513 events on record Subscribe June 29, 2026
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Trump signed EO 14187, directing federal defunding of institutions providing gender-affirming care to minors

On January 28, 2025, President Trump signed Executive Order 14187, "Protecting Children from Chemical and Surgical Mutilation," directing all executive agencies to end federal funding to medical institutions providing gender-affirming care—including hormone therapy, puberty blockers, and surgery—to individuals under 19. The order instructed HHS to revise Medicaid and Medicare conditions of participation to exclude coverage, directed TRICARE and the Federal Employee Health Benefit Program to exclude such treatments, and required federal research and education grant recipients to certify they did not provide such care. The order also directed HHS to rescind reliance on World Professional Association for Transgender Health guidelines from all federal policy.

Jurisdiction
federal
Location
Washington, D.C.

Abuses documented

Actors

On January 28, 2025, President Trump signed Executive Order 14187, "Protecting Children from Chemical and Surgical Mutilation," directing all executive departments and agencies to immediately take steps to end federal funding to any medical institution providing gender-affirming care to individuals under 19. The order defined the targeted care as surgery, hormone therapy, and puberty blockers, and activated funding conditionality across Medicaid, Medicare, TRICARE, the Federal Employee Health Benefit Program, and federal research and education grant programs.

The order directed the Secretary of HHS to revise Medicaid and Medicare conditions of participation to exclude reimbursement for gender-affirming care for minors; directed OPM and DoD to exclude such coverage from federal employee and military health plans; directed HHS to rescind reliance on World Professional Association for Transgender Health (WPATH) Standards of Care Version 8 from all federal policy and conduct a new review; and required federal research and education grant recipients to certify they did not provide gender-affirming care. The order additionally directed the Attorney General and the Secretary of HHS to take all appropriate steps to end such care in federally funded facilities.

In the weeks following the order, hospitals in Massachusetts, Maryland, Washington, Colorado, and Virginia paused gender-affirming care for transgender patients under 19. On March 4, 2025, U.S. District Court Judge Brendan A. Hurson issued a nationwide preliminary injunction in PFLAG, Inc. v. Trump, blocking federal agencies from conditioning or terminating funding based on provision of gender-affirming care to patients under 19. The Trump administration appealed to the Fourth Circuit; the appeal was placed in abeyance, leaving the injunction in force.

Updates

2025-06-18 — Supreme Court upheld Tennessee's gender-affirming care ban in Skrmetti [6]

The Supreme Court upheld Tennessee's state law banning gender-affirming care for minors 6–3 in United States v. Skrmetti, holding that the law did not violate the Equal Protection Clause and was not subject to heightened scrutiny. The ruling substantially weakened the constitutional footing of equal-protection challenges to EO 14187's funding restrictions.

Why we recorded this

Civil rights law holds that the government may not use the spending power to discriminate against a class of people in the administration of public programs. EO 14187 weaponized federal funding conditionality—Medicaid, Medicare, TRICARE, and research grants—to coerce medical institutions into refusing gender-affirming care to transgender youth as a class. The archive records executive orders that deploy the spending power to enforce demographic discrimination, establishing a documented pattern of targeted funding cuts against care used by a marginalized group.

Sources

  1. Protecting Children from Chemical and Surgical Mutilation — The White House primary accessed June 29, 2026
  2. Protecting Children From Chemical and Surgical Mutilation (90 FR 8771) — Federal Register primary accessed June 29, 2026
  3. Trump signs order to block federal support for minors' gender transitions — CNN secondary accessed June 29, 2026
  4. Trump signs an order restricting gender-affirming care for people under 19 — NPR secondary accessed June 29, 2026
  5. Federal Judge Grants Preliminary Injunction Against Trump's Anti-Trans Healthcare Order — PFLAG secondary accessed June 29, 2026
  6. United States v. Skrmetti, No. 23-477 (June 18, 2025) — Supreme Court of the United States primary accessed June 29, 2026

See also