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[Federal Register Volume 90, Number 21 (Monday, February 3, 2025)]
[Presidential Documents]
[Pages 8771-8773]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-02194]



                        Presidential Documents 



Federal Register / Vol. 90 , No. 21 / Monday, February 3, 2025 / 
Presidential Documents

[[Page 8771]]

                Executive Order 14187 of January 28, 2025

                
Protecting Children From Chemical and Surgical 
                Mutilation

                By the authority vested in me as President by the 
                Constitution and the laws of the United States of 
                America, it is hereby ordered:

                Section 1. Policy and Purpose. Across the country 
                today, medical professionals are maiming and 
                sterilizing a growing number of impressionable children 
                under the radical and false claim that adults can 
                change a child's sex through a series of irreversible 
                medical interventions. This dangerous trend will be a 
                stain on our Nation's history, and it must end.

                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. Moreover, these vulnerable youths' 
                medical bills may rise throughout their lifetimes, as 
                they are often trapped with lifelong medical 
                complications, a losing war with their own bodies, and, 
                tragically, sterilization.

                Accordingly, it is the policy of the United States that 
                it 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.

                Sec. 2. Definitions. For the purposes of this order:

                    (a) The term ``child'' or ``children'' means an 
                individual or individuals under 19 years of age.
                    (b) The term ``pediatric'' means relating to the 
                medical care of a child.
                    (c) The phrase ``chemical and surgical mutilation'' 
                means the use of puberty blockers, including GnRH 
                agonists and other interventions, to delay the onset or 
                progression of normally timed puberty in an individual 
                who does not identify as his or her sex; the use of sex 
                hormones, such as androgen blockers, estrogen, 
                progesterone, or testosterone, to align an individual's 
                physical appearance with an identity that differs from 
                his or her sex; and surgical procedures that attempt to 
                transform an individual's physical appearance to align 
                with an identity that differs from his or her sex or 
                that attempt to alter or remove an individual's sexual 
                organs to minimize or destroy their natural biological 
                functions. This phrase sometimes is referred to as 
                ``gender affirming care.''

                Sec. 3. Ending Reliance on Junk Science. (a) The 
                blatant harm done to children by chemical and surgical 
                mutilation cloaks itself in medical necessity, spurred 
                by guidance from the World Professional Association for 
                Transgender Health (WPATH), which lacks scientific 
                integrity. In light of the scientific concerns with the 
                WPATH guidance:

(i) agencies shall rescind or amend all policies that rely on WPATH 
guidance, including WPATH's ``Standards of Care Version 8''; and

(ii) within 90 days of the date of this order, the Secretary of Health and 
Human Services (HHS) shall publish a review of the existing literature on 
best practices for promoting the health of children who assert gender 
dysphoria, rapid-onset gender dysphoria, or other identity-based confusion.

                    (b) The Secretary of HHS, as appropriate and 
                consistent with applicable law, shall use all available 
                methods to increase the quality of data to guide 
                practices for improving the health of minors with 
                gender dysphoria, rapid-onset gender dysphoria, or 
                other identity-based confusion, or who otherwise seek 
                chemical or surgical mutilation.

[[Page 8772]]

                Sec. 4. Defunding Chemical and Surgical Mutilation. The 
                head of each executive department or agency (agency) 
                that provides research or education grants to medical 
                institutions, including medical schools and hospitals, 
                shall, consistent with applicable law and in 
                coordination with the Director of the Office of 
                Management and Budget, immediately take appropriate 
                steps to ensure that institutions receiving Federal 
                research or education grants end the chemical and 
                surgical mutilation of children.

                Sec. 5. Additional Directives to the Secretary of HHS. 
                (a) The Secretary of HHS shall, consistent with 
                applicable law, take all appropriate actions to end the 
                chemical and surgical mutilation of children, including 
                regulatory and sub-regulatory actions, which may 
                involve the following laws, programs, issues, or 
                documents:

(i) Medicare or Medicaid conditions of participation or conditions for 
coverage;

(ii) clinical-abuse or inappropriate-use assessments relevant to State 
Medicaid programs;

(iii) mandatory drug use reviews;

(iv) section 1557 of the Patient Protection and Affordable Care Act;

(v) quality, safety, and oversight memoranda;

(vi) essential health benefits requirements; and

(vii) the Eleventh Revision of the International Classification of Diseases 
and other federally funded manuals, including the Diagnostic and 
Statistical Manual of Mental Disorders, Fifth Edition.

                    (b) The Secretary of HHS shall promptly withdraw 
                HHS's March 2, 2022, guidance document titled ``HHS 
                Notice and Guidance on Gender Affirming Care, Civil 
                Rights and Patient Privacy'' and, in consultation with 
                the Attorney General, issue new guidance protecting 
                whistleblowers who take action related to ensuring 
                compliance with this order.

                Sec. 6. TRICARE. The Department of Defense provides 
                health insurance, through TRICARE, to nearly 2 million 
                individuals under the age of 18. As appropriate and 
                consistent with applicable law, the Secretary of 
                Defense shall commence a rulemaking or sub-regulatory 
                action to exclude chemical and surgical mutilation of 
                children from TRICARE coverage and amend the TRICARE 
                provider handbook to exclude chemical and surgical 
                mutilation of children.

                Sec. 7. Requirements for Insurance Carriers. The 
                Director of the Office of Personnel Management, as 
                appropriate and consistent with applicable law, shall:

                    (a) include provisions in the Federal Employee 
                Health Benefits (FEHB) and Postal Service Health 
                Benefits (PSHB) programs call letter for the 2026 Plan 
                Year specifying that eligible carriers, including the 
                Foreign Service Benefit Plan, will exclude coverage for 
                pediatric transgender surgeries or hormone treatments; 
                and
                    (b) negotiate to obtain appropriate corresponding 
                reductions in FEHB and PSHB premiums.

                Sec. 8. Directives to the Department of Justice. The 
                Attorney General shall:

                    (a) review Department of Justice enforcement of 
                section 116 of title 18, United States Code, and 
                prioritize enforcement of protections against female 
                genital mutilation;
                    (b) convene States' Attorneys General and other law 
                enforcement officers to coordinate the enforcement of 
                laws against female genital mutilation across all 
                American States and Territories;
                    (c) prioritize investigations and take appropriate 
                action to end deception of consumers, fraud, and 
                violations of the Food, Drug, and Cosmetic Act by any 
                entity that may be misleading the public about long-
                term side effects of chemical and surgical mutilation;

[[Page 8773]]

                    (d) in consultation with the Congress, work to 
                draft, propose, and promote legislation to enact a 
                private right of action for children and the parents of 
                children whose healthy body parts have been damaged by 
                medical professionals practicing chemical and surgical 
                mutilation, which should include a lengthy statute of 
                limitations; and
                    (e) prioritize investigations and take appropriate 
                action to end child-abusive practices by so-called 
                sanctuary States that facilitate stripping custody from 
                parents who support the healthy development of their 
                own children, including by considering the application 
                of the Parental Kidnaping Prevention Act and recognized 
                constitutional rights.

                Sec. 9. Enforcing Adequate Progress. Within 60 days of 
                the date of this order, the heads of agencies with 
                responsibilities under this order shall submit a 
                single, combined report to the Assistant to the 
                President for Domestic Policy, detailing progress in 
                implementing this order and a timeline for future 
                action. The Assistant to the President for Domestic 
                Policy shall regularly convene the heads of agencies 
                with responsibilities under this order (or their 
                designees) to coordinate and prepare for this 
                submission.

                Sec. 10. Severability. If any provision of this order, 
                or the application of any provision to any person or 
                circumstances, is held to be invalid, the remainder of 
                this order and the application of any of its other 
                provisions to any other persons or circumstances shall 
                not be affected thereby.

                Sec. 11. General Provisions. (a) Nothing in this order 
                shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or 
the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget 
relating to budgetary, administrative, or legislative proposals.

                    (b) This order shall be implemented consistent with 
                applicable law and subject to the availability of 
                appropriations.
                    (c) This order is not intended to, and does not, 
                create any right or benefit, substantive or procedural, 
                enforceable at law or in equity by any party against 
                the United States, its departments, agencies, or 
                entities, its officers, employees, or agents, or any 
                other person.
                
                
                    (Presidential Sig.)

                THE WHITE HOUSE,

                    January 28, 2025.

[FR Doc. 2025-02194
Filed 1-31-25; 8:45 am]
Billing code 3395-F4-P
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