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The latest of Trump’s asinine stream of Executive Orders attempts to delegitimize and prevent gender-affirming care for all trans people under the age of 19 — and if you’re thinking “19? That’s new!” you’re correct. 18-year-olds are considered “youth” in this order.
Protecting Children From Chemical and Surgical Mutilation is, of course, not at all about protecting children. Gender-affirming care, which this order doesn’t seem to actually understand, is evidence-based and necessary healthcare, and it saves lives. Attempts to ban it are malicious and aggressive.
Trump’s Executive Order attempts to obscure its own violence by using violent words in reference to gender-affirming surgery and completely disregards science and misrepresents what gender-affirming care actually entails.
It will harm trans kids; and as aforementioned, it will harm some trans adults, too, as the EO also comes for everyone under the age of 19, so including 18 year olds, who are typically considered adults in the U.S. Anti-trans groups have long hid behind the reasoning that their efforts are directed at children, but that’s because it’s easy to get a consensus on children — from both sides of the political aisle. Ending trans healthcare for everyone has always been the real goal of these far-right groups, and by including 18 years olds in this latest coordinated attack in the form of an Executive Order, those true intentions are starting to come to the surface.
Below, find a brief overview of the Executive Order and what things might look like moving forward. Stay tuned for another piece in the next 24 hours that will give you a point-by-point guide to refuting the misinformation in this Executive Order.
What Does Trump’s Gender-Affirming Care Executive Order Say?
Well, truly, a whole lot of nonsense and outright lies, but you already knew that.
Essentially, the Executive Order proposes that any hospitals, clinics, or medical schools that receive federal funding and also provide gender-affirming care must now choose between continuing to receive that federal funding — which many of these institutions rely on — and continuing to providing this life-saving care, the criminalization of which has been condemned by basically all major medical organizations. It does not create an immediate ban on care, but it does direct several federal agencies to start taking the steps toward ending gender-affirming care for anyone under the age of 19, steps that rely on pseudoscience, outright falsehoods, fear-mongering, and the threat of prosecution against medical practices enthusiastically endorsed by medical professionals.
The EO directs the Office of Health and Human Services to publish new guidelines for “promoting the health of children who assert gender dysphoria” or other “identity-based confusion” and to re-evaluate the DSM-V, the first version of the DSM to drop the classification of “gender identity disorder” as a mental illness.
It also directs the federal government to make rules that could exclude gender-affirming care from Medicaid benefits and create a ban on trans youth healthcare under Tricare, the insurance issued through the Department of Defense under which two million children are insured. It also asks for provisions to be added to the Federal Health Employee Benefits Plan, which covers over 8 million people, so that hormones and gender-affirming surgeries will not be covered. The children of military personnel, postal workers and federal workers will not be able to receive gender-affirming care.
Chillingly, the EO also calls upon the Department of Justice to “prioritize enforcement of protections against female genital mutilation” and the states Attorneys General and cops to “coordinate the enforcement of laws against female genital mutilation.” Phalloplasty is not female genital mutilation. And this encouragement of investigations and prosecutions of people providing or seeking gender-affirming care could have immediate impact even before any actual laws are made, as insurance providers might be quick to drop coverage due to any perceived risk of investigation. And Trump’s EO even specifically targets trans healthcare sanctuary states that have welcomed in patients from states where seeking care for themselves or their children risk prosecution. The EO says the Parental Kidnapping Prevention Act should be potentially applied to these instances of families crossing borders for care. Trump wants to criminalize any attempts to get trans kids the care they need, even in states where there are significant codified protections.
Journalist Erin Reed has a quick video breakdown of some of the EO’s main points, which I recommend watching rather than reading the EO in full, as a lot of the language used in the EO is disturbingly transphobic.
Is Trump’s Gender-Affirming Care Executive Order Legal?
Absolutely not, and as such, it will face legal pushback.
Lambda Legal declared: “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.” Trans lawyer and activist Chase Strangio reiterated multiple times in his Instagram story last night that this EO will be challenged in the courts. The EO’s most immediate directives are to ban trans youth healthcare provided by institutions that receive federal funding, and according to Strangio, that money can’t lawfully just automatically be cut off.
But that doesn’t mean there isn’t already significant risk created by this Executive Order. Early compliance becomes a major issue with federal directives like this, and we could see both insurance providers and also hospitals quickly dropping gender-affirming care out of fears of prosecution or, in the case of medical schools and research hospitals, losing crucial federal funding. These knee-jerk reactions could have an immediate impact on accessibility to services.
Trump campaigned hard on his anti-trans agenda, and cruelty toward trans Americans has indeed seemingly been his top priority during his first nine days in office, along with further destroying the planet and significantly gutting access to HIV medications and to abortion in countries outside of the U.S., which yes, he can indeed do. We knew a federal trans youth healthcare ban was coming, and Trump tried it during his first term, but this time, the points laid out in the Executive Order are much more coordinated and far-reaching, especially the alarming inclusion of 18-year-old adults in a directive supposedly about children’s “welfare.” Legal experts reiterate these policies will be challenged in the courts, and indeed, nothing goes into effect immediately, but fighting this — and pushing back against the pervasive anti-trans rhetoric this EO traffics in — should be a primary priority of the entire LGBTQ community. Trump has made this an urgent priority, so we have to make fighting it one, too.
Read more about Trump’s parade of anti-trans maneuvers:
- Trump’s Latest Attempt to Ban Trans People From The Military Comes With Extra Malice
- Updating Documents as a Trans Person Is Hell Right Now. Here Are My Tips for Navigating the Process
- What Will Trump’s Anti-Trans “Gender Ideology Extremism” Executive Orders Actually Do?
thank you for writing this, Kayla! It’s super scary times and having someone break down these EO’s in a way where we can understand and digest them is super helpful. It’s a fantastic display of both journalism and ally ship.
For me the most worrying thing was the part not limited to the under-19… The whole section about delegitimizing WPATH and SOC 8, which is basically the standard of care that means insurance has to pay for our medical transition expenses. Much of this EO looks blatantly in violation of the Bostock supreme court decision (a recent one so maybe it still means something?), and the section about WPATH is their answer. While WPATH SOC 8 isn’t perfect, and the org has a troublesome history, it’s a lot better than the standards from even 15 years ago, and it’s pretty darn important to those of us in the USA who chose to medically transition to any degree. If they succeed in convincing people SOC 8 is not the relevant scientific consensus standard of care, they can effectively make medical transition cost prohibitive to most people regardless of age. (It doesn’t cost the insurance companies much money, nowhere near what it would cost an individual without insurance, due to our messed up model of medical care.)
*That* is the really scary part, the part that looks like planning and preparing for a full defacto medical transition ban.
Of course, my heart breaks for any trans kid whose medical team overly obeys in advance – the sorry state of trans healthcare leads me to believe there are probably several. I hope they can get what they need without too much damage.
Now trans folks have gotten through such before and we will again if we must, but we need less-marginalized people to stand with us and fight this every step of the way.