President Trump signed an executive order on Tuesday to withhold federal funding for gender-affirming care for those under the age of 19.
The executive order requires the Department of Health and Human Services to reconsider insurance coverage under Medicare, Medicaid and the Affordable Care Act and end forms of gender-affirming care.
The order called gender-affirming care a “dangerous trend” that “will be a stain on our Nation’s history.”
Sarah, a transgender student who requested anonymity for fear of safety, said the order is “a sign that things are getting pretty bad.”
“It was expected that Trump would sign an executive order banning it for minors, but the fact that it is 18 and under ... is a subtle way of hinting [that] we’re testing the waters with bans for adults,” Sarah said.
Tam Phan, an assistant professor of clinical pharmacy at the USC Mann School for Pharmacy and Pharmaceutical Sciences, specializes in providing care to LGBTQ+ communities and individuals with HIV.
For Phan, the executive order was about more than simply restricting access to healthcare.
“When policies restrict gender-affirming care, they don’t just create barriers to essential medical services; they send a broader message that erases the existence and legitimacy of transgender and nonbinary people,” Phan said in an email to Annenberg Media.
The order is not the first that the Trump administration has made concerning gender and sexuality. On the first day of his presidency, Trump signed an executive order directing the federal government to recognize only two sexes — male and female.
He signed a separate executive order Monday that could potentially ban transgender people from serving in the military. The executive order claimed that “expressing a false ‘gender identity’ divergent from an individual’s sex cannot satisfy the rigorous standards necessary for military service.”
From a scientific perspective, Phan argues that gender-affirming care is vital.
“Evidence overwhelmingly shows that gender-affirming care improves mental health outcomes, reduces suicidality, and fosters well-being in transgender youth,” Phan said. “Policies like this executive order disregard both the science and the lived experiences of the people they affect.”
However, the administration may not consider Phan’s perspective.
“The executive order … holds these institutions hostage and says, ‘We’re not banning [hormone replacement therapy] and transgender surgeries, but if you do provide these, then you will receive no federal funding,’” Sarah said.
A 2024 study from Harvard’s T.H. Chan School of Public Health found that among transgender individuals, teenagers aged 15 to 17 underwent gender-affirming surgery at a rate of 2.1 per 100,000 people.
The study’s lead author, Dannie Dai, a research assistant at Harvard University, said in the report, “Our findings suggest that legislation blocking gender-affirming care among youth is not about protecting children, but is rooted in bias and stigma against identities and seeks to address a perceived problem that does not actually exist.”
Phan also warned of this order’s broader impact on the LGBTQ+ community.
“These harmful policies may disproportionately impact underserved communities by reducing access to knowledgeable providers and essential treatments,” Phan said.
Dr. Jennifer Israel, an associate professor of clinical obstetrics and gynecology, said the Keck School of Medicine’s gender-affirming care team is “currently processing the news about the executive order and its implications for the university, school, and health system.”
The road ahead for transgender students and the broader LGBTQ+ community at USC may be bleak, a prospect Sarah is well aware of.
She said she asks the USC community to “rally for us now, rally for us later and just to try and be supportive in an unsupportive administration.”
A previous version of this article wrote that Tam Phan is an assistant professor of clinical pharmacy at USC’s Keck School of Medicine. Phan is an assistant professor of clinical pharmacy at USC’s Mann School for Pharmacy and Pharmaceutical Sciences. Annenberg Media regrets this error.