New York Attorney General Letitia James is doing her part to protect trans kids in her state. In a recent letter, she informed healthcare providers that halting gender-affirming care for minors remains a violation of state law despite Donald Trump’s executive order seeking to ban gender-affirming care for anyone under 19.

James explained that providers will not be penalized by the federal government because she, along with 22 other state attorneys general, sued in district court on January 28 to stop “the government’s illegal efforts to freeze federal funding.” The court, she explained, issued a temporary restraining order banning federal agencies from freezing any funding based on Trump’s executive orders.

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“Regardless of the availability of federal funding,” she continued, “we write to further remind you of your obligations to comply with New York State laws, including those that prohibit discrimination against individuals based on their membership in a protected class… Electing to refuse services to a class of individuals based on their protected status, such as withholding the availability of services from transgender individuals based on their gender identity or their diagnosis of gender dysphoria, while offering such services to cisgender individuals, is discrimination under New York law.”

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Trump’s executive order, “Protecting Children From Chemical and Surgical Mutilation,” seeks to ban those under the age of 19 from accessing puberty blockers, hormone therapy, and surgical procedures as gender-affirming care for transgender individuals. The order threatens prosecution against sanctuary states that protect this care. 

“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,” the order states, omitting the fact that gender-affirming care has been safely provided to cisgender and trans children for decades and is suggested as a best medical practice by most major American medical and psychological associations.

The order directs the heads of all government agencies to stop all funding to all medical institutions, including medical schools and hospitals, that research, teach about, or provide gender-affirming care. This would not only result in the loss of hundreds of billions of dollars that keep these institutions operating but would also guarantee that pediatric medical students nationwide do not learn about how to treat gender dysphoria for children.

The order dismisses all studies upholding the necessity of gender-affirming care as “junk science” and gives the Department of Health and Human Services (HHS) a 90-day deadline to 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.”

The order commands the HHS to disregard all research and guidance produced or endorsed by the World Professional Association for Transgender Health (WPATH), the leading health authority on trans healthcare. This command ensures the exclusion of studies affirming the effectiveness of gender-affirming care.

In response, the government’s largest health insurance program for federal employees has officially ended coverage of gender-affirming care for anyone under 19.

The U.S. Office of Personnel and Management’s Healthcare and Insurance program – which covers “8 million Federal employees, retirees, former employees, family members, and former spouses,” according to the handbook – sent a directive to health insurance companies that work with the federal government stating they must comply with the order, along with another one Trump signed declaring there are only two sexes, male and female.

“All Carriers for Plan Year 2026 ‘will exclude coverage for pediatric transgender surgeries or hormone treatments’ for the purpose of gender transition,” the directive states, according to Huffington Post. “OPM recognizes that there are some bona fide medical conditions, such as precocious puberty, or therapy subsequent to a traumatic injury, where hormone treatments for individuals under the age of 19 may be lawfully covered by Carriers.”

Precocious puberty is when a child goes through puberty too young. These kids often take puberty blockers to keep them aligned with their peers. As such, the directive makes it clear that cisgender kids can use puberty blockers, but transgender kids can’t.

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