable thousands of people to be their true selves and improve their mental health.