Protecting Children From Chemical and Surgical Mutilation
The order declares it is U.S. policy to withhold all federal funding and support from gender-transition procedures for minors, directing multiple agencies to cut off grants, modify federal insurance programs, and pursue enforcement actions — affecting millions of military and federal-employee families.
It immediately imposes obligations on agencies providing research and education grants, instructs HHS to overhaul Medicare, Medicaid, and ACA coverage rules, and directs the Justice Department to prioritize related enforcement and draft new federal legislation.
What this order does
What it orders
The order establishes a national policy against funding, promoting, or supporting gender-transition procedures — which it defines and terms "chemical and surgical mutilation" — for minors under age 19. It directs all agencies that provide research or education grants to immediately take steps ensuring grantee institutions end those procedures. It requires HHS to take regulatory and sub-regulatory actions affecting Medicare, Medicaid, ACA Section 1557, essential health benefits, and federally funded clinical manuals, and to promptly withdraw a March 2022 HHS guidance document on gender-affirming care while issuing new whistleblower protections. It directs the Secretary of Defense to initiate rulemaking to exclude these procedures from TRICARE, and directs OPM to remove coverage for pediatric gender surgeries and hormone treatments from FEHB and PSHB plans for the 2026 plan year.
The Attorney General is directed to prioritize enforcement of existing female genital mutilation statutes, coordinate with state attorneys general, investigate fraud by providers regarding long-term side effects, work to draft federal legislation creating a private right of action for affected minors, and investigate "sanctuary state" custody practices. The order includes a severability clause and explicitly states it does not create judicially enforceable rights against the United States.
Who it affects
Medical institutions receiving federal research or education grants that perform these procedures; military families covered by TRICARE (nearly 2 million enrolled minors); federal and postal employees and their families covered by FEHB and PSHB; minors seeking gender-transition treatments; and medical providers subject to potential federal fraud or consumer protection investigations.
Why it matters
Federal funding will be conditioned on institutions ending these procedures, and insurance coverage will be removed from military and federal employee health plans for the 2026 plan year. Minors in those programs who currently receive or seek these treatments will face reduced coverage and access; providers face potential federal investigations.
What must happen and when
How the order is supposed to work
Agency heads with grant authority must act immediately to condition funding on institutions stopping these procedures; HHS follows with regulatory changes to Medicare, Medicaid, and ACA coverage rules. TRICARE changes require a formal rulemaking initiated by Defense, while FEHB and PSHB changes are required in the 2026 call letter. Within 60 days all covered agency heads must submit a combined progress report to the Assistant to the President for Domestic Policy, who is also directed to convene those heads regularly. A severability clause preserves remaining provisions if any part is invalidated.
Actions and deadlines
- Rescind or amend all agency policies that rely on WPATH guidance, including Standards of Care Version 8
- HHS Secretary publishes a review of existing literature on best practices for children asserting gender dysphoria
- Agency heads providing research or education grants take immediate steps to defund institutions performing these procedures
- HHS Secretary withdraws the March 2, 2022 HHS guidance on gender-affirming care
- HHS Secretary issues new guidance protecting whistleblowers related to compliance with this order
- Secretary of Defense commences rulemaking or sub-regulatory action to exclude these procedures from TRICARE coverage
- OPM Director includes coverage exclusion provisions in FEHB and PSHB 2026 Plan Year call letter
- OPM Director negotiates corresponding premium reductions in FEHB and PSHB plans
- Attorney General reviews and prioritizes enforcement of federal female genital mutilation statute
- Attorney General convenes state attorneys general to coordinate enforcement of female genital mutilation laws
- Attorney General works with Congress to draft legislation creating a private right of action for affected children
- All covered agency heads submit a combined progress report to the Assistant to the President for Domestic Policy