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What Trump’s Executive Order on Gender Means for Trans Health Care

What Trump’s Executive Order on Gender Means for Trans Health Care

A photo of President Donald Trump holding up a signed executive order. Text below the photo reads, "What Trump's Executive Order on Gender Means for Trans Health Care."
A slide with text reads, "President Donald Trump issued an executive order stripping gender identity from federal policies and funding. The order particularly affects transgender people incarcerated in federal prisons as it seeks to bar people assigned male “at conception” from being housed in women’s prisons or detention centers. The Federal Bureau of Prisons reports having 1,538 transgender females in custody as of Jan. 18. The order also calls for the bureau to stop spending federal money on medical care “conforming an inmate’s appearance to that of the opposite sex.”"
A slide of text reads the following: “It is wild to me. It is just sort of a revisionist history that is convenient for a particular political base,” said Michelle García, deputy legal director of the ACLU of Illinois. García helped win a legal settlement in 2022 that led to the second-ever gender-affirmation surgery for a person in federal custody. But García said the needs of transgender people in federal custody have been recognized for decades, including the Federal Bureau of Prisons’ Transgender Offender Manual published in 2017 that was in place throughout the first Trump administration."
A slide of text that reads, "The Eighth Amendment to the U.S. Constitution that prohibits “cruel and unusual punishments” requires medical care for all prisoners, García said. She said transgender prisoners often have a medical condition called “gender dysphoria,” the term for psychological distress when someone’s biological sex and gender identity don’t match. The medical community and the Federal Bureau of Prisons view gender-affirming care as a way to treat the condition that can be life-threatening — “much like you would if someone had cancer or any other medical condition in prison,” García said."
A slide of text reads, "The Prison Rape Elimination Act, signed into law by President George W. Bush in 2003, recognizes the particular vulnerability of transgender inmates when officials decide whether to assign them to a male or female facility. Trump’s executive order calls for an amendment to that provision."
A slide of text that reads, "It is less clear how transgender health care provided outside of federal prisons could be affected by Trump’s executive order. The language saying “federal funds shall not be used to promote gender ideology” could be read to target federal funding for gender-affirming care for transgender people, according to Lindsey Dawson, director for LGBTQ Health Policy at KFF, the health information nonprofit that includes KFF Health News. But, Dawson stressed, restrictions of that magnitude would require a lengthy rulemaking and comment process and would surely face legal challenges. So it would likely be a long time before they could be implemented."
The final slide of text reads, "KFF Health News will be tracking these health care changes and others. Follow us @kffhealthnews or visit kffhealthnews.org to stay up to date on the latest health care and policy news."

In his first days in office, President Donald Trump signed an executive order on gender that affects transgender health care. The order aims to directly limit care for trans people incarcerated in federal prisons, but the broader implications on health aren’t clear-cut.

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This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.