Trump could restrict transgender surgeries for kids in second term, policy analysts say

Washington, D.C. Newsroom, Nov 11, 2024 / 07:00 am

President-elect Donald Trump’s victory over Vice President Kamala Harris could prompt major changes to the federal government’s promotion of transgender ideology and the endorsement of gender transitions for children, according to scholars closely watching the issue.

“The left-wing gender insanity being pushed in our children is an act of child abuse,” Trump said earlier this year in a campaign video. “... On Day 1, I will revoke [President] Joe Biden’s cruel policies on so-called gender-affirming care.”

In 24 states, doctors can still legally facilitate gender transitions for minors through transgender drugs and surgeries. Twenty-six states have either banned or put limits on gender transitions for minors. 

Although most legislative debates about so-called gender transitions for children occur at the state level, Biden’s administration used regulatory agencies and the Department of Justice (DOJ) to try to expand access. Before his presidency, the issue was not on the minds of most Americans or most politicians.

The Department of Health and Human Services (HHS), for example, issued a regulation that interpreted “sex discrimination” bans within the Affordable Care Act to include discrimination based on a person’s self-asserted gender identity.

Under the rule, any health care provider or insurer not covering surgeries or drugs for gender transitions would lose federal funding. This rule applies regardless of whether the patient is an adult or a minor but is currently unenforceable because it has been blocked by a judge.

Biden’s DOJ also sued Tennessee because the state does not allow doctors to facilitate surgical or drug-induced gender transitions on children. The DOJ based its arguments on laws that prohibit sex discrimination and the case will be heard by the United States Supreme Court.

The administration also revised Title IX protections to redefine sex discrimination to include any discrimination based on gender identity. This could have forced publicly funded schools and colleges to allow biological men in women’s locker rooms, dormitories, and athletic competitions but was blocked by multiple court rulings.

“Those regulations are where they have their teeth,” Marie Hilliard, a registered nurse and senior fellow at the National Catholic Bioethics Center, told CNA. 

According to Hilliard, Trump’s first step in tackling this issue should be to throw out Biden-era policies promoting gender ideology and then subsequently harness the power of regulatory agencies to protect children from irreversible transgender drugs and surgeries.

“I think it’s going to be through the regulatory agencies because the current administration has used these regulations to basically distort what sex means,” Hilliard added.

First step: reversing Biden’s policies

A reversal of Biden’s regulations would be an important first step, according to Mary Rice Hasson, who works as the director of the Person and Identity Project at the Ethics and Public Policy Center.

“Then it needs an agency-by-agency effort to delete ‘gender identity’ language, reverse policies that sweep self-defined ‘identities’ into the protected category of ‘sex,’ and which promote or fund medicalized ‘gender transitions,’ particularly in minors,” Hasson told CNA.

Hasson encouraged a complete overhaul of the agenda of the last four years. 

This includes ending programs “that tell children to ‘self-identify’ according to sexual orientation and ‘gender identity’” and the collection of such data by the government, according to Hasson. It includes removing all publications from agencies that promote transgender surgeries and drugs for minors and ending the DOJ’s efforts to prevent states from restricting transgender drugs and surgeries for children.

“Ending these disabling, disfiguring, and sterilizing interventions in minors will require derailing the ‘transgender train’ at the station as well as shuttering all the stops down the line,” Hasson said. 

Hilliard agreed, saying the Biden administration used the anti-discrimination argument to force people to violate their conscience and “cooperate in what we know are mutilating activities.”

Trump signaled support for such actions earlier this year, saying: “I will sign a new executive order instructing every federal agency to cease all programs that promote the concept of sex and gender transition at any age.”

Next step: using executive authority

After reversing the Biden administration’s actions, the next step would be to use regulatory agencies to prevent gender transitions of children across the country. 

“The Trump administration should stop feeding this monster with federal funds,” Hasson told CNA. 

Hasson said the administration should end grant funding for “unethical ‘gender’ experiments” on minors and impose federal funding restrictions “on hospitals that do ‘transgender’ experiments on minors.” 

Hilliard noted that withholding Medicaid funding for hospitals that perform gender transitions on minors could be an effective approach, saying “that’s where they can use their money” to hold these hospitals accountable. 

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Hasson added that the Food and Drug Administration (FDA) could “prohibit the off-label use of sterility-inducing puberty-blocking and ‘transgender’ hormones in otherwise healthy minors.”

Hilliard similarly suggested using the FDA to restrict gender transition drugs, noting that “regulations are being misused right now to advance the whole agenda of gender identity.” She said the drugs have “good moral uses” for helping children born with sex development disorders but should be regulated to prevent the “mutilating use” of gender transitioning minors.

Jane Anderson, the vice president of the American College of Pediatricians, told CNA the Trump administration should hold federal agencies accountable to “follow the science that European countries are endorsing.”

“We and other organizations launched the Doctors Protecting Children Declaration to call on prominent U.S. medical organizations to stop promoting these [transgender surgeries and drugs] that harm our children,” Anderson said.

Father Tadeusz Pacholczyk, a senior ethicist at the National Catholic Bioethics Center, told CNA that Trump should “establish a president’s bioethics council to address critical ethical issues arising in medicine and the biosciences.” 

“This advisory council would assist the administration in policy decisions and in raising the profile of important issues of the day before the public,” he said. “The president could task the bioethics council to begin its work with a mandate to address the matter of suitable and unsuitable treatments for young people facing gender dysphoria.”

Earlier this year, Trump said he supported a DOJ investigation of “Big Pharma and the big hospital networks to determine whether they have deliberately covered up horrific long-term side effects of sex transitions in order to get rich at the expense of vulnerable patients.” 

The president-elect has said he would support congressional action to prohibit transgender surgeries for children and prohibit any taxpayer money from being used to support transgender procedures. He also urged lawmakers to support people who want to file lawsuits against doctors who performed gender transition procedures on them while they were children.