Trump bans gender-affirming care for people younger than 19

Photo: Alvaro Medina Jurado/Getty Images

President Donald Trump has signed an executive order that seeks to eliminate government support for transgender healthcare, saying the feds will not fund, sponsor or support gender-affirming surgery and will “rigorously” enforce laws that prohibit or limit such procedures.

The order, “Protecting Children from Chemical and Surgical Mutilation,” applies to Americans younger than 19 and forbids the federal government from promoting or assisting in such transitions.

“Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding,” the order read. “Moreover, these vulnerable youths’ medical bills may rise throughout their lifetimes, as they are often trapped with lifelong medical complications, a losing war with their own bodies, and, tragically, sterilization.”

The order also authorizes the Department of Health and Human Services to include this stance in the conditions of participation and coverage for Medicare and Medicaid, and pulls research grant funding for organizations providing those services. Federal health employees’ benefit programs will also exclude coverage of such services.

Due to the order, HHS will withdraw a 2022 guidance document, “HHS Notice and Guidance on Gender Affirming Care, Civil Rights and Patient Privacy,” and instead will issue new guidance, in coordination with the attorney general, to protect whistleblowers who are trying to maintain compliance with the order.

At the same time, the Department of Justice will coordinate with state law enforcement on enforcement of the order.

WHAT’S THE IMPACT

Almost immediately, the executive order drew strong reaction from the Gay and Lesbian Alliance Against Defamation (GLAAD), which called the move “unconstitutional” and called the rhetoric and inflammatory language in the order “inaccurate, incoherent and extreme.”

“Healthcare for transgender people is supported by every major medical association,” said GLAAD. “The Trump administration’s unhinged obsession with attacking transgender people and their healthcare does not reflect medical fact and does not represent the reality of trans people, youth, and their freedom to be themselves, and make their own healthcare decisions, without being discriminated against and lied about.

“The more the Trump administration focuses on spreading lies, the less it is focusing on solving problems and improving people’s lives,” GLAAD wrote.

Medical associations that are on record as supporting transgender care include the World Health Organization, World Medical Association, American Medical Association, American Heart Association, American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, Texas Medical Association and American Psychiatric Association, among others.

THE LARGER TREND

Despite support from major medical associations, transgender care has been under challenge. Just last year, Florida Attorney General Ashley Moody, along with the Catholic Medical Association, sued the Department of Health and Human Services over a new rule under Section 1557 of the Affordable Care Act that outlines bans on sex-based discrimination in healthcare, including discrimination based on stereotypes, sexual orientation, gender identity, and pregnancy or related conditions.

In the lawsuit, Moody and the Catholic Medical Association claimed the new rule would effectively force Florida to violate state laws prohibiting hormone treatment and surgery for minors, and argue it would pave the way toward funding children’s gender transition surgeries.

Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.