New executive order to defund gender-affirming care for minors: 7 notes

President Donald Trump signed an executive order Jan. 28 to restrict federal funding and support for gender-affirming care for minors. The order directs federal agencies to reassess policies and to ensure institutions that receive federal research or education grants are not providing gender-related care. 

"It is the policy of the United States that it will not fund, sponsor, promote, assist or support the so-called 'transition' of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures," the order said. 

Seven notes: 

  1. The executive order, titled "Protecting Children from Chemical and Surgical Mutilation,"  instructs agencies to halt education grants and research dollars for hospitals and medical schools that provide gender-affirming care to individuals under the age of 19. This includes puberty blockers, hormone therapy and gender-related surgeries.

  2. The White House directed HHS to "take all appropriate actions" to end what it called "the chemical and surgical mutilation of children." Specifically, the order tasked the agency with exploring regulatory changes to exclude coverage of gender-affirming care under Medicare, Medicaid and the ACA. The Defense Department is also directed to remove coverage for such care from TRICARE, which insures nearly 2 million minors.

  3. The order also gives HHS 90 days to publish a review of existing literature and share new best practices "for promoting the health of children who assert gender dysphoria, rapid-onset gender dysphoria or other identity-based confusion." The review is intended to revise current standards of care endorsed by the World Professional Association for Transgender Health, which the order says "lacks scientific integrity."

  4. The Justice Department is instructed to prioritize the enforcement of laws "against female genital mutilation," and to work with Congress to draft legislation that would allow individuals who have received gender-affirming care as minors and their parents to sue medical professionals. 

  5. The Children's Hospital Association said it is reviewing the order.

    "Children's hospitals prioritize the physical and mental health, safety and well-being of children, adolescents and young adults," the CHA said in a statement to Becker's.

    "Diagnostic and therapeutic care is guided by specialty-trained physicians and providers, each patient's individual health needs and appropriate family consent. High-quality care — informing the best possible health outcomes — requires patients, families and care teams working together to make medical decisions to meet the unique needs of each child, adolescent and young adult."

    A spokesperson for the AHA told Becker's they are still looking into Mr. Trump's latest round of executive orders and have sent an advisory to their members.

  6. Twenty-six states currently have laws in place that restrict transition-related care for minors, according to CNBC and The New York Times. Demand for gender-affirming treatments among transgender youth hasn't been extensively researched, though a study published in January found less than 0.1% of adolescents with private insurance in the U.S. who are transgender or gender diverse are prescribed puberty blockers or hormone therapy.

  7. The American Medical Association and American Academy of Pediatrics refute claims that gender-affirming care is "experimental," and support related treatments for minors with gender dysphoria. Guidance from the AAP says such care is effective and necessary to treat gender dysphoria, a diagnosis given to patients, "who experience impairment in peer and/or family relationships, school performance or other aspects of their life as a consequence of the incongruence between their assigned sex and their gender identity."

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