In his first State of the Union address of his second term, President Donald Trump again focused heavily on transgender youth. During remarks before Congress, Trump called for a national ban on gender-affirming care for minors and framed the issue as a matter of parental rights and child protection.
The president highlighted the story of a Virginia teenager whose family is suing a local school district over how school officials handled the student’s gender identity. Trump used the case to argue that schools and medical providers are facilitating transitions without proper parental involvement. He urged lawmakers to pass legislation banning gender-affirming medical care for anyone under 18.
Civil rights advocates and major medical organizations quickly pushed back, arguing that Trump’s remarks misrepresented how gender-affirming care works. Medical experts note that care for transgender youth typically involves a careful, multi-step process that includes mental health assessments, parental consent, and oversight by trained clinicians.
The president’s speech comes as his administration advances regulatory changes that could significantly restrict access to care. Proposed rules from the Department of Health and Human Services would tie certain federal funding streams, including Medicare and Medicaid reimbursements, to hospitals’ compliance with limits on providing gender-affirming care to minors. Critics say such measures could force hospitals to scale back services in order to protect broader funding.
Advocacy groups, including the Human Rights Campaign and other LGBTQ organizations, warned that the administration’s approach risks making healthcare inaccessible for transgender youth nationwide. They argue that medical decisions should remain between families and providers, not federal officials. Legal challenges are expected if the proposed regulations move forward.
The speech also comes amid a growing number of state-level restrictions. More than two dozen states have enacted laws limiting or banning gender-affirming care for minors. Families in restrictive states often travel long distances to seek treatment, a burden that disproportionately affects lower-income households.
Some major healthcare institutions have already adjusted services in response to political and regulatory pressure. In recent weeks, certain hospital systems have paused or reevaluated programs serving transgender youth, citing uncertainty around federal policy.
Medical associations, including the American Academy of Pediatrics and the American Medical Association, have repeatedly stated that gender-affirming care is evidence-based and can improve mental health outcomes for transgender adolescents when delivered according to established guidelines.
With the issue elevated to the national stage during the State of the Union, advocates expect continued legislative and legal battles over the future of transgender healthcare. For many families, the debate is not about abstract policy but about an urgent question of access to care.
