After The Fact

Trump Administration Policy Directives on Financial Assistance and Gender-Affirming Care for Minors

January 28, 2025

These two documents from January 28, 2025, outline the Trump administration's policy directives concerning federal financial assistance programs and the treatment of gender dysphoria in children. The first document is an OMB Q&A explaining a temporary pause on certain federal programs pending review for alignment with the President's executive orders. The second document is an executive order detailing the administration's policy to prohibit the use of federal funds for "chemical and surgical mutilation" of children, defined as gender-affirming care. This executive order mandates reviews of existing practices, defunding of programs related to gender transition in minors, and directs several federal agencies to take actions in line with this policy.

OMB Q&A on Paused Federal Financial Assistance Programs

The Office of Management and Budget (OMB) issued guidance to pause certain federal grant, loan, and financial assistance programs pending review for compliance with the President's executive orders.

Programs providing direct benefits to individuals, including Social Security, Medicare, Medicaid, SNAP, small business funds, farm funds, Pell grants, Head Start, and rental assistance, are exempt from the pause.

The pause is not a freeze on all federal financial assistance and is intended to ensure programs align with the administration's policy priorities, such as ending Diversity, Equity, and Inclusion (DEI) initiatives, opposing the "green new deal," and defunding NGOs deemed contrary to the national interest.

Agencies are to consult with OMB to resolve any potential conflicts between their programs and the President's executive orders.

The OMB asserts that this pause is not an impoundment under the Impoundment Control Act and is a standard practice for new administrations to review existing programs.

Executive Order on Protecting Children from "Chemical and Surgical Mutilation"

This executive order declares a policy to prohibit federal funding, sponsorship, promotion, assistance, or support for gender transition interventions for individuals under 19 years of age.

The order defines "chemical and surgical mutilation" as the use of puberty blockers, sex hormones, and surgeries related to gender transition, which it terms "gender-affirming care".

Agencies are directed to rescind policies relying on guidance from the World Professional Association for Transgender Health (WPATH) and the Secretary of Health and Human Services (HHS) is tasked with publishing a review of best practices for children experiencing gender dysphoria within 90 days.

The order directs agencies to ensure that institutions receiving federal research or education grants cease providing gender-affirming care to minors.

The Secretary of HHS is instructed to take actions to end "chemical and surgical mutilation" of children through various regulatory means, including reviewing Medicare/Medicaid conditions, drug use reviews, and the Affordable Care Act's Section 1557.

The Department of Defense is directed to exclude gender-affirming care for children from TRICARE coverage.

The Office of Personnel Management is instructed to exclude coverage for pediatric gender transition procedures and treatments from Federal Employee Health Benefits (FEHB) and Postal Service Health Benefits (PSHB) programs and negotiate corresponding premium reductions.

The Attorney General is directed to review enforcement of laws against female genital mutilation, coordinate with state Attorneys General on enforcement, investigate potential fraud and misrepresentation regarding the long-term effects of gender-affirming care, draft legislation to create a private right of action for children harmed by such care, and investigate "child-abusive practices" by states that support gender transition for minors, potentially invoking the Parental Kidnapping Prevention Act.

Last updated at 2/7/2025 10:43 PM

- After The Fact Editorial Team