Executive Order 14187

Executive Order 14187
Protecting Children from Chemical and Surgical Mutilation Edit this on Wikidata
Seal of the President of the United States
TypeExecutive order
PresidentDonald Trump Edit this on Wikidata
SignedJanuary 28, 2025 Edit this on Wikidata
Federal Register details
Federal Register
document number		2025-02194 Edit this on Wikidata
Publication dateFebruary 3, 2025 Edit this on Wikidata
Document citation90 FR 8771 Edit this on Wikidata
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Executive Order 14187, titled "Protecting Children from Chemical and Surgical Mutilation", is an executive order issued by Donald Trump on January 28, 2025.[1] The order acts to prevent gender affirming care for Americans under 19 years old by withholding federal funding and directing agencies to take a variety of steps to prevent surgeries, hormone therapy, puberty blockers and other gender-affirming treatments.[2]

In response, some hospitals paused providing gender-affirming care for minors, while others continued. Attorneys general from 15 states said their states are committed to continuing to provide gender-affirming care to minors. Multiple groups filed lawsuits challenging the legality of the executive order. In response to one of the lawsuits, a federal judge issued a temporary restraining order that prevents withholding federal funds from hospitals that provide gender affirming care to minors.[3] Following the injunction, some hospitals that initially paused gender-affirming care for minors resumed the care.

Background

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On January 20, 2025, Donald Trump signed executive order Executive Order 14168 ("Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government"), which described transgender identity as an ideology.[2] On January 27, 2025, Donald Trump signed executive order Executive Order 14183 ("Prioritizing Military Excellence and Readiness") which stated that the policy of United States military readiness is "inconsistent with the medical, surgical, and mental health constraints on individuals with gender dysphoria" and that beyond that, being trans "conflicts with a soldier’s commitment to an honorable, truthful, and disciplined lifestyle, even in one’s personal life."[4] This order is seen as consistent with these prior orders.[2]

Summary

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The order described gender-affirming care for minors as "chemical and surgical mutilation of children" as well as "maiming" and "sterilizing".[5] It stated "countless children" who received such care would regret a "horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding."[6] The order also described the World Professional Association for Transgender Health's (WPATH) guidance as "junk science".[6][5]

The order states that the US Federal Government will not "fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another."[2] The provisions include:

Implementation

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In February 2025, the Office of Personnel Management announced that insurance carriers that provide health insurance coverage to Federal employees under the Federal Employees Health Benefits Program will no longer be allowed to provide coverage for gender affirming care for minors. Carriers must identify any resulting premium reductions and incorporate those reductions into their 2026 rates. Carriers may continue to offer coverage for gender affirming care for persons 19 years old and older, but they are not required to do so.[8]

Analysis

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According to The New York Times, this executive order, in combination with other gender related executive orders, results in "essentially placing the federal government in opposition to a wide variety of gender-related therapies and to anyone who seeks them."[2] The New York Times has also said that the financial implications of the order are "enormous" since a large fraction of many health care institutions' research budgets come from the federal government, and patient care income comes from Medicare and Medicaid.[9]

In an interview[10] with The Conversation, Elana Redfield, federal policy director at the Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy, stated:

  • "...a big part of the executive order is directing the federal agencies that administer these programs to review their own policies to ensure that they are not supporting gender-affirming care for minors"[10]
  • "Ultimately, the president can only take actions in ways that are designated by the Constitution, or through some specific power that Congress has granted to the executive branch. I don’t see that authority granted for a lot of what’s contained in this executive order."[10]
  • "...there’s a pending U.S. Supreme Court decision regarding a Tennessee law banning gender-affirming care for minors. Should the Supreme Court determine that Tennessee is able to ban gender-affirming care for minors, it’s possible to see how this could impact private health insurance coverage for gender-affirming care."[10]
  • "...it’s important to remember that executive orders aren’t established policy. They’re simply directing agencies to craft certain policies and encouraging lawmakers to enact legislation."[10]

NBC News described the language in the executive order as inflammatory and noted that major medical associations support access to transgender health care for minors.[11] It also referenced a study published in JAMA Pediatrics that found "less than 0.1% of adolescents with private insurance in the U.S. are transgender or gender-diverse and are prescribed puberty blockers or gender-affirming hormones."[11]

The executive order is similar to a portion of Project 2025 that called for withdrawing "guidance issued under the Biden Administration concerning sexual orientation and gender identity under Section 1557" of the Affordable Care Act.[12][13]

Reactions

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Hospitals

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The following hospitals or health care providers have paused or ended gender-affirming care for minors in response to the executive order:

  • Children's National Hospital in Washington DC paused prescriptions of puberty blockers and gender-affirming hormone therapy for minors in order to "assess the situation further" as of January 30, 2025.[14] The hospital already did not perform gender affirming surgeries on minors. In 2022, the hospital was subject to a harassment campaign for allegedly providing gender-affirming surgeries to minors.[15]
  • NYU Langone Health has reportedly cancelled appointments for providing puberty blockers for some children as of February 3, 2025. They have not, however, made any announcement.[9]
  • VCU Medical Center in Virginia suspended gender-affirming medication and gender-affirming surgeries for those under 19 as of January 30, 2025.[14]
  • Memorial Health in Georgia reportedly began canceling gender-affirming surgery appointments for transgender adults in their mid-20s, despite the executive order only applying to those under 19.[16] A state law in Georgia already bans gender-affirming surgery for people under 18.[17][18]

The following hospitals and heathcare providers have stated they will continue to provide gender affirming care to minors notwithstanding the executive order:

  • Transhealth in Massachusetts said on its website that it will continue providing care.[19]
  • Lurie Children's Hospital and Howard Brown Health, both in Illinois, have issued statements stating they will monitor the executive order, but will otherwise continue to provide gender affirming care as needed by their patients.[20]
  • M Health Fairview, Allina Health, Children's Minnesota and North Memorial Health, all in Minnesota, said that they will continue providing gender-affirming care for minors and adults.[21]
  • On February 11, 2025, Legacy Health and Kaiser Permanente in Oregon said that they had not had not made any changes in the way they provide gender-affirming care.[22]
  • Whitman-Walker Health in D.C. said that they will continue providing gender-affirming care to minors and adults.[23]
  • Children's Hospital Colorado and Denver Health in Colorado both announced that they had stopped providing gender-affirming care in late January 2025.[14] On February 20, 2025, it was announced that both hospitals would resume providing gender-affirming care after the Colorado Attorney General, Phil Weiser joined the legal challenge filed in Washington state to block the order.[24]
  • Kaiser Permanente and Cedars-Sinai Medical Center in California said that they will continue to offer gender-affirming care for trans youth.[25]
  • Children's Wisconsin Hospital canceled a transgender teenager's appointment to receive hormone therapy. The next day, the hospital reversed this decision and rescheduled the appointment.[26]
  • Corewell Health in Michigan initially said that they would "pause" gender-affirming hormone therapy for new patients under 19, but a few days later said that they had lifted the pause following backlash.[27]
  • Amoskeag Health in New Hampshire said that they would "pause" gender-affirming care for minors, but within 48 hours, they notified patients that they had reversed the decision and would resume the service.[28]
  • Prisma Community Care in Phoenix, Arizona said during the week of February 3rd that they had "paused" gender-affirming hormones for minors. However, after the executive order was blocked in court, they swiftly lifted the pause saying "the court ruling was the green light to fully restore care."[29]
  • University of Virginia (UVA) Health initially "paused" gender-affirming care for minors, but subsequently lifted the pause after the executive order was blocked in court.[30] On February 21, 2025, The University of Virginia's governing board passed a resolution which said UVA Health could continue providing gender-affirming care to minors already receiving it, but should refer new patients to private providers "until further notice."[31][32]
  • Children's Hospital Los Angeles (CHLA) in California paused gender-affirming care for trans youth while they review the executive order and court orders challenging it. In response Attorney General, Rob Bonta, warned hospitals in California that refusing to give gender-affirming care from transgender youth may violate state discrimination laws which protect access to the care in the state. On February 21, 2024, CHLA announced that they will resume gender-affirming care for trans youth due to Bonta's warning.[33]

For

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According to The New York Times, "On social media, conservative activists struck a celebratory tone."[34]

Against

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Human Rights Campaign President Kelley Robinson said, "It is deeply unfair to play politics with people's lives and strip transgender young people, their families and their providers of the freedom to make necessary health care decisions."[35]

After some hospitals announced that they had paused gender-affirming care for patients under 19 in order continue to receive federal funding, protests were held at the hospitals demanding that they reverse the pauses, including at Seattle Children's Hospital,[36] Children's Hospital Colorado[37] and Children's Hospital Los Angeles (CHLA).[38] Some of these hospitals subsequently lifted their pauses on the care.

States

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In February 2025, attorneys general from 15 states issued a joint statement that their states are committed to continuing to provide gender affirming care to minors despite the executive order. The statement cites a federal court's ruling that the Trump administration cannot halt funding approved by Congress.[39] The states that signed the joint statement were California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Rhode Island, Vermont and Wisconsin.[20][39]

New York's attorney general, Letitia James, sent a letter to New York hospitals and other health care providers on February 2, 2025 warning them that denying health care to pediatric transgender patients may violate New York's anti-discrimination laws.[9] After Children's Hospital Los Angeles said that that it had paused some gender-affirming care for minors, California's attorney general, Rob Bonta, publicly warned the hospital that state law requires providing equal access to healthcare.[40][41] On February 19, 2025, the California LGBTQ Health and Human Services Network, said that they were unaware of any healthcare providers in California other than CHLA that are continuing to restrict gender-affirming care for trans youth after Bonta issued his warning.[42] On February 21, 2024, CHLA announced that they will resume gender-affirming care for trans youth due to Bonta's warning.[33]

[edit]

On February 4, 2025, several groups including ACLU, Lambda Legal, PFLAG, and GLMA filed a lawsuit in the federal District Court in Maryland against the Trump administration over the executive order.[19] The lawsuit was filed on behalf of two young transgender adults, five transgender adolescents, and their families, whose health care has been disrupted by the executive order.[19] The filing of the lawsuit was followed by a request for an immediate restraining order against the enforcement of the executive order.[19][43] On February 13, a federal judge issued a temporary restraining order that prevents withholding federal funds from hospitals that provide gender affirming care to minors.[3][44]

On February 7, 2025, the states of Washington, Minnesota, and Oregon, along with three doctors, filed a lawsuit in the federal District Court for the Western District of Washington requesting a court order to block enforcement of the executive order.[45][46] The filing argues that the order is in violation of transgender people's rights to equal protection under the Fifth Amendment, and in violation of the Tenth Amendment by trying to unilaterally criminalize medical practices.[45] All three states require Medicaid and private health plans to cover transgender health care.[47] The lawsuit also argues that the president cannot discontinue research funding already authorized by Congress for hospitals and medical schools in Oregon, Washington and Minnesota.[47] On February 19, 2025, Colorado Attorney General, Phil Weiser, announced that the state of Colorado had also joined the lawsuit.[48]

See also

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References

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  1. ^ "Executive Order: Protecting Children for Chemical and Surgical Mutilation". US White House. January 28, 2025. Archived from the original on January 29, 2025. Retrieved January 29, 2025.Public Domain This article incorporates text from this source, which is in the public domain.
  2. ^ a b c d e f g Montague, Zach (January 28, 2025). "Trump Signs Order Restricting Gender-Affirming Treatments for Minors". The New York Times. Archived from the original on January 29, 2025. Retrieved January 29, 2025.
  3. ^ a b Harmon, Amy; Macur, Juliet (February 13, 2025). "Judge Temporarily Stops Trump's Plan to End Funds for Trans Youths' Health Providers". The New York Times. ISSN 0362-4331. Retrieved February 14, 2025.
  4. ^ "Prioritizing Military Excellence and Readiness". US White House. January 27, 2025.
  5. ^ a b "Some hospitals pause gender-affirming care to evaluate Trump's executive order". NBC News. Associated Press. January 31, 2025. Retrieved February 1, 2025.
  6. ^ a b Montague, Zach (January 29, 2025). "Trump Signs Order Restricting Gender-Affirming Treatments for Minors". The New York Times. Archived from the original on January 29, 2025. Retrieved February 1, 2025.
  7. ^ Strack, Haley (January 28, 2025). "Trump Signs Executive Order Protecting Children from Chemical and Surgical Gender Mutilation". National Review.
  8. ^ Moss, Kevin (February 12, 2025). "How new executive orders will impact FEHB coverage next year". Government Executive.
  9. ^ a b c Goldstein, Joseph (February 3, 2025). "N.Y. Attorney General Warns Hospitals Against Canceling Transgender Care". The New York Times. Archived from the original on February 4, 2025. Retrieved February 6, 2025.
  10. ^ a b c d e "A federal policy expert weighs in on Trump's efforts to stifle gender-affirming care for Americans under 19". The Conversation. January 30, 2025. Archived from the original on January 30, 2025. Retrieved January 31, 2025.
  11. ^ a b Yurcaba, Jo (February 4, 2025). "Trans young adults and parents sue over Trump's orders restricting transition care". NBC News. Retrieved February 8, 2025.
  12. ^ "37 ways Project 2025 has shown up in Trump's executive orders". Politico. February 5, 2025. Retrieved February 8, 2025.
  13. ^ Quinn, Melissa (February 3, 2025). "Where Trump policies and Project 2025 proposals match up". CBS News. Retrieved February 8, 2025.
  14. ^ a b c Johnson, Carla K.; Bose, Devna; Bargfeld, Laura (January 30, 2025). "Some hospitals pause gender-affirming care to evaluate Trump's executive order". Associated Press.
  15. ^ Venhuizen, Harm (August 27, 2022). "D.C. children's hospital harassed over trans youth services". Associated Press. Archived from the original on April 3, 2023. Retrieved February 13, 2025.
  16. ^ "Memorial Health no longer doing gender-affirming care for those under 19; cancels all appointments". Savannah Now. February 20, 2025. Retrieved February 22, 2025.
  17. ^ Boboltz, Sara (March 21, 2023). "Georgia Legislature Sends Anti-Trans Health Care Bill To GOP Governor". HuffPost. Retrieved March 21, 2023.
  18. ^ Riedel, Samantha (September 6, 2023). "Georgia's Ban on Gender-Affirming Care for Youth Is Back In Effect". them.us. Retrieved February 5, 2024.
  19. ^ a b c d Christensen, Jen (February 4, 2025). "Social justice groups sue to block Trump executive order restricting care for transgender children". CNN. Retrieved February 13, 2025.
  20. ^ a b Hall, Alexander (February 6, 2025). "15 state AGs vow to protect trans procedures for minors despite Trump executive order". Fox News.
  21. ^ "Minnesota hospitals still offering gender-affirming care amid federal challenges". Twin Cities Pioneer Press. February 10, 2025. Retrieved February 12, 2025.
  22. ^ "With lawsuits tying up Trump's gender care order, Oregon hospitals still provide services — so far". Portland Tribune. February 11, 2025. Retrieved February 20, 2025.
  23. ^ "With gender-affirming care under threat, D.C. area providers worry about continuing services". WAMU. February 19, 2025. Retrieved February 20, 2025.
  24. ^ "Two Colorado hospitals to resume gender-affirming care for youth". Colorado Sun. February 20, 2025.
  25. ^ "California gender-affirming care in limbo for trans youth". Spectrum News. February 13, 2025.
  26. ^ "Children's Wisconsin hospital reinstates gender-affirming care for trans teen after canceling in wake of Trump's executive order". Wisconsin Watch. February 6, 2025. Retrieved February 12, 2025.
  27. ^ "Corewell Health lifts pause on new hormone therapies for pediatric patients". WSJM. February 11, 2025. Retrieved February 12, 2025.
  28. ^ "NH healthcare provider resumes gender-affirming care after confusion over Trump's executive order". The Keene Sentinel. February 10, 2025. Retrieved February 16, 2025.
  29. ^ "Phoenix clinic to resume gender-affirming care for children paused by Trump order". The Arizona Republic. February 15, 2025. Retrieved February 16, 2025.
  30. ^ "UVA Health set to resume transgender care services". CBS News. February 13, 2025. Retrieved February 16, 2025.
  31. ^ "U-Va. board: Gender affirming care for some youth can continue for now". Washington Post. February 21, 2025. Retrieved February 22, 2025.
  32. ^ "UVa Health to continue transgender care for now, new patients will be directed elsewhere". Virginia Mercury. February 21, 2025. Retrieved February 22, 2025.
  33. ^ a b Alpert Reyes, Emily (February 21, 2025). "Children's Hospital L.A. lifts recent limits on hormonal therapy for transgender youth". LA Times. Retrieved February 22, 2025.
  34. ^ Harmon, Amy (January 28, 2025). "Transgender Americans say Trump's orders are even worse than feared". The New York Times. Archived from the original on January 29, 2025. Retrieved January 29, 2025.
  35. ^ "Trump signs order restraining 'chemical, surgical' sex-change procedures for minors". The Indian Express. January 29, 2025. Archived from the original on January 29, 2025. Retrieved January 29, 2025.
  36. ^ "Demonstrators demand Seattle Children's resume gender-affirming surgeries". KING-TV. February 8, 2025. Retrieved February 20, 2025.
  37. ^ "Protest outside Children's Hospital Colorado after sudden suspension of gender-affirming care". CPR. February 14, 2025. Retrieved February 22, 2025.
  38. ^ "Protesters rally outside CHLA after it pauses gender-affirming care for new transgender patients". ABC. February 7, 2025. Retrieved February 22, 2025.
  39. ^ a b Migdon, Brooke (February 5, 2025). "Democratic attorneys general pledge to protect gender-affirming care following Trump order". The Hill. Archived from the original on February 6, 2025. Retrieved February 14, 2025.
  40. ^ Alpert Reyes, Emily (February 5, 2025). "California AG warns L.A. hospital: Withholding transgender care could violate state law". Los Angeles Times. Retrieved February 8, 2025.
  41. ^ "Attorney General Bonta Reminds Hospitals and Clinics of Anti-Discrimination Laws Amid Executive Order on Gender Affirming Care". State of California - Department of Justice - Office of the Attorney General. February 5, 2025. Retrieved February 8, 2025.
  42. ^ Alpert Reyes, Emily (February 19, 2025). "Children's Hospital keeps limits on transgender care amid challenges to Trump order". LA Times. Retrieved February 20, 2025.
  43. ^ "PFLAG, Inc. v. Donald J. Trump, 1:25-cv-00337". CourtListener. Retrieved February 14, 2025.
  44. ^ Portnoy, Jenna; Rizzo, Salvador (February 13, 2025). "Federal judge blocks Trump order on health care for transgender youth". The Washington Post. Retrieved February 13, 2025.
  45. ^ a b Brasch, Ben (February 7, 2025). "Three states sue Trump for attack on gender-affirming care for minors". The Washington Post. Retrieved February 7, 2025.
  46. ^ Bourgeois, Michaela (February 7, 2025). "'Clearly illegal and unusually cruel': Washington, Oregon challenge Trump's order on gender-affirming care". KOIN. Retrieved February 7, 2025.
  47. ^ a b Templeton, Amelia (February 7, 2025). "Oregon, Washington sue over Trump order targeting gender-affirming care". OPB (Oregon Public Broadcasting). Retrieved February 8, 2025.
  48. ^ "Colorado joins lawsuit challenging White House gender-affirming care order". February 19, 2025. Retrieved February 20, 2025.
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