Executive orders are disrupting transgender care

February 13, 2025

The Trump Administration has issued multiple executive orders which reverse protections and recognition that transgender people gained over recent years. This includes orders prohibiting transgender people from serving in the military, eliminating options other than “male” and “female” in federal documents, not allowing transgender people to use bathrooms in federally-funded buildings that align with their gender identity, prohibiting hormonal or surgical therapy in those under the age of 19 and prohibiting transgender women from participating in women’s sports.

These executive orders have led to the removal of data about transgender individuals from federal websites and databases of the Centers for Disease Control and Prevention, and the Administration has required researchers to withdraw unpublished papers that refer to genders other than male and female. They also ordered a review of federal health insurance policies to prevent any federal payment for transgender care.

None of these executive orders specifically target employer-sponsored health plans, but plan members may already be having difficulty obtaining care. Many families with a transgender adolescent were already traveling across state lines to receive care, and since the executive orders, multiple hospitals across the country have canceled appointments and closed their transgender programs. These hospitals fear losing federal payments for research and for unrelated medical care.

Transgender people will continue to need medical care, and obtaining hormonal treatment or puberty blockers for those under age 19 is likely to become very difficult. Surgical treatment of transgender minors was already very rare. Transgender people have higher rates of mental illness and suicide than cisgender people, making access to appropriate mental health services especially important. Previous research has shown that gender affirming care reduces risk of suicide.

Implications for employers:

• Employers can continue to be supportive of transgender employees and dependents and should expect increased needs for mental health services in the coming months and years.

• Employers that offer gender affirming medical and surgical services might find more members accessing travel benefits, if these are offered. Employers can make sure that behavioral health conditions, like gender dysphoria, are part of travel benefits.

• Employers can offer members access to virtual vendors that specialize in gender dysphoria care to supplement carrier resources.

• If employers offer optional legal services as a benefit, consider vendors that include support for updating identity documents.

2/13/25 Addendum: The New England Journal of Medicine published Advancing Transgender Health amid Rising Policy Threats yesterday. This article is paywalled, but non-subscribers can sign up to read 2 articles without charge each month.

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