On Jan. 28, Trump signed an executive order that declared the U.S. government "will not fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures."

The action followed similar steps 25 states have undertaken to ban gender-affirming medical care for transgender youth. 

Trump's order called for ending federal funding to hospitals or medical schools that provide gender-affirming medical care to people under 19 years old. It directed the Department of Health and Human Services to "take all appropriate actions" under law to end access to care. This could include changing Medicare and Medicaid insurance coverage. 

Trump's pledge to call for a national legislative ban on gender-affirming surgical care for minors remains a promise for now. The order he signed did not include such a congressional directive.

But after Trump signed the order, some U.S. hospitals, including in states where gender-affirming care for youth is legal, responded by suspending their care offerings. 

Families with transgender children challenged the order in court and, on Feb. 13, a federal district court judge in Maryland temporarily blocked the order's enforcement for review. 

Trump's order does not make the care illegal nationally, nor does it call for it to be "outlawed," but if the legal block is lifted, the order will likely further restrict access to care. 

The order proposes Congress pursue legislation establishing "a private right of action" to sue medical providers who perform gender-affirming care if a minor's "body parts have been damaged." It also directs the attorney general to enforce existing laws against "female genital mutilation."

Experts said gender-affirming surgical care is not the same as female genital mutilation. That is one of several misleading claims in the executive order that we fact-checked.

Several Republican House and Senate members have introduced bills this term that propose to either end federal funding for gender-affirming care for youth or establish a private right-of-action. 

Trump's executive order signals a step toward reducing access to gender-affirming medical and surgical care for transgender youth. Congress has separately proposed limitations on access to gender-affirming care that may move forward. We rate this promise In the Works.