{"id":38649,"date":"2025-01-30T13:50:00","date_gmt":"2025-01-30T13:50:00","guid":{"rendered":"https:\/\/www.lifeandnews.com\/articles\/?p=38649"},"modified":"2025-01-31T06:49:32","modified_gmt":"2025-01-31T06:49:32","slug":"a-federal-policy-expert-weighs-in-on-trumps-efforts-to-stifle-gender-affirming-care-for-americans-under-19","status":"publish","type":"post","link":"https:\/\/www.lifeandnews.com\/articles\/a-federal-policy-expert-weighs-in-on-trumps-efforts-to-stifle-gender-affirming-care-for-americans-under-19\/","title":{"rendered":"A federal policy expert weighs in on Trump\u2019s efforts to stifle gender-affirming care for Americans under 19"},"content":{"rendered":"\n

Elana Redfield<\/a>, University of California, Los Angeles<\/a><\/em><\/p>\n\n\n\n

Amid a flurry of executive orders affecting transgender Americans, the Trump administration ordered restrictions<\/a> on gender-affirming care for minors. Calling it \u201ca stain on our Nation\u2019s history,\u201d the Jan. 28, 2025, order seeks to \u201cend\u201d this form of treatment for Americans under 19 years old.<\/em><\/p>\n\n\n\n

The Conversation U.S. interviewed Elana Redfield<\/a>, federal policy director at the Williams Institute, an independent research center at the UCLA School of Law dedicated to studying sexual orientation and gender identity law. She describes the aims of the executive order, how much weight it carries, and how it should be understood in the broader context of legal battles over access to gender-affirming care.<\/em><\/p>\n\n\n\n

What\u2019s the scope of the executive order?<\/strong><\/p>\n\n\n\n

Twenty-six states<\/a> have already restricted gender-affirming care for minors or banned it outright. So the order seeks to extend restrictions to the rest of the country using the weight of the executive branch.<\/p>\n\n\n\n

However, it\u2019s not a national ban on gender-affirming care for minors. Instead, it\u2019s directing federal agencies to regulate and restrict this form of care.<\/p>\n\n\n\n

That being said, federal agencies have a tremendous impact on American life. Trans kids rely on publicly funded health insurance programs such as Medicaid<\/a> and TRICARE<\/a>, which is administered to the children of active duty service members via the Department of Defense. And a big part of the executive order is directing the federal agencies that administer these programs to review their own policies to ensure that they are not supporting gender-affirming care for minors.<\/p>\n\n\n\n

So what we\u2019re really seeing is the federal government trying to erect barriers to kids accessing this care.<\/p>\n\n\n\n

Does the executive branch have the authority to unilaterally ban federal funding of certain medical treatments?<\/strong><\/p>\n\n\n\n

The answer is a little mixed. A president might be able to suspend or put a temporary pause on funding a particular type of treatment or service. But the actual parameters of a program \u2013 and how agencies should implement them \u2013 are determined by Congress and, to some extent, by the courts<\/a>.<\/p>\n\n\n\n

Ultimately, the president can only take actions in ways that are designated by the Constitution, or through some specific power that Congress has granted to the executive branch. I don\u2019t see that authority granted for a lot of what\u2019s contained in this executive order. But many of these directives will probably be litigated in court, where the president will likely argue that he has the power to direct agencies to do all they can to put a halt to gender-affirming care for minors.<\/p>\n\n\n\n

Do private health insurers fall outside the scope of this executive order?<\/strong><\/p>\n\n\n\n

On the surface, yes. But it\u2019s easy to see how directives from the executive branch can touch broader components of the country\u2019s health care system, including private hospitals and private health insurance.<\/p>\n\n\n\n

For example, Section 1557 of the Affordable Care Act<\/a> is a nondiscrimination provision. It says there can be no sex discrimination when it comes to approving health care treatments. This has been interpreted to mean that health insurance plans receiving federal funding cannot deny a policyholder gender-affirming care. However, this interpretation has been blocked by a federal court<\/a>.<\/p>\n\n\n\n

The question of whether this definition of sex discrimination encompasses gender identity is currently playing out in the courts. For example, there\u2019s a pending U.S. Supreme Court decision regarding a Tennessee law banning gender-affirming care for minors. Should the Supreme Court determine that Tennessee is able to ban gender-affirming care for minors, it\u2019s possible to see how this could impact private health insurance coverage for gender-affirming care.<\/p>\n\n\n\n

\"A
Transgender rights supporters and opponents rally outside of the U.S. Supreme Court as the high court hears arguments in a case about Tennessee\u2019s law banning gender-affirming care for minors on Dec. 4, 2024. Kevin Dietsch\/Getty Images<\/a><\/figcaption><\/figure>\n\n\n\n

What else stood out to you from the executive order?<\/strong><\/p>\n\n\n\n

The executive order directs the Department of Justice to discourage doctors and hospitals from administering gender-affirming care to minors, characterizing it as genital mutilation<\/a>, which is a heinous-sounding offense. Even though this is an inaccurate comparison, it could have a chilling effect even in states where this form of care is legal.<\/p>\n\n\n\n

The order also contains a provision that asks Congress to extend the statute of limitations for gender-affirming care, so that someone who received gender-affirming care as a minor and decides they\u2019re not happy with it decades later can sue their doctor. Some states have already extended the statute of limitations to 30 years<\/a> for gender-affirming care.<\/p>\n\n\n\n

Again, this could have a chilling effect in states where the care is legal. What doctor or hospital would want to expose themselves to this risk?<\/p>\n\n\n\n

Of course, these two elements constitute directives from the executive branch, but we don\u2019t know how they\u2019ll be enforced. They do reveal, however, some of the ways in which the administration plans to direct its efforts.<\/p>\n\n\n\n

Before Roe v. Wade was overturned, federal funding of elective abortion had been restricted for decades under the Hyde Amendment<\/a>. You can\u2019t receive coverage for an abortion under a Medicaid plan, for example. Do you see this executive order as Trump trying to simply enact \u2013 via fiat, of course \u2013 his own version of the Hyde Amendment, but instead applied to gender-affirming care for minors?<\/strong><\/p>\n\n\n\n

I think there\u2019s a key difference between the two. The Hyde Amendment, which has been repeatedly reenacted by Congress, prohibits federal funding of abortion care, but it doesn\u2019t prohibit states from allowing or permitting abortion. It\u2019s always operated as a sort of compromise: It says providers can\u2019t use federal funding for an abortion, but they can use their own funding to administer abortions \u2013 and oh, by the way, they can still receive federal funding for other health services.<\/p>\n\n\n\n

This executive order, on the other hand, takes a much more uncompromising position: It tells agency heads to stop directing any and all federal funds to institutions that research or provide gender-affirming care.<\/p>\n\n\n\n

Again, it\u2019s important to remember that executive orders aren\u2019t established policy. They\u2019re simply directing agencies to craft certain policies and encouraging lawmakers to enact legislation.<\/p>\n\n\n\n

So far, much of the legislation restricting gender-affirming care \u2013 whether it\u2019s at the state level or in the executive branch \u2013 has centered on minors, or individuals under 19. Are there any threats to gender-affirming care for adults?<\/strong><\/p>\n\n\n\n

Only one state, Florida, has enacted a law that specifically regulates gender-affirming care for adults. That law basically sets some compliance standards and restricts who can prescribe the care. Florida also banned the use of state funds for gender-affirming care for everyone<\/a>, adults and children. So that means, for example, those who are incarcerated in state prisons can\u2019t receive gender-affirming care.<\/p>\n\n\n\n

Florida isn\u2019t the only state that has enacted a state funding ban<\/a>. Depending on your insurance, this could mean you\u2019re forced to pay out of pocket for your procedures and treatment, which can be prohibitively expensive.<\/p>\n\n\n\n

What are you going to be watching for in the coming weeks?<\/strong><\/p>\n\n\n\n

I\u2019m sure someone\u2019s going to sue to challenge the order. The problem, though, is that an executive order is an expression of policy ideas. You need something to actually happen before lawyers and activists can react to it. So I\u2019ll be tracking federal agencies to see how they specifically try to enact some of these directives.<\/p>\n\n\n\n

Is there anything else you\u2019d like to add?<\/strong><\/p>\n\n\n\n

This executive order contains language that characterizes the science around gender-affirming care as junk science. It\u2019s repeatedly described as chemical and surgical mutilation, or as maiming and sterilizing kids. There\u2019s talk of rapid-onset gender dysphoria, which has been discredited<\/a>.<\/p>\n\n\n\n

So it rejects the idea that gender-affirming care has health benefits, even though there\u2019s robust, extensive evidence<\/a> supporting access to gender-affirming care<\/a>. Self-reporting by transgender individuals is overwhelmingly positive: 98% of trans people who had hormone therapy said it made their lives better, according to the 2022 U.S. Transgender Survey<\/a>.<\/p>\n\n\n\n

There are also rigorous standards of practice<\/a>, including for how you support and treat minors, that are intended to prevent overprescription or overutilization of services.<\/p>\n\n\n\n

In other words, there are already barriers in place and checks and balances for minors if they want to access gender-affirming care.<\/p>\n\n\n\n

Elana Redfield<\/a>, Federal Policy Director at the Williams Institute, University of California, Los Angeles<\/a><\/em><\/p>\n\n\n\n

This article is republished from The Conversation<\/a> under a Creative Commons license. Read the original article<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Elana Redfield, University of California, Los Angeles Amid a flurry of executive orders affecting transgender Americans, the Trump administration ordered restrictions on gender-affirming care for minors. Calling it \u201ca stain on our Nation\u2019s history,\u201d the Jan. 28, 2025, order seeks to \u201cend\u201d this form of treatment for Americans under 19 years old. The Conversation U.S. […]<\/p>\n","protected":false},"author":56,"featured_media":38650,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15534,8025,46,295,296,4],"tags":[6867,479,15097,9270,15984,10952,885,891,886,860,2497,1666],"_links":{"self":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38649"}],"collection":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/users\/56"}],"replies":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/comments?post=38649"}],"version-history":[{"count":1,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38649\/revisions"}],"predecessor-version":[{"id":38651,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/posts\/38649\/revisions\/38651"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media\/38650"}],"wp:attachment":[{"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/media?parent=38649"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/categories?post=38649"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.lifeandnews.com\/articles\/wp-json\/wp\/v2\/tags?post=38649"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}