Trump’s Latest Executive Order: “Protecting Children From Chemical and Surgical Mutilation”

The following is a broken down review of Trump’s executive order titled “Protecting Children From Chemical and Surgical Mutilation”. The purpose of this post is to review and simplify the language in the order to help facilitate a better understanding of it’s implications.

PROTECTING CHILDREN FROM CHEMICAL AND SURGICAL MUTILATION

EXECUTIVE ORDER

January 28, 2025

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered:

Section 1. Policy and Purpose. Across the country today, medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions. This dangerous trend will be a stain on our Nation’s history, and it must end.

This states that healthcare professionals are “maiming and sterilizing” children to change their sex. This is a reference to hormone replacement therapy, and in particular, hormone blockers, which offer gender affirming care to trans children.

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. 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.

This paragraph talks about transition regret — specifically, children who undergo medical treatments like hormone replacement therapy and puberty blockers, and then later regret this transition as they come to recognize that their gender identity was misidentified in their youth. It cites potential lifelong regrets, like long-term medical bills and the inability to have children.

Accordingly, 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.

This states that it is the policy of the U.S. to end funding and support for gender affirming care.

Sec. 2. Definitions. For the purposes of this order:

(a) The term “child” or “children” means an individual or individuals under 19 years of age.

(b) The term “pediatric” means relating to the medical care of a child.

(c) The phrase “chemical and surgical mutilation” means the use of puberty blockers, including GnRH agonists and other interventions, to delay the onset or progression of normally timed puberty in an individual who does not identify as his or her sex; the use of sex hormones, such as androgen blockers, estrogen, progesterone, or testosterone, to align an individual’s physical appearance with an identity that differs from his or her sex; and surgical procedures that attempt to transform an individual’s physical appearance to align with an identity that differs from his or her sex or that attempt to alter or remove an individual’s sexual organs to minimize or destroy their natural biological functions. This phrase sometimes is referred to as “gender affirming care.”

Definitions according to this order are:

• “Child” means under 19 years old

• “Pediatric” means relating to the medical care of someone under 19 years old

• “Chemical and surgical mutilation” refers to puberty blockers, hormone replacement therapy, top surgery, facial feminization surgery, or anything else that is referred to as “gender affirming care”.
  
  
  

Sec. 3. Ending Reliance on Junk Science. (a) The blatant harm done to children by chemical and surgical mutilation cloaks itself in medical necessity, spurred by guidance from the World Professional Association for Transgender Health (WPATH), which lacks scientific integrity. In light of the scientific concerns with the WPATH guidance:

(i) agencies shall rescind or amend all policies that rely on WPATH guidance, including WPATH’s “Standards of Care Version 8”; and

(ii) within 90 days of the date of this order, the Secretary of Health and Human Services (HHS) shall publish a review of the existing literature on best practices for promoting the health of children who assert gender dysphoria, rapid-onset gender dysphoria, or other identity-based confusion.

Section 3 ends the U.S. relationship with the World Professional Association for Transgender Health, and says within 90 days that the Secretary of Health and Human Services (HHS) will create new recommendations on how to treat gender dysphoria in children—likely with a different, more restrictive approach.

(b) The Secretary of HHS, as appropriate and consistent with applicable law, shall use all available methods to increase the quality of data to guide practices for improving the health of minors with gender dysphoria, rapid-onset gender dysphoria, or other identity-based confusion, or who otherwise seek chemical or surgical mutilation.

The Secretary of HHS will use all the data available to figure out the best way to treat gender dysphoria in minors without the use of gender-affirming care.

Sec. 4. Defunding Chemical and Surgical Mutilation. The head of each executive department or agency (agency) that provides research or education grants to medical institutions, including medical schools and hospitals, shall, consistent with applicable law and in coordination with the Director of the Office of Management and Budget, immediately take appropriate steps to ensure that institutions receiving Federal research or education grants end the chemical and surgical mutilation of children.

Every agency or department head in the federal government is required to look into all of the current research/education grants to ensure that these funds are not being used on gender affirming care for minors.

Sec. 5. Additional Directives to the Secretary of HHS. (a) The Secretary of HHS shall, consistent with applicable law, take all appropriate actions to end the chemical and surgical mutilation of children, including regulatory and sub-regulatory actions, which may involve the following laws, programs, issues, or documents:

(i) Medicare or Medicaid conditions of participation or conditions for coverage;

(ii) clinical-abuse or inappropriate-use assessments relevant to State Medicaid programs;

(iii) mandatory drug use reviews;

(iv) section 1557 of the Patient Protection and Affordable Care Act;

(v) quality, safety, and oversight memoranda;

(vi) essential health benefits requirements; and

(vii) the Eleventh Revision of the International Classification of Diseases and other federally funded manuals, including the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

The government is telling the Health and Human Services (HHS) Secretary to take action to stop doctors from giving puberty blockers, hormones, or surgeries to kids for gender transition. To do this, they might:

• Stop paying for it with government health programs (Medicare & Medicaid).

  • If a doctor or hospital does this, they might not get government money.

• Say that using these treatments for kids is "abuse" or "inappropriate" under Medicaid.

  • This would make it harder for states to cover it with public health insurance.

• Make sure doctors are closely watched when they prescribe these drugs.

  • They might check if puberty blockers or hormones are being used “wrongly” and limit them.

• Change a healthcare anti-discrimination rule (ACA Section 1557).

  • Right now, doctors can’t refuse care based on gender identity. This could change so they can refuse.

• Send official safety warnings.

  • HHS could tell hospitals and clinics that these treatments are unsafe.

• Remove gender-affirming care from the list of important medical treatments.

  • This means insurance companies wouldn’t have to cover it anymore.

• Change medical rulebooks (ICD-11 & DSM-5).

  • These books decide what doctors treat as real medical conditions. If they change, it could mean gender dysphoria isn’t treated as a medical issue, making it harder for people to get care.

Basically, this is a big push to block access to gender-affirming medical care for minors by making it unfunded, discouraged, or even considered harmful under federal rules.

(b) The Secretary of HHS shall promptly withdraw HHS’s March 2, 2022, guidance document titled “HHS Notice and Guidance on Gender Affirming Care, Civil Rights and Patient Privacy” and, in consultation with the Attorney General, issue new guidance protecting whistleblowers who take action related to ensuring compliance with this order.

This part of the order is telling the Secretary of Health and Human Services (HHS) to do two things:

• Cancel an old rule from 2022

  • That rule (called the HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy) said that denying gender-affirming care could be illegal discrimination and that patient privacy must be protected.

  • The new order wants to get rid of that rule, meaning hospitals and doctors wouldn’t be required to provide or protect gender-affirming care under federal law.

• Create a new rule protecting whistleblowers

  • A whistleblower is someone who reports wrongdoing at work.

  • This order says that if a doctor, nurse, or healthcare worker speaks out against gender-affirming care for kids (like reporting a hospital for offering it), they should be protected from being punished or fired.

  • The Attorney General (top law enforcement officer in the U.S.) will help decide how to protect these whistleblowers legally.

Sec. 6. TRICARE. The Department of Defense provides health insurance, through TRICARE, to nearly 2 million individuals under the age of 18. As appropriate and consistent with applicable law, the Secretary of Defense shall commence a rulemaking or sub-regulatory action to exclude chemical and surgical mutilation of children from TRICARE coverage and amend the TRICARE provider handbook to exclude chemical and surgical mutilation of children.

TRICARE is the health insurance program for military families. It covers nearly 2 million children of service members.

The Secretary of Defense is being ordered to change TRICARE rules so that puberty blockers, hormone treatments, and gender-related surgeries for minors are no longer covered.

Sec. 7. Requirements for Insurance Carriers. The Director of the Office of Personnel Management, as appropriate and consistent with applicable law, shall:

(a) include provisions in the Federal Employee Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) programs call letter for the 2026 Plan Year specifying that eligible carriers, including the Foreign Service Benefit Plan, will exclude coverage for pediatric transgender surgeries or hormone treatments; and

(b) negotiate to obtain appropriate corresponding reductions in FEHB and PSHB premiums.

The Office of Personnel Management (OPM) oversees health insurance for federal employees and postal workers through FEHB (Federal Employee Health Benefits) and PSHB (Postal Service Health Benefits) programs.

This order requires federal health insurance plans to stop covering gender-affirming care (hormones and surgeries) for minors starting in 2026.

It specifically applies to all eligible insurance carriers, including the Foreign Service Benefit Plan (which covers diplomats and foreign service workers).

Since fewer treatments would be covered, the government also wants to negotiate lower insurance costs for these plans.

Sec. 8. Directives to the Department of Justice. The Attorney General shall:

(a) review Department of Justice enforcement of section 116 of title 18, United States Code, and prioritize enforcement of protections against female genital mutilation;

(b) convene States’ Attorneys General and other law enforcement officers to coordinate the enforcement of laws against female genital mutilation across all American States and Territories;

(c) prioritize investigations and take appropriate action to end deception of consumers, fraud, and violations of the Food, Drug, and Cosmetic Act by any entity that may be misleading the public about long-term side effects of chemical and surgical mutilation;

(d) in consultation with the Congress, work to draft, propose, and promote legislation to enact a private right of action for children and the parents of children whose healthy body parts have been damaged by medical professionals practicing chemical and surgical mutilation, which should include a lengthy statute of limitations; and

(e) prioritize investigations and take appropriate action to end child-abusive practices by so-called sanctuary States that facilitate stripping custody from parents who support the healthy development of their own children, including by considering the application of the Parental Kidnapping Prevention Act and recognized constitutional rights.

This section targets gender-affirming care through legal enforcement by:

• Cracking down on female genital mutilation (there is already a law against this, but this order prioritizes those investigations)

• Investigating potential fraud in transgender medical care, by looking into whether doctors, drug companies, or advocacy groups are hiding or misrepresenting risks of puberty blockers, hormones, or surgeries.

• Pushing for new laws to let children (or their parents) to sue doctors if they regret gender-related medical treatments. The law would include a “lengthy statute of limitations” (so lawsuits could be filed years later, even into adulthood).

• Going after states that support trans youth by allowing them access to care without parental approval, potentially using the Parental Kidnapping Prevention Act (PKPA) to go after states that take custody away from parents who reject gender-affirming treatments for their child.

Sec. 9. Enforcing Adequate Progress. Within 60 days of the date of this order, the heads of agencies with responsibilities under this order shall submit a single, combined report to the Assistant to the President for Domestic Policy, detailing progress in implementing this order and a timeline for future action. The Assistant to the President for Domestic Policy shall regularly convene the heads of agencies with responsibilities under this order (or their designees) to coordinate and prepare for this submission.

This is a progress check to make sure the agencies are doing what the order says and sticking to a timeline of 60 days.

Sec. 10. Severability. If any provision of this order, or the application of any provision to any person or circumstances, is held to be invalid, the remainder of this order and the application of any of its other provisions to any other persons or circumstances shall not be affected thereby.

Sec. 11. General Provisions. (a) Nothing in this order shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.

(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

If a court strikes down one part of the order, the rest still stands.

The order must follow existing laws and budgets.

No one can sue the government over this order.

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