Trump’s Executive Orders on Transgender Policies Face Scientific and Legal Challenges

On his first day in office, President Donald Trump signed an executive order directing the federal government to recognize people solely as either male or female, based on the size of their reproductive cells at conception. This directive served as the foundation for a series of subsequent orders targeting transgender protections across multiple sectors.

The administration’s directives have called for defunding medical and educational institutions that protect transgender students, provide gender-affirming care to transgender youth, or allow transgender women to participate in women’s sports. Another order attempted to ban transgender people from the military.

“For four long years, we had an administration that tried to abolish the very concept of womanhood and replace it with radical gender ideology,” Trump declared at a Women’s History Month event at the White House in March.

However, scientists and legal experts have raised significant concerns about the accuracy of Trump’s statements and the scientific foundation of these executive orders.

The first transgender-related order defined people as either male or female “at conception.” Scientists have pointed out this definition is problematic and doesn’t align with current scientific understanding. Sex development is a complex biological process that occurs progressively during gestation and beyond, not solely at conception.

“Sex is a catch-all phrase that actually refers to a constellation of features, not just one as they’ve defined it here,” explained Margaret M. McCarthy, a neuroscientist and pharmacology professor at the University of Maryland School of Medicine.

The order’s definition also excludes people with Differences of Sex Development (DSD), also known as intersex conditions, which affect approximately 1 in 4,500 births in the United States annually. These individuals may have chromosomal, gonadal, or anatomical characteristics that don’t align with typical definitions of male or female.

The Pediatric Endocrine Society stated that the executive order’s definition “should not and cannot apply” to people with DSD, as some may not produce sperm or eggs, may produce both, or may produce reproductive cells that don’t match their overall biological sex development.

A separate executive order issued on February 28 targeted gender-affirming medical care for people under 19, using language that medical experts consider misleading and inaccurate. The order described medical professionals as “maiming and sterilizing” children and referred to treatments as “chemical and surgical mutilation.”

Medical organizations, including the American Academy of Pediatrics, the Endocrine Society, and the World Professional Association for Transgender Health, support gender-affirming care under specific guidelines. They emphasize that gender-affirming surgeries typically occur after age 18, following comprehensive assessment by medical teams.

Most transgender children don’t receive medical treatments, instead undergoing social transitions such as changing their name, pronouns, or clothing. Medical interventions usually begin with puberty blockers between ages 8-14, with hormone therapy typically starting around age 16 when adolescents can make informed decisions.

Studies indicate that gender-affirming care is associated with improved mental health outcomes for transgender youth, who face elevated risks of depression, anxiety, and suicidal thoughts.

“The order does not acknowledge any benefits of gender-affirming care, instead making unsubstantiated statements of widespread harm and disregarding decades of science,” noted Elana Redfield, federal policy director at UCLA’s Williams Institute.

Contrary to the executive order’s claims, not all gender-affirming treatments are irreversible. Puberty blockers are reversible, and some effects of hormone therapy can be reversed if discontinued early. The medical guidance requires comprehensive screening and assessment to ensure patients understand the risks and benefits of each intervention.

The administration’s policies have prompted multiple lawsuits nationwide. Federal judges have already blocked some orders from taking effect while legal challenges proceed. Two separate restraining orders and a preliminary temporary injunction have been issued to prevent the government from withholding funding for medical institutions providing gender-affirming care.

Nearly 1.6 million Americans over age 13—approximately 0.5% of the U.S. population—identify as transgender, according to a 2022 report from UCLA’s Williams Institute.

The White House did not respond to requests for supporting evidence for statements made in the executive orders.