Abstract
Prohibitions on gender-affirming care for minors in the United States came to a head in the last few months, with the issuance of an Executive Order by the Trump Administration that threatens to penalize institutions that provide such care. While about half of all American states ban such care, the Order seeks to ensure that such care becomes unavailable nationwide. On cue, numerous healthcare systems in jurisdictions that have historically safeguarded such care ceased providing it in the wake of the Executive Order. Even after courts enjoined enforcement of the Order, many hospital systems have adhered to their termination of care to some degree or the other. Indeed, recent reporting claims that some systems have ceased caring for adults as well—the problem is getting worse.
Many hospital systems and even law professors appear to believe that the Executive Order effects changes in the law and hospital obligations. This Essay argues that such termination of care is, in fact, illegal, for several key reasons. Many of the jurisdictions where entities have terminated care have on-point federal and state opinions that are best read as requiring such care. Terminating care violates these laws. Second, the Executive Order cannot on its own—even before it was enjoined—enforce the penalties it promises. Third, the termination of care violates various ethical standards to which medical professionals are held. More generally, such anticipatory compliance harms vulnerable individuals and undermines the rule of law.
