By Tiffany Williams –
WASHINGTON — In recent months, a growing number of hospitals and health systems have revised or suspended parts of their gender-affirming care programs for minors. The changes come as the legal and political landscape surrounding transgender healthcare evolves under President Donald Trump, who has made restricting gender-affirming medical treatments for minors a central pillar of his domestic policy.
On January 28, President Trump signed an executive order aimed at curtailing access to gender-affirming healthcare for youth under the age of 19. The order directs federal agencies to withdraw support for such care and to reassess clinical guidelines developed over decades.
Gender-affirming care typically refers to medical services that help individuals live in alignment with their gender identity when it differs from their sex assigned at birth. This care may include puberty blockers, hormone therapy, and—in rare cases for minors—surgical procedures. These treatments follow evidence-based protocols supported by the American Academy of Pediatrics, American Medical Association, and other national medical organizations.
The Trump administration’s order characterizes gender-affirming care as harmful and unscientific, despite overwhelming consensus among health experts to the contrary. The order calls for a federal review of the literature and directs agencies to prioritize research critical of these interventions—research that mainstream medical experts often consider flawed or misrepresented.
The executive order also takes steps to limit federal involvement in gender-affirming care through:
- Prohibiting federal funding for hospitals that offer gender-affirming services to minors.
- Directing the Department of Defense to exclude such care from military health plans.
- Halting the use of federal employee health benefits for these services.
- Encouraging the Department of Justice to investigate providers under child protection laws.
Meanwhile, a wave of hospitals has acted swiftly. Yale New Haven Health and Connecticut Children’s Medical Center announced this week that they will end gender-affirming services for minors. They join a growing list of institutions making similar moves, including Phoenix Children’s Hospital, Stanford Medicine, and Children’s Hospital Los Angeles.
In total, more than 20 major health systems across the country have restricted or suspended gender-affirming care for minors in recent months. Among them are facilities in Colorado, Illinois, New York, Pennsylvania, Virginia, Washington, and California. Kaiser Permanente has also paused such procedures nationwide.
Hospitals have cited a range of reasons, from legal uncertainty and funding risks to institutional policy reviews and fear of litigation. While some describe these as temporary pauses pending evaluation, others indicate they may be permanent shifts in policy.
The executive order’s momentum has been bolstered by recent legislative action. On May 22, 2025, the U.S. House of Representatives passed a budget reconciliation bill that prohibits the use of federal funds from Medicaid, CHIP, and the Affordable Care Act for gender-transition procedures at any age. The Crenshaw Amendment, introduced by Rep. Dan Crenshaw (R-TX), specifically targets gender-affirming treatments for minors.
Crenshaw called these procedures “the lobotomy of our generation,” arguing they are unsafe and unsupported by rigorous science. Other Republican lawmakers echoed similar sentiments.
“It’s simple, federal funds should not be used to give children sex change operations,” said Rep. John McGuire. “We must protect our children and surround them with the resources and support they need.”
Rep. Rich McCormick, a physician, added: “I will never stop fighting to protect all children by ensuring these dangerous medical procedures are not funded by American taxpayers.”
Rep. Andrew Clyde called such treatments “premeditated child abuse,” describing the impact as “irreparable damage.”
The financial impact of the federal policy shift is already being felt. St. John’s Community Health in Los Angeles, one of the largest providers of reduced-cost care in the region, reported that the Centers for Disease Control and Prevention terminated a $1.6 million grant that supported its transgender health program. According to a CDC letter, the funding was cut to comply with the executive order’s requirement that federal agencies only recognize two genders.
“At St. John’s, we believe everyone has a fundamental human right to healthcare,” said Jim Mangia, president and CEO of St. John’s. “You can disagree with how people choose to live, but that doesn’t give you the right to strip away their access to care.”
As legal challenges unfold and Congress debates further action, hospitals and families across the nation are navigating an increasingly complex and uncertain environment. While some applaud the administration’s efforts as necessary to protect children, others warn that these decisions risk causing harm to already vulnerable youth.
The long-term effects of the executive order remain to be seen, but for now, the Trump administration’s stance is clear: federal support for gender-affirming care for minors is no longer part of U.S. healthcare policy.