On January 28, 2025, President Donald Trump signed an executive order titled "Protecting Children From Chemical and Surgical Mutilation." The order intends to end federal support and funding for medical procedures that aim at altering the gender of those who are under nineteen years old—this includes the use of surgical intervention, puberty blockers, and sex hormones. The order states:
"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,"
The order instructs the Secretary of Health and Human Services to "take all appropriate actions" to end gender-affirming care for children under nineteen and to withdraw its involvement in gender-affirming care and patient privacy. These actions can affect the participation of Medicare, Medicaid, and the Affordable Care Act in providing minors with sex changes.
In a recent interview with Fox News, Dr. Marc Siegel explained that treatments such as puberty blockers and sex reassignment surgery for minors are highly discouraged under the new executive order. When asked about puberty blockers, Dr. Siegel stated:
"Puberty blockers, the main one is Lupron, which we use for prostate cancer, enough said." He then went on to say, "I mean, it interferes with bone growth, it can potentially interfere with fertility if it's combined with hormones, and it can interfere with thinking and cognition. I don't believe that we can say the puberty blockers with hormones don't have long-term side effects; they do."
Dr. Siegel then weighed in on the harm that gender reassignment surgery can have on a child by stating:
"Surgery, we're talking about mastectomies, we're talking about upper and lower surgeries. I think that that's something that's not reversible, and it should never be done on children. Proponents of this will say, 'Well, the longer you wait, the more the child suffers.' I think that there's conflicting research on that. I'm not convinced of that."
During the interview, Dr. Siegel also emphasized the importance of mental health treatment for minors and warned that sex-change procedures are irreversible. He stated this in this interview:
"You have a child, they're having gender confusion. Did they get enough mental health counseling? Did they get a chance to develop? Are they being pressured politically by somebody in society, their parents? And then, most importantly, is the intervention leading to something that's not reversible?"
Hospitals across the U.S. began canceling appointments for minors due to the executive order. NYU Langone Health and its affiliated hospitals followed suit. According to the New York Times, they did not make their announcement public. But over the past five years, the hospital charged $4.48 million for sex-changing procedures for minors.
Shortly after the executive order was in place on February 3, 2025, New York Attorney General Letitia James told New York hospitals not to follow President Trump's signed executive order, which prohibits sex-change procedures for children. James argued that following President Trump's order would violate the state's anti-discrimination laws—this, however, is false. Federal law typically precedes state law due to the Supremacy Clause found in Article VI, Clause 2 of the U.S. Constitution. The clause states:
"This Constitution, and the Laws of the United States which shall be made in Pursuance thereof; and all Treaties made, or which shall be made, under the Authority of the United States, shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, any Thing in the Constitution or Laws of any State to the Contrary notwithstanding."
If the executive order pertains to federal funding, agencies, and/or programs, New York must comply to maintain their eligibility for federal funding. Like any state, New York could legally challenge the order if it is believed to exceed presidential authority or is unconstitutional. While the state may not enforce the order, federal agencies must implement it directly within their jurisdiction, involving audits, withholding of federal funds, and legal action against the non-compliant entities. In conclusion, while New York is expected to follow federal directions related to federal funding or operations, there is a clear indication of resistance from the state. Ultimately, it would most likely be decided in court whether New York would have to abide by the executive order.
In response to James' resistance, President Trump revoked her security clearance. In an exclusive interview with The New York Post on Saturday, Trump stated that he had revoked security clearances for several current and formal democratic officials, including Letitia James and Joe Biden.
A spokesperson for James' office spoke to USA Today regarding the impact of James' losing her security clearance. Her spokesperson stated:
