PROTECTING CHILDREN FROM CHEMICAL AND SURGICAL MUTILATION

By the authority vested in me as President by the Constitution and the 
laws of the United States of America, it is hereby ordered:

Section 1.  Policy and Purpose.  Across the country today, medical 
professionals are maiming and sterilizing a growing number of 
impressionable children under the radical and false claim that adults can 
change a child’s sex through a series of irreversible medical 
interventions.  This dangerous trend will be a stain on our Nation’s 
history, and it must end.

Countless children soon regret that they have been mutilated and begin to 
grasp the horrifying tragedy that they will never be able to conceive 
children of their own or nurture their children through breastfeeding.  
Moreover, these vulnerable youths’ medical bills may rise throughout their 
lifetimes, as they are often trapped with lifelong medical complications, 
a losing war with their own bodies, and, tragically, sterilization.

Accordingly, it is the policy of the United States that it will not fund, 
sponsor, promote, assist, or support the so-called “transition” of a child 
from one sex to another, and it will rigorously enforce all laws that 
prohibit or limit these destructive and life-altering procedures.

Sec. 2.  Definitions.  For the purposes of this order:

(a)  The term “child” or “children” means an individual or individuals 
under 19 years of age.

(b)  The term “pediatric” means relating to the medical care of a child.

(c)  The phrase “chemical and surgical mutilation” means the use of 
puberty blockers, including GnRH agonists and other interventions, to 
delay the onset or progression of normally timed puberty in an individual 
who does not identify as his or her sex; the use of sex hormones, such as 
androgen blockers, estrogen, progesterone, or testosterone, to align an 
individual’s physical appearance with an identity that differs from his or 
her sex; and surgical procedures that attempt to transform an individual’s 
physical appearance to align with an identity that differs from his or her 
sex or that attempt to alter or remove an individual’s sexual organs to 
minimize or destroy their natural biological functions.  This phrase 
sometimes is referred to as “gender affirming care.”

Sec. 3.  Ending Reliance on Junk Science.  (a)  The blatant harm done to 
children by chemical and surgical mutilation cloaks itself in medical 
necessity, spurred by guidance from the World Professional Association for 
Transgender Health (WPATH), which lacks scientific integrity.  In light of 
the scientific concerns with the WPATH guidance:

(i)   agencies shall rescind or amend all policies that rely on WPATH 
guidance, including WPATH’s “Standards of Care Version 8”; and 

(ii)  within 90 days of the date of this order, the Secretary of Health 
and Human Services (HHS) shall publish a review of the existing literature 
on best practices for promoting the health of children who assert gender 
dysphoria, rapid-onset gender dysphoria, or other identity-based 
confusion.

(b)  The Secretary of HHS, as appropriate and consistent with applicable 
law, shall use all available methods to increase the quality of data to 
guide practices for improving the health of minors with gender dysphoria, 
rapid-onset gender dysphoria, or other identity-based confusion, or who 
otherwise seek chemical or surgical mutilation.

Sec. 4.  Defunding Chemical and Surgical Mutilation.  The head of each 
executive department or agency (agency) that provides research or 
education grants to medical institutions, including medical schools and 
hospitals, shall, consistent with applicable law and in coordination with 
the Director of the Office of Management and Budget, immediately take 
appropriate steps to ensure that institutions receiving Federal research 
or education grants end the chemical and surgical mutilation of children.

Sec. 5.  Additional Directives to the Secretary of HHS.  (a)  The 
Secretary of HHS shall, consistent with applicable law, take all 
appropriate actions to end the chemical and surgical mutilation of 
children, including regulatory and sub-regulatory actions, which may 
involve the following laws, programs, issues, or documents:

(i)    Medicare or Medicaid conditions of participation or conditions for 
coverage;

(ii)   clinical-abuse or inappropriate-use assessments relevant to State 
Medicaid programs;

(iii)  mandatory drug use reviews;

(iv)   section 1557 of the Patient Protection and Affordable Care Act;

(v)    quality, safety, and oversight memoranda;

(vi)   essential health benefits requirements; and

(vii)  the Eleventh Revision of the International Classification of 
Diseases and other federally funded manuals, including the Diagnostic and 
Statistical Manual of Mental Disorders, Fifth Edition.

(b)  The Secretary of HHS shall promptly withdraw HHS’s March 2, 2022, 
guidance document titled “HHS Notice and Guidance on Gender Affirming 
Care, Civil Rights and Patient Privacy” and, in consultation with the 
Attorney General, issue new guidance protecting whistleblowers who take 
action related to ensuring compliance with this order.

Sec. 6.  TRICARE.  The Department of Defense provides health insurance, 
through TRICARE, to nearly 2 million individuals under the age of 18.  As 
appropriate and consistent with applicable law, the Secretary of Defense 
shall commence a rulemaking or sub-regulatory action to exclude chemical 
and surgical mutilation of children from TRICARE coverage and amend the 
TRICARE provider handbook to exclude chemical and surgical mutilation of 
children.

Sec. 7.  Requirements for Insurance Carriers.  The Director of the Office 
of Personnel Management, as appropriate and consistent with applicable 
law, shall:

(a)  include provisions in the Federal Employee Health Benefits (FEHB) and 
Postal Service Health Benefits (PSHB) programs call letter for the 2026 
Plan Year specifying that eligible carriers, including the Foreign Service 
Benefit Plan, will exclude coverage for pediatric transgender surgeries or 
hormone treatments; and

(b)  negotiate to obtain appropriate corresponding reductions in FEHB and 
PSHB premiums.

Sec. 8.  Directives to the Department of Justice.  The Attorney General 
shall:

(a)  review Department of Justice enforcement of section 116 of title 18, 
United States Code, and prioritize enforcement of protections against 
female genital mutilation;

(b) convene States’ Attorneys General and other law enforcement officers 
to coordinate the enforcement of laws against female genital mutilation 
across all American States and Territories; 

(c)  prioritize investigations and take appropriate action to end 
deception of consumers, fraud, and violations of the Food, Drug, and 
Cosmetic Act by any entity that may be misleading the public about long-
term side effects of chemical and surgical mutilation;

(d)  in consultation with the Congress, work to draft, propose, and 
promote legislation to enact a private right of action for children and 
the parents of children whose healthy body parts have been damaged by 
medical professionals practicing chemical and surgical mutilation, which 
should include a lengthy statute of limitations; and

(e)  prioritize investigations and take appropriate action to end child-
abusive practices by so-called sanctuary States that facilitate stripping 
custody from parents who support the healthy development of their own 
children, including by considering the application of the Parental 
Kidnapping Prevention Act and recognized constitutional rights.

Sec. 9.  Enforcing Adequate Progress.  Within 60 days of the date of this 
order, the heads of agencies with responsibilities under this order shall 
submit a single, combined report to the Assistant to the President for 
Domestic Policy, detailing progress in implementing this order and a 
timeline for future action.  The Assistant to the President for Domestic 
Policy shall regularly convene the heads of agencies with responsibilities 
under this order (or their designees) to coordinate and prepare for this 
submission.

Sec. 10.  Severability.  If any provision of this order, or the 
application of any provision to any person or circumstances, is held to be 
invalid, the remainder of this order and the application of any of its 
other provisions to any other persons or circumstances shall not be 
affected thereby.

Sec. 11.  General Provisions.  (a)  Nothing in this order shall be 
construed to impair or otherwise affect:

(i)    the authority granted by law to an executive department or agency, 
or the head thereof; or

(ii)   the functions of the Director of the Office of Management and 
Budget relating to budgetary, administrative, or legislative proposals.

(b)  This order shall be implemented consistent with applicable law and 
subject to the availability of appropriations.

(c)  This order is not intended to, and does not, create any right or 
benefit, substantive or procedural, enforceable at law or in equity by any 
party against the United States, its departments, agencies, or entities, 
its officers, employees, or agents, or any other person.

THE WHITE HOUSE,

January 28, 2025.

https://www.whitehouse.gov/presidential-actions/2025/01/protecting-
children-from-chemical-and-surgical-mutilation/