Brandon
Nov 20
6 mins read
In this article, unless stated otherwise, the term “transgender” or “trans” is used broadly to include a spectrum of gender identities and refers to anyone who identifies with a different gender than the sex they were assigned at birth.
Within days of taking office President Donald Trump, signed a wave of executive orders directly attacking gender-affirming care and trans existence. Among them was an order titled “Protecting Children From Chemical and Surgical Mutilation”, which blatantly rejects the legitimacy of gender-affirming care and defines “children” as anyone under 19. As directed by that order, the Department of Health and Human Services (HHS) released a report titled Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices. Following the report, the HHS sent a letter to health care providers and state medical boards, requesting the revision of treatment protocols for “minors with gender dysphoria”.
“Puberty blockers, cross-sex hormones, and surgeries have very weak evidence of benefit, but carry risk of significant harms, including sterilization. Providers should no longer rely on discredited guidelines that promote these dangerous interventions for children and adolescents based on ideology, not evidence.” – HHS
The HHS review was openly criticized by medical authorities for the blatant political bias, rampant misinformation, and disregard to established medical guidelines and evidence supporting gender-affirming care. In fact, nearly all medical associations and world health authorities endorse transgender health care as safe and with high life saving potential.
The government interference in critical healthcare for trans youth is not mere words, it’s triggering real world consequences. Since the start of Trump’s second term, over 20 hospital systems have paused or ended gender-affirming care for people under 19 years old, with more restrictions expected. Altogether 27 states, more than half of the country have enacted legal bans restricting gender-affirming care for trans youth.
Most recently, the Trump administration is reportedly planning to end gender-affirming care for transgender youth nationwide based on new proposals brought by the Department of Health and Human Services.
NPR obtained draft policy documents that would prohibit federal Medicaid reimbursement for medical care provided to transgender patients 18 and younger, including coverage through the Children’s Health Insurance Program (CHIP) for patients under 19. A separate measure would block all Medicaid and Medicare funding for any hospitals or provider that offers pediatric gender-affirming care. According to a Centers for Medicare and Medicaid Services employee, the proposals are expected to be released publicly in early November.
Rampant misinformation from federal and state entities fuels anti-trans legislation and normalizes public anti-trans hate. One of the strongest tools against these attacks on our trans communities is arming ourselves with facts and knowledge.
Below are answers to some of the most common questions about gender-affirming care backed by medical authorities, research institutions, and advocacy organizations. Hopefully, this information provides readers with clarity and understanding on the dynamics and application of gender-affirming care.
All information has been sourced from credible, verified, medical and professional references.
What is the difference between sex, gender, and gender identity?
Sex is assigned at birth based on physical, chromosomal, genetic, and hormonal traits typically categorized as male, female, or intersex.
Gender is a social construct, not a biological one. As a social status, gender functions on a set of normative, societal expectations around behaviors, presentation, and roles (for example, stereotypes like “girls wear pink” and “boys wear blue”).
Gender identity refers to a person’s internal understanding of their own gender. It may influence how someone presents themselves, including clothing, hair, pronouns, how one speaks, and ultimately expression. Gender identity can include identities like transgender, non-binary, genderfluid, male, female, agender, and gender expansive.
Both gender and gender identity can be fluid and may evolve over time.
What do transgender, non-binary, and intersex mean?
Transgender: an umbrella term for people whose gender identity does not align with the sex they were assigned at birth. “Trans” is commonly used as shorthand for transgender.
Non-binary: a gender expansive term for people who do not identify strictly as male or female, or as a man or woman. Non-binary individuals may identify with multiple genders, no gender, or a gender outside the traditional gender binary.
Intersex: people born with reproductive or sexual anatomy (including genitals, chromosomes, or reproductive organs) that do not fit typical definitions of male or female.
What is gender-affirming care?
Gender-affirming care includes individual or a combination of social, mental health, medical, and non-medical interventions which aim to support and affirm an individual’s gender identity.
What are examples of gender-affirming care?
What is gender dysphoria?
Gender dysphoria is a state of psychological distress that a person may experience due to their gender identity not aligning with their sex assigned at birth. Children and adults can undergo gender dysphoria.
Symptoms of gender dysphoria can include severe discomfort, anxiety, depression, anger, body dysmorphia, and general internal distress and confusion. Symptoms vary by the person and their age.
Is gender-affirming care only for transgender and non-binary people?
Although gender-affirming care is most often discussed in the context of transgender, non-binary, or gender-diverse people, it can be relevant to people of all genders.
What are the benefits of gender-affirming care for trans youth and adults?
It is widely accepted by major medical and science research organizations that gender-affirming care has been shown to decrease rates of anxiety, depression, and suicidality in trans youth and adults.
Will trans youth that receive gender-affirming care go through permanent surgical procedures?
No, most trans youth who receive gender-affirming care do not undergo permanent surgical procedures. In fact, such surgeries are rarely performed on trans youth before the age of 18.
Do many trans people regret transitioning after gender-affirming surgery?
According to recent national survey data, no.
In the 2022 US Trans Survey of over 92,000 transgender adults, the largest of its kind, the vast majority of participants self-reported improved life satisfaction after accessing gender-affirming care, in this case hormone treatment and gender-affirming surgery.
Of course, these numbers don’t capture every trans person’s experience, but the survey gives a clear picture of how transitioning positively impacts the lives of most trans adults.
Ultimately, gender-affirming care is health care. Trans people deserve the same attention and quality of care as cisgender people. While a person’s gender is relevant, it should never be used as the reason to deny essential medical treatment.
The misconception that only trans or genderqueer people need gender-affirming care is trans- exceptionalism, where trans existence is minimized and othered. The belief that trans bodies are so fundamentally different that doctors cannot provide even routine, basic medical care is completely false. The trans-exceptionalist rhetoric makes it easier for the public to see gender-affirming care as exclusive to trans people, even though cis people regularly access the same types of care. Gender-affirming care should never be oversimplified as solely a “trans and non-binary” issue.
The combined effect of systemic hostility, anti-trans legislation, and attacks on LGBTQ+ healthcare has undoubtedly led to the rise in anti-trans violence.
According to Trans Legislation Tracker, there has been an estimated count of 1000+ anti-trans bills considered in 2025 alone. The anti-trans legislation primarily consists of bans, barriers, and restrictions that impact sectors such as healthcare, identification, bathrooms, and education. 124 of these anti-trans bills have passed across 49 states.
It is imperative we take the time out, get uncomfortable, and learn what we don’t know. Otherwise, we leave ourselves vulnerable to manipulation and confusion. We as Black, queer people must be on a unified front, especially when it comes to understanding and defending such a critical lifeline like gender-affirming care.
We must continue to educate to challenge the toxic culture advanced by the state. By learning together as a community, we can build a safeguard against the intellectual and systemic attacks faced daily by our Black, femme, trans, genderqueer, and queer communities. We must call out the anti-Black, anti-queer realities that have shaped our world for centuries.
Gayes, with knowledge and community, we can fight back.
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