Executive Order 14187

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Executive Order 14187
Protecting Children from Chemical and Surgical Mutilation  OOjs UI icon edit-ltr-progressive.svg
Seal of the President of the United States.svg
Type Executive order
Number14187  OOjs UI icon edit-ltr-progressive.svg
President Donald Trump   OOjs UI icon edit-ltr-progressive.svg
SignedJanuary 28, 2025  OOjs UI icon edit-ltr-progressive.svg
Federal Register details
Federal Register
document number
2025-02194  OOjs UI icon edit-ltr-progressive.svg
Publication dateJanuary 28, 2025  OOjs UI icon edit-ltr-progressive.svg

Executive Order 14187, titled "Protecting Children from Chemical and Surgical Mutilation", is an executive order issued by Donald Trump on January 28, 2025. [1] The order acts to prevent gender-affirming care for Americans under 19 years old by withholding federal funding and directing agencies to take a variety of steps to prevent surgeries, hormone therapy, the use of puberty blockers, and other gender-affirming treatments. [2]

Contents

In response, some hospitals paused providing gender-affirming care for minors, while others continued. Attorneys general from 15 states said their states are committed to continuing to provide gender-affirming care to minors. Multiple groups filed lawsuits challenging the legality of the executive order. In response to one of the lawsuits, several federal judges issued injunctions blocking the government from withholding federal funds from hospitals that provide gender-affirming care to minors. [3] [4] Following the injunctions, some hospitals that initially paused gender-affirming care for minors resumed the care.

Background

On January 20, 2025, Donald Trump signed executive order Executive Order 14168 ("Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government"), which described transgender identity as an ideology. [2] On January 27, 2025, Donald Trump signed executive order Executive Order 14183 ("Prioritizing Military Excellence and Readiness") which stated that the policy of United States military readiness is "inconsistent with the medical, surgical, and mental health constraints on individuals with gender dysphoria" and that beyond that, being trans "conflicts with a soldier’s commitment to an honorable, truthful, and disciplined lifestyle, even in one’s personal life." [5] This order is seen as consistent with these prior orders. [2]

Summary

The order described gender-affirming care for minors as "chemical and surgical mutilation of children" as well as "maiming" and "sterilizing". [6] It stated "countless children" who received such care would regret a "horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding." [7] The order also described the World Professional Association for Transgender Health's (WPATH) guidance as "junk science". [7] [6]

The order states that the U.S. Federal Government will not "fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another." [2] Its provisions include:

Implementation

In February 2025, the Office of Personnel Management announced that insurance carriers that provide health insurance coverage to Federal employees under the Federal Employees Health Benefits Program will no longer be allowed to provide coverage for gender-affirming care for minors. Carriers must identify any resulting premium reductions and incorporate those reductions into their 2026 rates. Carriers may continue to offer coverage for gender-affirming care for persons 19 years old and older, but they are not required to do so. [9]

In May 2025, the United States Department of Health and Human Services published a report titled Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices . [10] The report promotes gender exploratory therapy, a form of conversion therapy intended to delay or prevent someone suffering gender dysphoria from seeking gender transition. [11]

Analysis

According to The New York Times , this executive order, in combination with other gender related executive orders, results in "essentially placing the federal government in opposition to a wide variety of gender-related therapies and to anyone who seeks them." [2] The New York Times has also said that the financial implications of the order are "enormous" since a large fraction of many health care institutions' research budgets come from the federal government, and patient care income comes from Medicare and Medicaid. [12] Contributor Masha Gessen argued that this order, along with the wide array of restrictions implemented as part of Executive Order 14168 and Executive Order 14183, constituted an effort by the Trump administration to "denationalize" transgender people, much in the way that Jews were in 1930s Germany. [13]

In an interview [14] with The Conversation, Elana Redfield, federal policy director at the Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy, stated:

NBC News described the language in the executive order as inflammatory and noted that major medical associations support access to transgender health care for minors. [15] It also referenced a study published in JAMA Pediatrics that found "less than 0.1% of adolescents with private insurance in the U.S. are transgender or gender-diverse and are prescribed puberty blockers or gender-affirming hormones." [15]

The executive order is similar to a portion of Project 2025 that called for withdrawing "guidance issued under the Biden Administration concerning sexual orientation and gender identity under Section 1557" of the Affordable Care Act. [16] [17]

After some hospitals began pausing or ending gender-affirming care for minors in response to the executive order, psychiatrist and professor Dr. Robert Klitzman said he believed that providers, local governments or nonprofit organizations would look into setting up private clinics to continue offering gender-affirming care for minors. Such clinics would be entirely separate from other hospitals and the federal government. [18]

Reactions

Hospitals

The following hospitals or health care providers have paused or ended gender-affirming care for minors in response to the executive order:

The following hospitals and healthcare providers have stated they will continue to provide gender-affirming care to minors notwithstanding the executive order:

For

According to TheNew York Times, "On social media, conservative activists struck a celebratory tone." [78]

Against

Human Rights Campaign President Kelley Robinson said, "It is deeply unfair to play politics with people's lives and strip transgender young people, their families and their providers of the freedom to make necessary health care decisions." [79]

American Civil Liberties Union (ACLU) attorney Harper Seldin called the order "[clearly not meant to] protect anyone in this country, but rather to single-mindedly drive out transgender people of all ages from all walks of civic life". [80]

After some hospitals announced that they had paused gender-affirming care for patients under 19 in order continue to receive federal funding, protests were held at the hospitals demanding that they reverse the pauses, including at Seattle Children's Hospital, [81] Children's Hospital Colorado [82] and Children's Hospital Los Angeles (CHLA). [83] Some of these hospitals subsequently lifted their pauses on the care.

States

In February 2025, attorneys general from 15 states issued a joint statement that their states are committed to continuing to provide gender-affirming care to minors despite the executive order. The statement cites a federal court's ruling that the Trump administration cannot halt funding approved by Congress. [84] The states that signed the joint statement were California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Nevada, New Jersey, New York, Rhode Island, Vermont and Wisconsin. [61] [84]

New York attorney general Letitia James sent a letter to New York hospitals and other health care providers on February 2, 2025, warning them that denying health care to pediatric transgender patients may violate New York's anti-discrimination laws. [12] In April 2025, with several hospitals in New York City still not having resumed care, the New York City Council approved several bills to expanding protections for gender-affirming care and providers. [76]

After Children's Hospital Los Angeles said that that it had paused some gender-affirming care for minors, California attorney general Rob Bonta publicly warned the hospital that state law requires providing equal access to healthcare. [85] [86] On February 19, 2025, the California LGBTQ Health and Human Services Network, said that they were unaware of any healthcare providers in California other than CHLA that are continuing to restrict gender-affirming care for trans youth after Bonta issued his warning. [87] On February 21, 2024, CHLA announced that they will resume gender-affirming care for trans youth due to Bonta's warning. [43] However, on June 12, 2025, CHLA announced that they would be closing their entire gender clinic on July 22 which, in addition to minors, treats patients up to the age up 25. CHLA said they had been left with "no viable alternative" and cited the increasing pressure from the Trump administration and the fact that the hospital "relies on federal funding more than any other pediatric hospital in the state" and without the funds, the entire hospital would only last 50 days. [44] [45]

On February 4, 2025, several groups including the ACLU, Lambda Legal, PFLAG, and GLMA filed a lawsuit, PFLAG v. Trump , in the federal District Court in Maryland against the Trump administration over the executive order. [60] The lawsuit was filed on behalf of two young transgender adults, five transgender adolescents, and their families, whose health care has been disrupted by the executive order. [60] The filing of the lawsuit was followed by a request for an immediate restraining order against the enforcement of the executive order. [60] [88] On February 13, Judge Brendan Hurson issued a temporary restraining order that prevents withholding federal funds from hospitals that provide gender-affirming care to minors. [3] [89] On March 4, Hurson extended a nationwide block on enforcement of the executive order. [90] [91]

On February 7, 2025, the states of Washington, Minnesota, and Oregon, along with three doctors, filed a lawsuit in the federal District Court for the Western District of Washington requesting a court order to block enforcement of the executive order. [92] [93] The filing argues that the order is in violation of transgender people's rights to equal protection under the Fifth Amendment, and in violation of the Tenth Amendment by trying to unilaterally criminalize medical practices. [92] All three states require Medicaid and private health plans to cover transgender health care. [94] The lawsuit also argues that the president cannot discontinue research funding already authorized by Congress for hospitals and medical schools in Oregon, Washington and Minnesota. [94] On February 19, 2025, Colorado Attorney General, Phil Weiser, announced that the state of Colorado had also joined the lawsuit. [95] On March 1, 2025, Judge Lauren King blocked the executive order, but only in the four states that filed the lawsuit. [4]

On August 1, 2025, following an increasing number of hospitals in blue states either stopping or pausing gender-affirming care for minors in blue states out of fear of the Trump administration's actions, the states of California, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New York, New Mexico, Rhode Island, Wisconsin and Pennsylvania, as well as Washington, D.C. filed a lawsuit to block the administration's investigations into providers who provide gender-affirming care to minors. The lawsuit argues that by threatening to investigate and prosecute providers, the administration is attempting to enact a national ban on gender-affirming care minors, which is unlawful without Congress enacting federal ban. [96] Additionally, the states argue that gender-affirming care is legally protected in their states and that the administration's attempt to illegally intimidate providers and indirectly ban the care violates the Tenth Amendment to the United States Constitution. [97]

See also

References

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