‘Order’ Without Law: Trump's Trans Care Ban Relies on Threats to Induce Compliance
Trump’s threats are having a disastrous effect on trans health care across the country, despite significant resistance to them.
by Allison Chapman
President Trump’s discriminatory effort to ban gender affirming care for people under 19, in defiance of many state and federal laws, has already led to considerable advanced compliance since its signing last week, putting young transgender people nationwide at ever greater medical and mental health risk.
The order uses government funding as its primary leverage, threatening to withhold Medicaid and Medicare dollars from any health system that provides gender affirming care to young people – including adults age 19, a notable expansion of anti-trans efforts. It goes on to demand that the Department of Health and Human Services retract its policies that rely on or refer to WPATH SOC8, the worldwide standards of care for transgender medicine.
Trump’s order further calls on the U.S. attorney general to “prioritize investigations” into standard efforts to provide information on gender affirming care, infusing his words with false and inflammatory language like “chemical and surgical mutilation.” This sort of broad political cudgel has been used by Texas Attorney General Ken Paxton against Seattle Children’s Hospital in an effort to obtain out-of-state patient information.
As journalist Erin Reed describes, “Trump relies on dubious reinterpretations of existing laws to justify parts of the order while outright bypassing constitutional limits in others.”
Already a coalition of attorneys general representing 14 states has pledged to oppose the actions. Still, the effects of the order have been felt nationwide, even in blue states like New York, Washington and California, where hospitals have halted or suspended gender affirming care for minors — choosing not to risk funding even at the cost of withholding medically necessary care.
“It is unconscionable,” said Alexis McGill Johnson, president of the Planned Parenthood Federation of America in a statement. “Less than 24 hours after trying to take away Head Start programs and school meals for kids, President Trump issued an order demonizing transgender youth and spreading dangerous lies about gender-affirming care.”
While some hospitals like NYU Langone have suspended care for new patients, others have dropped care completely.
“The sudden suspension of gender-affirming care has devastating consequences.” Liana Douillet Guzmán, the chief executive of FOLX Health, a telehealth HRT provider, told Assigned Media, “It not only exacerbates mental health challenges such as anxiety, depression, and dysphoria but also poses serious health risks associated with the abrupt discontinuation of hormone therapy.” Despite these warnings, some administrators have chosen federal funding over providing life-saving medical care.
But those hospital administrators who have acceded to the Trump order have been met with quick and strong resistance. Demonstrations drawing hundreds of trans people, families and allies have sprung up across the country in the past week. The ACLU and Lambda Legal, working with PFLAG, have filed a lawsuit on behalf of transgender people in an attempt to block enforcement. In New York, Attorney General Letitia James directly warned hospitals within the state that dropping gender affirming care would be a violation of state law.
The relentless bombardment of executive orders is an attempt to push transgender people out of public life. Despite this bigoted campaign, transgender youths and adults have always, and will always exist.
Allison Chapman is a transgender legislative researcher focusing on LGBTQ+ legislation.