Feb. 24, 2025
If you’re a transgender person or an ally, you might be wondering how recent federal policy changes under the Trump administration could impact access to gender-affirming healthcare. With new executive orders redefining sex in federal law and restricting funding for certain medical treatments, many trans individuals—both minors and adults—are facing new barriers to essential care. Here’s what you need to know.
The Executive Orders and Their Impact
In January 2025, the Trump administration issued two executive orders that significantly alter how the federal government recognizes gender and funds gender-affirming care:
-
Executive Order 14168 redefines sex in federal law strictly based on birth sex, effectively removing federal recognition of transgender identities.
-
Executive Order 14187 specifically targets gender-affirming care for minors, blocking federal funding to medical institutions that provide treatments like hormone therapy and surgery to individuals under 19.
While the latter order focuses on minors, the broader redefinition of sex is already affecting transgender adults as well.
What This Means for Adults Seeking Gender-Affirming Surgery
Although Executive Order 14187 primarily targets minors, adults are not immune to the consequences of these policy shifts. Here’s how the changes could impact transgender individuals over 18:
-
Loss of Federal Coverage: Medicaid and Medicare may no longer cover gender-affirming procedures under the new federal definition of sex.
-
Restrictions on Federally Funded Healthcare Providers: Hospitals and clinics that rely on federal funding may feel pressured to stop offering gender-affirming care to comply with new regulations.
-
Increased Legal and Financial Hurdles: As federal protections shift, private insurance companies may revise their coverage policies, and legal challenges to these changes could take years to resolve.
The Role of States and Legal Challenges
Despite these federal changes, many states and advocacy groups are pushing back. Attorneys general in at least 15 states have affirmed their commitment to protecting access to gender-affirming care, and legal battles are already underway to challenge the executive orders. Some hospitals have temporarily paused their gender-affirming care services while awaiting further legal clarification.
What Can You Do?
If you or someone you know is affected by these changes, here are some steps to consider:
-
Stay Informed: Follow updates from LGBTQ+ advocacy organizations and legal groups.
-
Know Your State’s Policies: Some states continue to support trans healthcare despite federal shifts, so access may vary based on location.
-
Seek Legal Guidance: If you experience discrimination or denial of care, LGBTQ+ legal advocacy groups can help.
-
Support Community Efforts: Donations, petitions, and local activism can make a difference in pushing back against harmful policies.
Final Thoughts
The landscape of transgender healthcare is changing rapidly, however, resistance from states, advocacy groups, and legal experts continues to provide hope for protecting access to essential medical care. Staying informed and engaged is more important than ever as this issue unfolds.
