Last week, President Donald Trump signed yet another executive order targeting the rights of transgender people in this country. This one bars federal funds from going to health care providers that provide gender-affirming care to trans people under age 19.
Because the order blocks 18-year-olds, legal U.S. adults, from accessing transition care, early speculation among some legal observers is that bumping up the age of restriction to 19 instead of limiting it to under-18s provides federal courts with a precedent that brings the administration closer to enacting a complete ban on all gender-affirming care, including for adults. Understandably, the executive order quickly spread further panic among trans people, who have faced action after action from the White House over the first two weeks of the new presidential term.
“It really feels like we took two steps forward and are now being dragged backwards. It’s kind of terrifying living day to day waiting to see what’s going to be stripped away next.”
Already as president, Trump has signed executive orders that have led to a ban on trans people serving in the U.S. military, a bathroom ban in federal government buildings, the Equal Employment Opportunity Commission reserving the right to investigate any employers who allow trans employees to use bathrooms according to their gender identity, and the Education Department to investigate funding for any schools that accommodate trans students. The White House also ordered government staff to remove pronouns from their email signatures, and the State Department removed “TQI” from the standard LGBTQI or LGBTQI+ abbreviation on a number of resource pages, addressing only LGB users. “It’s really … demoralizing,” Lyra, a 19-year-old trans woman from New York, told me. “I started estrogen when I was 18, and it was a large reason as to why I could continue my studies in college.”
Trump’s actions appear to be a blatant attempt to wholesale wipe out a highly marginalized minority by fiat. There will, of course, be legal challenges ahead, but with a firmly conservative Supreme Court in place for the foreseeable future, any court wins will likely be temporary at best.
For Lyra, who only just recently passed the 19-year-old threshold laid out in the medical order, the expansion into restrictions on young adult care for 18-year-olds is particularly concerning. “It shows that this isn’t just about ‘kids’ as they say, because so many are already waiting for that 18 [year old] barrier for informed consent,” she said. “They’re pushing the line here, and mixed with all the other EOs relating to trans people, it really feels like we took two steps forward and are now being dragged backwards. It’s kind of terrifying living day to day waiting to see what’s going to be stripped away next.”
Along with threatening funding cuts to facilities providing youth gender-affirming care, Trump’s order seeks to politically overturn the medical consensus undergirding the current protocol for providing gender-affirming care. It orders the Department of Health and Human Services to disregard the current World Professional Association for Transgender Health guidelines, which have been formed over decades by the leading medical experts in transgender health care, and states the Trump administration will conduct its own review of the science behind gender-affirming care.It’s a move similar to that of Florida Gov. Ron DeSantis in 2022, when he appointed a political lackey to run the Florida Department of Health and produce a sham “review” of the evidence behind gender-affirming care, which a team of experts reviewed and stated was “thoroughly flawed and lacking scientific weight.”
We’ve seen politicians work to politically banish health care they disapprove of before. They did it with abortion care, they’re doing it now with birth control, and they’re well on their way to overriding the many doctors, experts and caretakers who know best what trans kids need.
This is lifesaving, medically necessary care according to mainstream legitimate medical authority in the United States, including the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, the Endocrine Society, the World Professional Association for Transgender Health, the American College of Obstetricians and Gynecologists, and many others.
Accessing gender-affirming care already saved Lyra’s life once.
Lyra’s parents disowned her when she started estrogen at age 18, she tells me, and she says without the care she currently receives, she fears she would be dead by now. Her care “was a large part of why I was able to claim financial independence,” she said. “Otherwise, I’d likely have been in a much worse state today even if I was still with [my parents], being made to watch my body mature another year. I’d likely have turned to do-it-yourself” — meaning ordering her own hormones from a black market website and guessing at her dosage — “instead. Access to testing and medical offices really helped, making sure I was safe and that my dosages were correct.”
The conservatives in power want us to disappear. They want to purge us from society. Existing is the best revenge. Without elaborating further, Lyra said she has contingency plans for accessing her hormones should a full adult ban come down from the White House. It’s a calculation that hundreds of thousands of trans people are having to make right now.I want to finish this piece by directly addressing the trans people reading this. I know these are dark, hard times. We have so little information right now, and we don’t know what else is coming down the pike. But our community has been here before. There might not have been a total ban on our care, but there was a time not long ago when only the wealthiest among us could access legitimate health care. We persisted then and we can persist now. Look after your trans friends, check in on them. Reach out to others if you need help. Find a reason to keep going. “A lot of the reason I made it through my youth was in spite of my family, and I think some part of that continues on here,” Lyra said. “I’m motivated to keep going in spite of the bans and hate.” The conservatives in power want us to disappear. They want to purge us from society. Existing is the best revenge. If you consider the potential impacts of blocking people from receiving vital, lifesaving care, the message feels painfully clear: “[Trump] wants us dead,” Lyra said — “so I’m not doing it.” We have to live, if only to prove to those who are trying to erase us today that they are wrong.
Katelyn Burns is a freelance journalist based in New England. 
