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Families of transgender minors and advocates have filed a lawsuit against an executive order by U.S. President Donald Trump’s administration. The order, titled “Protecting Children From Chemical and Surgical Mutilation,” was signed on Jan. 28 and attempts to end necessary medical care for transgender minors nationwide.
Federal agencies have been directed to withhold funds from medical institutions that provide gender-affirming medical treatments like puberty blockers, hormone therapies, or surgical procedures to transgender youth under the age of 19.
“It is the policy of the United States that it will not fund, sponsor, promote, assist or support the so-called ‘transition’ of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures,” the order reads.
The American Civil Liberties Union (ACLU), along with other organizations, filed the lawsuit against President Trump’s order on behalf of two transgender young adults and their families whose healthcare was disrupted. PFLAG National and GLMA joined the lawsuit as plaintiffs.
In response, major hospitals and clinics across the nation suspended necessary care for transgender youth while they evaluated and assessed the order.
Virginia Commonwealth University (VCU) Health and the Children’s Hospital of Richmond, Children’s National Hospital in Washington D.C., and Denver Health in Colorado are among the top hospitals that have suspended gender-affirming surgeries for transgender individuals under 19 in compliance with the White House directive.
“Our doors remain open to all patients and their families for screening, counseling, mental healthcare, and all other healthcare needs,” a statement from the VCU health center reads.
Similarly, Washington’s Children’s National Hospital also released a statement confirming they were pausing all puberty blockers and hormone therapy prescriptions for transgender youth patients. The hospital noted it “already does not perform gender affirming surgery for minors.”
“We will do everything we can to ensure the same uninterrupted access to mental health counseling, social support, and holistic and respectful care for every patient at Children’s National,” the statement added.
In a statement posted to its website, Denver Health said it was “deeply concerned for the health and safety of our gender diverse patients under the age of 19. We recognize this order will impact gender-diverse youth, including increased risk of depression, anxiety, and suicidality.”
The executive order, the hospital said, “includes criminal and financial consequences for those who do not comply, including placing participation in federal programs including Medicare, Medicaid and other programs administered by [the US Department of Health and Human Services] at risk.”
According to a study by the UCLA School of Law, approximately 300,000 American adolescents aged 13 to 17 identify as transgender, but significantly fewer pursue gender-affirming care. Of the 300,000 adolescents, more than 100,000 live in states that have previously banned gender affirming care for trans youth.
A study by Jama Pediatrics reveals fewer than 1 in 1,000 U.S. adolescents with commercial insurance received gender-affirming medications — puberty blockers or hormones — during a recent five-year period.
An analysis conducted by Reuters and Komodo Health revealed that from 2017 to 2021, fewer than 15,000 patients aged 6 to 17 received hormone therapy, and under 5,000 initiated puberty blockers, although the latter figure doubled over the five-year period.
President Trump’s order is in direct opposition to clinical evidence supported by major medical organizations, including the American Medical Association, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists. These organizations oppose government interference in doctor-patient decisions.
Over the years, many observational studies produced evidence that receiving this care and having their identity affirmed improves the mental health of young trans people.
A study published in JAMA Network Open investigated the mental health changes in over 100 transgender and nonbinary youth receiving gender-affirming care over 12 months. The results showed that youth who received gender-affirming medications had 60% lower odds of moderate or severe depression and 73% lower odds of suicidality compared to those who did not.
“Beyond the need to address anti-transgender legislation, there is an additional need for medical systems and insurance providers to decrease barriers and expand access to gender-affirming care,” the study authors wrote.
In 2021, the AMA sent a letter to America’s governors that involvement in the medical care of transgender minors would harm transgender youth’s health. The AMA’s Executive Vice President and CEO, James L. Madara, MD, stated that these actions would “insert the government into clinical decision-making and force physicians to disregard clinical guidelines.”
In 2023, Travis Campbell, an assistant professor of economics at Southern Oregon University, published the paper “Hormone Therapy, Suicidal Risk and Transgender Youth in the United States” in the American Economic Association’s Papers and Proceedings. The paper revealed hormone replacement therapy appears to result in a 14.4% decrease in the likelihood of those transgender youth ever attempting suicide.
“By comparing transgender youth who begin hormone therapy to those who begin one year later, our research provides evidence of hormone therapy meaningfully improving the mental health of the recipients,” Campbell said. “This insight suggests that legislation restricting access to gender-affirming care may have large, negative impacts on the lives of transgender youth.”
Campbell and Yana Rodgers of Rutgers University published another study titled “Conversion Therapy, Suicidality and Running Away: An Analysis of Transgender Youth in the U.S.” in the Journal of Health Economics. The study, which is also based on data from the 2015 U.S. Transgender Survey, found that the controversial practice of “conversion therapy” increases the risk of suicide attempts among transgender youth by 55% and increases the likelihood of running away from home by 128%.
