The Impact of Trump’s Executive Order on Gender-Affirming Care for Trans Youth

Paul’s 16-year-old trans daughter had been running out of her medication last month when he saw President Trump’s executive order that labeled gender-affirming care for minors “chemical and surgical mutilation.” She has been a patient at NYU Langone’s Transgender Youth Health Program for two years, so Paul immediately contacted her doctor for clarification before her next appointment, scheduled for late February.

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“I reached out to them through MyChart and said, ‘Hey, in light of this EO, I’m hoping we can get this prescription filled before the appointment. We’re obviously concerned,’” says Paul. The response did little to reassure him. “Her doctor made it clear this was coming down from above and she was not given much choice. But she said that they were waiting for better guidance from the institution.” (NYU Langone declined to comment on Paul’s and other parents’ accounts.)

Paul informed his daughter’s doctor of the medication shortage. The doctor initially confirmed they could renew prescriptions for existing patients but later retracted, citing mixed guidance. Finally, on Thursday, the prescription could be filled.

Parents like Paul have been communicating through text and Google Groups to make sense of the new landscape for their children’s care. “We’re all Signal chatting, trying to figure this out,” he explains. As of Tuesday, NYU Langone had canceled appointments for new patients and denied medication to some long-term patients. Mount Sinai has reportedly canceled young trans patients’ appointments as well, seemingly in response to the executive order.

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For Paul’s daughter, an estrogen replacement regimen, interrupted by a lack of medication, would be “catastrophic.” Should she experience testosterone-driven puberty, “that would put us in a position where I would greatly fear for her health and safety.” Paul’s daughter has seen trans individuals pushed to suicide and experiences suicidality daily. “These are kids with supportive families who go to an incredibly supportive high school,” he notes.

Paul has witnessed a transformation in his daughter’s happiness since she began receiving hormones. “Before she came out as trans, we were having incredible behavioral issues,” says Paul. “She was just not herself and depressed. Coming out really started her journey to flourishing as a person.”

The meanings of Trump’s executive order remain unclear, and its implications are stressful for children and families, as well as the physicians treating them. “We don’t know what to tell patients,” says a doctor working in a non-NYU clinic that treats trans youth, who wishes to remain anonymous. “Patients are fearful of what’s going to happen. There’s a mutual sense of stress because everyone understands the intent of these executive orders is to be confusing.”

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The doctor details how a mother in the Bronx, whose 12-year-old son transitioned at age three, faces a heartbreaking decision. He was to have a puberty-blocker device implanted in his arm in the spring as planned. NYU Langone had interpreted the executive order’s ban on “surgery” to include this outpatient procedure. The alternative—quarterly injections via a two-hour train journey each time—is not feasible for the boy, who fears needles.

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“Gender-affirming care for pediatric and adolescent populations is best-practice medical care, plain and simple,” maintains the doctor. “The disinformation is that this care is a threat to transgender patients instead of lifesaving and improving their quality of life and reducing adverse outcomes.”

Since the election, the doctor has heard from patients about changing their medical records, requesting diagnostic code modifications or removal of certain medications. He also fears that patients might seek hormonal treatment from unlicensed or unsafe sources.

“It’s concerning that patients might turn to hormones from non-licensed or non-FDA-approved sources,” warns the doctor. “People can buy hormones online from untraceable vendors without lot numbers or expiration dates.” He draws a parallel with the legal patchwork governing abortion post-Roe: “There’s worry among providers and patients that we’ll revert to a situation where best-practice medical care is not legally permissible.”

Community Solidarity and Legislative Support

J.D., the trans father of a 15-year-old trans daughter, stocked up on a year’s worth of medication after the election and shared stockpiling information with other families. “It’s a life-and-death issue,” he emphasizes. “There’s nothing more important in her life than having this care. We’ve known she was trans since she was 2 and a half.” J.D. describes their household mood as brutal since the election. “We are an all-LGBTQ family. I’m a trans person myself. I’m very angry and have a lot of despair.”

On Monday night, J.D., his daughter, the mother from the Bronx, Paul, and his daughter, along with other families, doctors, clergy members, and activists, gathered for a rally near NYU Langone. They shouted “Shame!” in unison. The mood was defiant and uplifting. Trans flag balloons bobbed among the crowd. Celebrity speakers like costume designer Qween Jean and actress Cynthia Nixon, whose son had top surgery at NYU, praised the gathering, noting it was “nothing has made me feel so good as coming around the corner today and seeing you all, standing here, fighting for transgender rights.”

New York’s Stand at the Frontline of Trans Healthcare

Earlier that day, New York Attorney General Letitia James warned doctors to continue providing gender-affirming care to comply with state law. Callen-Lorde Community Health Center, an LGBTQ+-focused clinic, confirmed it remains responsive. “Access to medically necessary transgender health care is explicitly protected in New York State,” their website states. “You are protected here in New York, and so is your care.”