A New York City doctor said he will continue providing gender-affirming treatments to his patients younger than 19 despite President Donald Trump’s executive order aiming to ban such care, because, the doctor said, these patients’ lives depend on it.
“Until somebody calls me away, I’m just going to keep doing it,” said Dr. Jeffrey Birnbaum, a pediatrician and adolescent medicine specialist. He doesn’t think that will happen, he added, noting that New York Attorney General Letitia James that state law requires them to continue providing such care.
However, as a result of the order and the decision by several hospitals to voluntarily cancel appointments for individuals 18 and younger, Birnbaum said his patients are scared. He said about 20 of his patients could be affected by the order.
“They’re terrified that their treatment is going to be interrupted, and they’re going to lose their treatment, plain and simple,” he said. “And for them, it’s life-sustaining.”
Trump’s order, “,” aims to prohibit federal funding from being used for transition-related care — including puberty blockers, hormone therapy and surgery — for trans people under 19 years old. It also states that medical schools and hospitals receiving federal research or education grants have to “end the chemical and surgical mutilation of children.”
The White House announced Monday, about a week after Trump signed the order, that hospitals in , , , , and , have either suspended or announced that they are reviewing their transition care programs for minors. On Tuesday, Children’s Hospital Los Angeles that it was pausing the initiation of hormone therapy for gender-affirming care patients under 19.
Birnbaum said Trump’s executive order seeking to restrict care, along with another that describes the idea that someone can be trans as “gender ideology,” denies the realities of the people he treats every day.
“If somebody says the sky is green, just because they say it, doesn’t make the sky green,” Birnbaum said. “I’m looking at the medical literature, research that’s been done. I’m looking at real people in front of me. I’m not looking at some right-wing, religious ideologue who is referring to this as ‘gender ideology.’ It’s no ideology. They have the ideology. I’m dealing with science and medicine.”
We’re looking to hear from federal government workers. If you’re willing to talk with us, please email or .
Trump’s executive order seeking to restrict trans care for those under 19 argues that the country has an obligation to protect children from “irreversible medical interventions.”
“Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding,” the order states, using inflammatory language to describe transition-related care.
Research shows that only a tiny percentage of minors in the U.S. access gender-affirming treatments. A study published in JAMA Pediatrics in January found that are trans or gender-diverse and are prescribed puberty blockers or hormone therapy.
One of Birnbaum’s patients, Akoni Drysdale-Ash, a trans 17-year-old living in Brooklyn, said starting testosterone nearly three years ago has dramatically improved his quality of life. He said he felt a misalignment between his birth sex and gender identity around seventh grade, when he started having periods that made him feel “totally dissociated” from his body.
He compared not being able to access testosterone to trying to run a car on something other than gas. The idea of losing that access is scary, he said, even though he feels like his care is relatively protected in New York.
“It does leave you with fear, because it’s like you’re taking away my visibility,” Drysdale-Ash said. “You’re taking away my care when all I want to do is live. Sometimes getting that care is all people need to live, being themselves. If I can’t be myself, who else can I be?”
His mother, Jasmine Aldridge, added that her son hasn’t received any irreversible treatments. If he stops taking testosterone, for example, he will experience the puberty associated with his birth sex, undoing many of the changes brought on by testosterone.
In response to people who ask why trans minors can’t wait until they’re adults to receive transition care, Aldridge said, “There’s that reality of your child might not even be here to see 19 if you don’t support them.”
Standards of care developed by medical organizations, including WPATH, a nonprofit association dedicated to transgender medical care that develops guidance that is widely used by health care professionals, recommend that trans minors are treated on a case-by-case basis.
The standards don’t recommend any medical transition prior to puberty.
At the onset of puberty, minors can begin puberty blockers if they have persistent gender dysphoria, which is the severe emotional distress caused by the misalignment between one’s gender identity and birth sex. Teenagers might start hormone therapy, and, in rare cases, some teens may receive a double mastectomy, where both breasts are removed.
Most major medical associations, such as the , the and the , support access to transition care for minors and oppose restrictions on it.
The American Civil Liberties Union and Lambda Legal, an LGBTQ legal advocacy group, regarding trans care and “gender ideology” last week on behalf of two transgender young adults and five families of trans minors. Friday to block the transition care order. New York’s Letitia James and Wednesday reaffirming their commitment to protecting access to such care for minors.
The Department of Justice and White House did not immediately return requests for comment regarding the lawsuits.
Omar Gonzalez-Pagan, senior counsel and health care strategist for Lambda Legal, noted that Trump signed a flurry of executive orders targeting trans rights during his first weeks in office — including in the military — which he said is proof that the order restricting care for minors is not actually about protecting children.
“They’re attacking adults as well,” he said, adding that the other executive orders targeting trans rights all “speak to gender identity being considered a false belief — that a person having a gender identity inconsistent or incongruent with your sex assigned at birth is something that is dishonorable, even in one’s private life. That’s the language of these executive orders, and the disdain, the cruelty just drips out of the page.”
As the legal battle begins to play out, Birnbaum said he’s shared the same message with many of his patients.
“I’m saying that this is also a safe space. We’re going to protect them,” he said. “We’re not going to interrupt their care, and we’re going to help sustain who they are as human beings, plain and simple.”
