WASHINGTON (AP) — President Donald Trump on Tuesday signed an executive order aimed at cutting federal support for gender transitions for people under age 19, his latest move to roll back protections for transgender people across the country.
“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,” the order says.
The order directs that federally-run insurance programs, including TRICARE for military families and Medicaid, exclude coverage for such care and calls on the Department of Justice to vigorously pursue litigation and legislation to oppose the practice.
Medicaid programs in some states cover gender-affirming care. The new order suggests that the practice could end, and targets hospitals and universities that receive federal money and provide the care.
The language in the executive order — using words such as “maiming,” “sterilizing” and “mutilation” — contradicts what is typical for gender-affirming care in the United States. It also labels guidance from the World Professional Association for Transgender Health as “junk science.”
On his Truth Social platform, Trump called gender-affirming care “barbaric medical procedures.”
Major medical groups such as the American Medical Association and the American Academy of Pediatrics support access to care.
Young people who persistently identify as a gender that differs from their sex assigned at birth are first evaluated by a team of professionals. Some may try a social transition, involving changing a hairstyle or pronouns. Some may later also receive puberty blockers or hormones. Surgery is extremely rare for minors.
“It is deeply unfair to play politics with people’s lives and strip transgender young people, their families and their providers of the freedom to make necessary health care decisions," said Human Rights Campaign President Kelley Robinson.
The order encourages Congress to adopt a law allowing those who receive gender-affirming care and come to regret it, or their parents, to sue the providers.
It also directs the Justice Department to prioritize investigating states that protect access to gender-affirming care and “facilitate stripping custody from parents” who oppose the treatments for their children. Some Democratic-controlled states have adopted laws that seek to protect doctors who provide gender-affirming care to patients who travel from states where it’s banned for minors.
Lambda Legal promised swift legal action.
Michel Lee Garrett, a trans woman whose teenage child only partially identifies as a girl and uses they/them pronouns, said such policies aim to erase trans people from public life but will never succeed. Her child has not elected to pursue a medical transition, but the mother from State College, Pennsylvania, said she won't stop fighting to preserve that option for her child and others.
“I'll always support my child's needs, regardless of what policies may be in place or what may come ... even if it meant trouble for me," Lee Garrett said.
For Howl Hall, an 18-year-old freshman at Eastern Washington University, taking testosterone not only changed his body but dramatically improved his experience with depression. With that treatment now under threat, Hall said he's concerned that getting off testosterone would hurt his mental health.
“I would be alive, but I wouldn’t be living,” Hall said. “I wouldn’t be living my life in a productive way at all. I can guarantee that I would be failing all of my classes if I was even showing up to them.”
The push is the latest by Trump to reverse Biden administration policies protecting transgender people and their care. On Monday, Trump directed the Pentagon to conduct a review that is likely to lead to them being barred from military service. A group of active-duty military personnel sued over that on Tuesday.
Hours after taking office last week, Trump signed another order that seeks to define sex as only male or female, not recognizing transgender, nonbinary or intersex people or the idea that gender can be fluid. Already that's resulted in the State Department halting issuing passports with an “X” gender marker, forcing transgender people to apply for travel documents with markers that don't match their identities.
Trump said he would address these issues during his campaign last year, and his actions could prove widely divisive.
In the November election, voters were slightly more likely to oppose than support laws that ban gender-affirming medical treatment, such as puberty blockers and hormone therapy, for minors under the age of 18 who identify as transgender, according to AP VoteCast. About half of voters, 52%, were opposed, but 47% said they were in favor.
Trump’s voters were much more likely to support bans on transgender care: About 6 in 10 Trump voters favored such laws.
“It’s very clear that this order, in combination with the other orders that we’ve seen over the past week, are meant to not protect anyone in this country, but rather to single-mindedly drive out transgender people of all ages from all walks of civic life,” said Harper Seldin, a staff attorney for the American Civil Liberties Union’s LGBTQ & HIV Project.
Seldin said the ACLU is reviewing the order “to understand what, if anything, has immediate effect versus what needs to go through continued agency action.”
Even as transgender people have gained visibility and acceptance on some fronts, they've become major targets for social conservatives. In recent years, at least 26 states have adopted laws restricting or banning gender-affirming medical care for transgender minors. Most of those states face lawsuits, including one over Tennessee's ban that's pending before the U.S. Supreme Court.
Republican-controlled states have also moved to keep transgender women and girls from competing in women's or girls’ sports and to dictate which bathrooms transgender people can use, particularly in schools.
“These policies are not serving anyone," said Shelby Chestnut, executive director of the Transgender Law Center. “They’re only creating confusion and fear for all people.”
Mulvihill reported from Cherry Hill, New Jersey, and Schoenbaum from Salt Lake City. Associated Press writers Carla K. Johnson and Hallie Golden in Seattle and Linley Sanders in Washington contributed reporting.
President Donald Trump arrives to speak about the economy during an event at the Circa Resort and Casino in Las Vegas, Saturday, Jan. 25, 2025. (AP Photo/Mark Schiefelbein)
ARLINGTON, Va. (AP) — Families of victims of the deadliest U.S. air disaster since 2001 visited the crash site Sunday just outside Washington, D.C., walking along the banks of the Potomac River near Reagan National Airport to memorialize their loved ones.
Dozens of people arrived in buses with a police escort close to where an American Airlines jet and an Army Black Hawk helicopter collided Wednesday, killing all 67 aboard the two aircraft. Federal investigators were working to piece together the events that led to the crash while recovery crews were set to pull more wreckage from the chilly water.
Transportation Secretary Sean Duffy on Sunday said he wanted to leave federal aviation investigators space to conduct their inquiry.
But he posed a range of questions about the crash while appearing on morning TV news programs.
“What was happening inside the towers? Were they understaffed? … The position of the Black Hawk, the elevation of the Black Hawk, were the pilots of the Black Hawk wearing night vision goggles?” Duffy asked on CNN.
The American Airlines flight with 64 people on board was preparing to land from Wichita, Kansas. The Army Black Hawk helicopter was on a training mission and had three soldiers on board. Both aircraft plunged into the Potomac River after colliding.
The plane’s passengers included figure skaters returning from the 2025 U.S. Figure Skating Championships in Wichita, Kansas, and a group of hunters returning from a guided trip.
Army Staff Sgt. Ryan Austin O’Hara, 28, of Lilburn, Georgia; Chief Warrant Officer 2 Andrew Loyd Eaves, 39, of Great Mills, Maryland; and Cpt. Rebecca M. Lobach, of Durham, North Carolina, were killed in the helicopter.
The National Transportation Safety Board said Saturday that preliminary data showed conflicting readings about the altitudes of the airliner and the Army helicopter.
Investigators also said that about a second before impact, the jet’s flight recorder showed a change in its pitch. But they did not say whether that change in angle meant that pilots were trying to perform an evasive maneuver to avoid the crash.
Data from the jet’s flight recorder showed its altitude as 325 feet (99 meters), plus or minus 25 feet (7.6 meters), when the crash happened Wednesday night, NTSB officials told reporters. Data in the control tower, though, showed the Black Hawk at 200 feet (61 meters), the maximum allowed altitude for helicopters in the area.
The discrepancy has yet to be explained.
Investigators said they hoped to reconcile the difference with data from the helicopter’s black box, which is taking more time to retrieve because it became waterlogged after the Black Hawk plunged into the Potomac. They also said they plan to refine the tower data, which can be less reliable.
“That’s what our job is, to figure that out,” NTSB member Todd Inman said.
“This is a complex investigation,” investigator in charge Brice Banning said. “There are a lot of pieces here. Our team is working hard to gather this data.”
Banning said the jet’s cockpit voice recorder captured sound moments before the crash.
“The crew had a verbal reaction,” Banning said, and the flight data recorder showed “the airplane beginning to increase its pitch. Sounds of impact were audible about one second later, followed by the end of the recording.”
Full NTSB investigations typically take at least a year, though investigators hope to have a preliminary report within 30 days.
Inman said he has spent hours meeting with victims’ families since the crash. The families are struggling, Inman said.
“Some wanted to give us hugs. Some are just mad and angry,” Inman said. “They are just all hurt. And they still want answers, and we want to give them answers.”
The remains of 42 people had been pulled from the river as of Saturday afternoon, including 38 that have been positively identified, officials said. They expect to recover all of the remains, though the plane’s fuselage will probably have to be pulled from the water to get the rest.
More than 300 responders were taking part in the recovery effort at a given time, officials said. Two Navy salvage barges were also deployed to lift heavy wreckage.
On Fox News Sunday, Duffy said the Federal Aviation Administration was looking into staffing in the Reagan Airport control tower.
Investigators said there were five controllers on duty at the time of the crash: a local controller, ground controller, assistant controller, a supervisor and supervisor in training.
According to an FAA report obtained by The Associated Press, one controller was responsible for helicopter and plane traffic. Those duties are often divided between two people but the airport typically combines them at 9:30 p.m., once traffic slows down. On Wednesday, the tower supervisor combined them earlier, which the report called “not normal.”
“Staffing shortages for air traffic control has been a major problem for years and years,” Duffy said, promising that President Donald Trump’s administration would address shortages with “bright, smart, brilliant people in towers controlling airspace.”
With the nation already grieving, an air ambulance crashed in Philadelphia on Friday, killing all six people on board, including a child returning home to Mexico from treatment, and at least one person on the ground.
Also Friday, the FAA heavily restricted helicopter traffic around Reagan National, hours after Trump claimed on social media that the Army helicopter had been flying higher than allowed.
“It was far above the 200-foot limit. That’s not really too complicated to understand, is it???” Trump wrote on Truth Social.
Wednesday’s crash was the deadliest in the U.S. since Nov. 12, 2001, when a jet slammed into a residential neighborhood in the New York City borough of Queens, just after takeoff from Kennedy Airport. The crash killed all 260 people on board and five people on the ground.
Experts regularly highlight that plane travel is overwhelmingly safe, but the crowded airspace around Reagan National can challenge even the most experienced pilots.
A memorial is seen along the boards at MedStar Capitals Iceplex Sunday, Feb. 2, 2025, in Arlington, Va., for the figure skaters who were among the 67 victims of a mid-air collision between an Army helicopter and an American Airlines flight from Kansas. (AP Photo/Carolyn Kaster)
A memorial is seen along the boards at MedStar Capitals Iceplex Sunday, Feb. 2, 2025, in Arlington, Va., for the figure skaters who were among the 67 victims of a mid-air collision between an Army helicopter and an American Airlines flight from Kansas. (AP Photo/Carolyn Kaster)
A memorial is seen along the boards at MedStar Capitals Iceplex Sunday, Feb. 2, 2025, in Arlington, Va., for the figure skaters who were among the 67 victims of a mid-air collision between an Army helicopter and an American Airlines flight from Kansas. (AP Photo/Carolyn Kaster)
Rescue and salvage crews with cranes work near the wreckage of an American Airlines jet in the Potomac River from Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
An American Eagle jet passes as rescue and salvage crews work near the wreckage of an American Airlines jet in the Potomac River from Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
An American Eagle jet passes as families of the victims of a mid-air collision between an American Airlines jet and an Army helicopter stand near the wreckage site in the Potomac River at the end of the runway 33 from Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
An American Airlines jet passes as families of the victims of a mid-air collision between an American Airlines jet and an Army helicopter stand near the wreckage site in the Potomac River at the end of the runway 33 from Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
An American Eagle jet passes as families of the victims of a mid-air collision between an American Airlines jet and an Army helicopter stand near the wreckage site in the Potomac River at the end of the runway 33 from Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Families of the victims of a mid-air collision between an American Airlines jet and an Army helicopter stand near the wreckage site in the Potomac River at the end of the runway 33 from Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Families of the victims of a mid-air collision between an American Airlines jet and an Army helicopter stand near the wreckage site in the Potomac River at the end of the runway 33 from Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Buses carrying family members of the victims of a mid-air collision between an American Airlines jet and an Army helicopter arrive to runway 33 near the wreckage site in the Potomac River at Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Family members of the victims of a mid-air collision between an American Airlines jet and an Army helicopter walk to the end of runway 33 near the wreckage site in the Potomac River at Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Police officers escort buses carrying family members of the victims of a mid-air collision between an American Airlines jet and an Army helicopter to runway 33 near the wreckage site in the Potomac River at Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Buses carrying family members of the victims of a mid-air collision between an American Airlines jet and an Army helicopter arrive to runway 33 near the wreckage site in the Potomac River at Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
An American Airlines jet passes as police officers escort buses carrying family members of the victims of a mid-air collision between an American Airlines jet and an Army helicopter to runway 33 near the wreckage site in the Potomac River at Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Families of the victims of a mid-air collision between an American Airlines jet and an Army helicopter stand near the wreckage site in the Potomac River at the end of the runway 33 from Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
An American Airlines jet passes as family members of the victims of a mid-air collision between an American Airlines jet and an Army helicopter stand at the end of runway 33 near the wreckage site in the Potomac River at Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Family members of the victims of a mid-air collision between an American Airlines jet and an Army helicopter gather at the end of runway 33 near the wreckage site in the Potomac River at Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Family members of the victims of a mid-air collision between an American Airlines jet and an Army helicopter gather at the end of runway 33 near the wreckage site in the Potomac River at Ronald Reagan Washington National Airport, Sunday, Feb. 2, 2025, in Arlington, Va. (AP Photo/Jose Luis Magana)
Police and coast guard boats are seen around a wreckage site in the Potomac River as an American Airlines plane passes in the foreground at Ronald Reagan Washington National Airport, Saturday, Feb. 1, 2025, in Arlington, Va., (AP Photo/Jose Luis Magana)
Roberto Marquez, of Dallas, places white roses at a memorial for the 67 victims of a midair collision between an Army helicopter and an American Airlines jet near the Ronald Reagan Washington National Airport, Saturday, Feb. 1, 2025, in Arlington, Va. (AP Photo/Carolyn Kaster)
A plane takes off from Ronald Reagan Washington National Airport as Roberto Marquez of Dallas places flowers at a memorial of crosses he erected for the 67 victims of a midair collision between an Army helicopter and an American Airlines jet, Saturday, Feb. 1, 2025, in Arlington, Va. (AP Photo/Carolyn Kaster)