Executive Order 14187: Restricting Gender-Affirming Care and Its Consequences

Sammy Meskill ’29

On January 28th, 2025, President Donald Trump signed Executive Order 14187, titled “Protecting Children From Chemical and Surgical Mutilation.” This move by the administration fits in with recent anti-transgender legislation across multiple levels of government, according to a New York Times article by Francesca Paris. Beyond restricting physically affirming care, Trump’s administration has also tried to revamp the language that the federal government uses through an executive order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.” Executive Order 14187 claimed that “medical professionals are maiming and sterilizing a growing number of impressionable children…through a series of irreversible medical interventions.” As part of this order, Trump has said that the United States government “will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another…” The administration has threatened to cut funding to hospitals if they do not cooperate. 

According to a report by Joseph Goldstein, the resulting pause that hospitals have put on gender-affirming care for youth has created chaos in the “transgender health landscape.” It has generated “anxiety among parents[,]” numerous lawsuits, demonstrations “by transgender activists and progressive politicians[,]” as well as placed doctors in difficult ethical positions, says Goldstein. This executive order is causing immense damage to hospitals, doctors and young transgender people, greatly outweighing the benefits that the Trump administration claims it brings about.

When gender-affirming care is restricted for young people, the likelihood of “depression and the risk of suicide[]” is increased, notes Paris. While the Trump Administration says that “many transgender children are ‘impressionable’ and confused[,]” why should the government have the authority to dictate whether that care is accessible to youth? The American Medical Association and the American Academy of Pediatrics have discouraged state, and by extension, federal government, interference with gender-affirming care. Additionally, many doctors “voiced concerns about how and when adolescents should receive gender-affirming care...” According to Paris, in an open letter, the doctors talked about a general “consensus in the field,” namely, that “gender-affirming medical care is important and beneficial for many transgender youth.” If anyone, it is the doctors and parents who should place the restrictions on the care, not the government. They are the ones who have relationships with their patients and children and, as such, should be the only authorities deciding on the best course of action. By contrast, the government mandating an umbrella ban on gender-affirming care is very harmful and is made by a party without knowledge of the patient. Perhaps, a different age limit — discussed in partnership with pediatric organizations — would allow for a more flexible and less harmful policy.

One particularly harmful aspect of the executive order is its call for an immediate halt on care. The executive order is “less flexible than some state laws that have sought to stop children from transitioning[,]” points out Goldstein. According to him, in 2023, the state of Texas passed a similar law, but instead of requiring hospitals to immediately stop care, the law dictated “that patients already on puberty blockers or hormone treatments ‘shall wean off the prescription drug over a period of time and in a manner that is safe.’” If Texas, one of the most right-leaning and conservative states in the country, recognizes the harm caused by stopping care in the way that the executive order asks hospitals to do, then the federal government must know the harm that immediately stopping care creates. Pediatric endocrinologist Dr. Gabrielle Grinstein, “whose patients have included transgender children,” says, “It’s not ethical to stop treatment in any patient, whether it’s hormone treatment or anything else, without measuring the consequences of what you’re doing. You can’t just stop medication and say, ‘Good luck.’” The executive order mandates hospitals do exactly that. With the complicity of hospitals, many harms will be done to children due to the abrupt end of care.

Doctors also feel conflicted on the matter. Their sense of duty to the patient centers around the principle, “Do no harm.” Doctors have "ethical and legal dut[ies] to keep treating patients in need of immediate care[,]” says Goldstein. Yet, their hospitals and organizations “could lose federal research funding if they don’t comply[.]” Dr. Marci Bowers, a transgender surgeon said that hospitals are “acquiescing to what they need to do to stay alive.” According to bioethicist Dr. Robert Klitzman, this “‘puts physicians in a terrible position[.]”’ Doctors want to provide care to patients “‘without getting their institutions in trouble[,]’” he said.

The executive order also violates anti-discrimination laws in New York state. This has put hospitals in a predicament: if they want to protect their federal funding for Medicaid and Medicare programs, they must stop providing gender-affirming care for youth. And yet, technically, not allowing the use of hormone treatments and puberty blockers is considered discriminatory, as those same treatments can be used on youth who are not taking them for gender-affirming care purposes. Due to the discrepancy between the executive order and state law, the New York Attorney General Office had to step in. Two weeks after NYU Langone Health closed its Transgender Youth Health Program, the New York Attorney General’s office wrote a letter to the hospital’s top lawyer, writes Goldstein. In the letter, the Attorney General’s Office stated “that puberty blockers and hormone treatments remained available to pediatric patients who were not transgender” which violated state laws. The office directed NYU Langone Health to resume care, an order which conflicts with the one that the Trump administration had given.

The executive order that the Trump administration issued harmed transgender youth by restricting the gender-affirming care they had access to. This caused anxiety and many lawsuits from parents. The executive order also put doctors and hospitals in a dilemma — whether they should adhere to the executive order’s demands or remain loyal to their duty to the patient. By causing these harms, it is my opinion that the damage that Executive Order 14187 inflicts upon people outweighs what benefits the administration said the executive order was intended for, the “Protect[ion of] Children From Chemical and Surgical Mutilation.” This becomes a message regarding the rights people have over themselves. When those rights are infringed upon, boundaries fade and governmental power encroaches upon us, threatening our autonomy.