President Donald Trump signed an executive order on Tuesday to halt federal funding for medical procedures aimed at changing  an individual’s sex or gender. This includes surgeries, puberty blockers, or sex hormones for individuals under the age of 19.

In the order, Trump asserts that the United States will not fund, sponsor, promote, or support the “transition” of children, and will strictly enforce laws that limit or prohibit these procedures. The policy emphasizes that such interventions are damaging and life-altering.

The order tasks the Secretary of Health and Human Services with taking necessary actions to stop gender-affirming care for minors, including potentially affecting Medicare, Medicaid, and the Affordable Care Act. It also directs HHS to retract its guidance on gender-affirming care and patient privacy.

While gender-affirming care encompasses both medicine and surgery, these interventions are typically reserved for adults. International guidelines do not recommend medical or surgical treatments for transgender children before puberty. Even for older teens and adults, surgery remains uncommon, according to research.

Gender-affirming care may also involve counseling for individuals and their families at any age. It aims to support transgender people, who identify with a gender different from the one assigned at birth, or those who are gender-diverse and have a nontraditional gender expression.

This holistic approach is based on medical evidence and is designed to help individuals transition from their assigned gender at birth to the gender they identify with, safely. The American Academy of Pediatrics defines gender-affirming care for children as developmentally appropriate, nonjudgmental treatment in a secure clinical environment, based on peer-reviewed scientific research that demonstrates its effectiveness.

Major medical organizations, such as the American Medical Association, the American Psychiatric Association, and others, support gender-affirming care as clinically appropriate and lifesaving for both children and adults. However, the executive order criticizes gender-affirming care, claiming that it leads to the maiming and sterilization of children under misleading and false premises.

The order directs federal agencies to revoke policies influenced by the World Professional Association for Transgender Health (WPATH) guidelines, which the order criticizes as lacking scientific credibility, despite being widely accepted by experts as a global standard in the field.

Additionally, the Director of the Office of Personnel Management is instructed to exclude gender-affirming care for minors from the 2026 Federal Employee Health Benefits and Postal Service Health Benefits plans. The Secretary of Defense is also directed to take regulatory steps to remove coverage for such procedures from TRICARE, the military’s health insurance.

The order instructs the Department of Justice to investigate states that protect access to these medical procedures and review enforcement of laws against female genital mutilation in minors. The order also outlines mechanisms to track progress in implementing these directives.

According to data from the Movement Advancement Project, 26 states have enacted bans on gender-affirming healthcare for transgender children and teens.