Washington DC, USA – September 15, 2020: President Donald Trump participates in the signing ceremony of the Abraham Accords between Israel, UAE and Bahrain at the White House in Washington, DC.
On Monday, the White House posted a summary of everything the administration has done during the president’s first 100 days in office to make it harder for trans young people to access gender-affirming care.
In his January 28 executive order laying out his plan to ban young people under 19 from accessing puberty blockers, hormone therapy, and surgical procedures for the purposes of gender-affirming care, President Donald Trump called for the heads of federal agencies to submit a combined report on their progress in implementing his directives within 60 days. An executive summary of that report was published on the White House website on Monday.
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As in Trump’s January executive order, the report blatantly mischaracterizes gender-affirming healthcare as “surgical and chemical mutilation” and “experimentation” on children. It claims that treatments like puberty blockers and surgical interventions have been “marketed to children on the basis of ideologically driven and financially motivated junk-science.”
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In reality, every major American medical association and leading world health authority has endorsed gender-affirming care as evidence-based, safe, and in some cases lifesaving for transgender youth.
The report also claims that during the first three years of the Biden administration, “more than 7,000 children were administered puberty blockers and cross-sex hormones” and “over 4,000 were subjected to sex-trait modification surgical interventions.”
It’s unclear where the administration is getting those figures, but if they are accurate, it would mean that 0.01 % of the population of children under 18 in the United States received puberty blockers and hormone therapy, and 0.005% of children under 18 utilized surgical intervention.
This is consistent with an analysis of private insurance claims published this year, which found that it is “rare” for children between the ages of 8 and 17 to receive gender-affirming hormone therapy and puberty-blocking medications. The Williams Institute cites another study that showed that gender-affirming surgeries among transgender and gender-diverse minors are also “rare.”
Responding to Trump’s executive order in January, the Williams Institute wrote that the president’s inflammatory mischaracterization “does not acknowledge any benefits of gender-affirming care, instead making unsubstantiated statements of widespread harm and disregarding decades of science that form the foundation of the services that are currently available to transgender youth.”
In Monday’s report, the administration said that since March 5, the Centers for Medicare & Medicaid Services, the Substance Abuse and Mental Health Services Administration, the Health Resources and Services Administration, and the Office of the Assistant Secretary for Health have all issued memos alerting providers to “the dangers of chemical mutilation as well as the lack of medical evidence supporting their use” — effectively spreading the administration’s own anti-trans “junk science” and misinformation.
The report falsely characterized the World Professional Association for Transgender Health’s (WPATH) “Standards of Care Version 8” as having been drafted based on “political considerations” rather than scientific evidence. It also touted the removal of former Assistant Secretary for Health Admiral Rachel Levine’s federal guidance on gender-affirming care for young people from the Department of Health and Human Services (HHS) website in January.
A February court order compelled HHS to restore the document, but as the report notes, the administration added a notice disavowing the guidance and all materials that cite WPATH “in the strongest possible terms.”
Per Trump’s directive for HHS to publish “an evidence-based review of the literature on best-practices to promote the health of children who assert gender dysphoria,” the report states that the department has “coordinated with a team of eight distinguished scholars” to produce such a review.
The Cass Review, a similar report commissioned in 2020 by England’s National Health Service (NHS), has been widely criticized for excluding hundreds of studies affirming the benefits of gender-affirming care. Trans advocates have accused lead author Hilary Cass of bending to conservative political forces in the U.K. Notably, Cass took four years to produce the final review, while the Trump administration says it will publish its own review by the president’s 90-day deadline.
As journalist Erin Reed notes, while it is unknown who the “eight distinguished scholars” are, the Trump administration’s review is likely to echo both the Cass Review and a similar report from the Florida Board of Medicine, “both of which excluded gender-affirming care experts and were engineered to justify crackdowns on care.”
The Trump administration’s review, Reed says, “could dramatically alter the legal landscape surrounding transgender healthcare,” granting “legitimacy to previously discredited voices.”
“Far-right commentators repeatedly rejected as experts in court cases could potentially leverage their inclusion in federally published documents to bolster their credibility in future litigation,” Reed writes.
The report notes that HHS has eliminated 215 federal grants in accordance with Trump’s directive to defund research on gender-affirming care for young people and states it is also “exploring every avenue to increase access to detransition care.”
Trump’s executive order instructed HHS to ban federal employee health insurance plans from covering gender-affirming care for minors. Monday’s report notes that the Department of Defense now requires its health services contractors to discontinue coverage of such care, while the Office of Personnel Management has excluded coverage of such care for the children of federal civilian employees beginning next year.
The administration says the Department of Justice (DOJ) is also targeting gender-affirming care providers, initiating “investigations of multiple entities that have misled the public about the long-term side effects of” gender-affirming care, and submitting for review draft legislation “creating a private right of action, with a long statute of limitations” allowing children and their parents to sue providers.
The report says the DOJ also intends to establish a “Parental Rights Task Force” to “vindicate the rights of parents in states… where parental refusal to consent to the mutilation of their children can enable the state to remove children from parental custody.” The administration falsely cites California as one such state. But as The Advocate notes, in 2023 Gov. Gavin Newsom (D) vetoed a bill that would have required judges to consider parents’ support for their trans children when ruling on custody and visitation arrangements.
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