in effect
This is Executive Order 14187, signed January 28, 2025 and published in the Federal Register on February 3, 2025. It sets a federal policy that the government will not fund, sponsor, promote, assist, or support gender-transition medical care for people under 19, and directs federal agencies to enforce laws limiting such procedures. The order defines the treatments it targets — puberty blockers, sex hormones, and related surgeries — using the term “chemical and surgical mutilation.”
The order defines a “child” as anyone under 19 and directs agencies to rescind or amend policies that rely on guidance from the World Professional Association for Transgender Health (WPATH), giving HHS 90 days to publish a review of the medical literature. Agencies that give research or education grants to hospitals and medical schools are told to take steps so those institutions stop providing these treatments to minors, and HHS is directed to pursue regulatory changes touching Medicare/Medicaid, the Affordable Care Act’s Section 1557, and diagnostic manuals. The Department of Defense is told to start rulemaking to exclude these treatments from TRICARE coverage, and the Office of Personnel Management is directed to bar coverage for them in the federal and postal employee health plans starting with the 2026 plan year (and to negotiate lower premiums accordingly). The order also directs the Justice Department to prioritize enforcement against female genital mutilation, investigate alleged consumer fraud about treatment side effects, and work with Congress on legislation creating a right to sue. Agencies must submit a combined progress report within 60 days.
People under 19 seeking gender-transition care and their families are directly affected, as are hospitals and medical schools that receive federal research or education grants. It also reaches roughly 2 million TRICARE beneficiaries under 18 and federal and postal employees covered by government health plans. The order states it does not create any legal right or benefit enforceable in court, and directs that it be carried out consistent with existing law and available funding.