US Justice Department Targets Gender Affirming Care for Transgender Children
TL/DR –
US Attorney General Pam Bondi has issued a memo outlining measures from the Department of Justice (DOJ) to oppose gender affirming care for treating gender dysphoria. The memo is the latest in a series of steps by the administration targeting care for transgender children. The direction the DOJ is taking increases risk for healthcare providers offering certain types of gender affirming care and could result in more limited access to these services.
U.S. AG Targets Gender Affirming Care in New Memorandum
On April 22, 2025, U.S. Attorney General Pam Bondi released a memorandum titled “Preventing the Mutilation of American Children“, announcing steps to challenge gender affirming care for gender dysphoria. This move is a vital escalation in the Administration’s efforts against care for transgender children.
Prevailing Executive Orders
The president had previously signed two Executive Orders: EO 14168 and EO 14187. Both target transgender individuals, particularly regarding treatment for gender dysphoria. Notably, EO 14187 defines “child” as under 19 years – an unusual move as the legal age of adulthood is 18 in most states.
Litigation and Injunctions
Both Executive Orders became immediate subjects of litigation, resulting in nationwide and regional preliminary injunctions. However, stay orders were issued when the government appealed, leaving the injunctions in place for the duration of the appeals. Significant developments include a credible threat of prosecution under 18 U.S. Code § 116 and allegations of government moving to implement provisions of the executive orders under new policies.
Detailed Directives in AG’s Memorandum
The AG’s Memorandum includes five significant directives:
- Enforcement of 18 U.S. Code § 116. Medical practitioners and institutions are reminded that female genital mutilation is a felony.
- Investigation of FDCA and FCA violations. The DOJ is directed to investigate potential violations by manufacturers and distributors for misbranding of drugs used for gender transition.
- “Ending Reliance on Junk Science.” WPATH Guidelines are to be discontinued by the DOJ.
- Federal and State Coalition. The Memorandum proposes a partnership with states against healthcare facilities violating laws banning female genital mutilation.
- Promoting new legislation. An initiative to draft legislation providing a private right of action for children who received gender affirming care and later wish to hold providers accountable.
Implications and Future Outlook
Litigation against the AG Memorandum is expected as it increases risk to healthcare providers offering certain types of gender affirming care. This could result in limited access to such care. Billing practices surrounding gender affirming care should be carefully reviewed to avoid potential FCA prosecution. The Memorandum also presents a conflict between federal initiatives and state laws intending to safeguard access to gender affirming care. This may necessitate urgent court action to reconcile the state and federal law conflict.
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