New York Attorney General Letitia James has directed hospitals across the state to continue providing gender-transition treatments to minors, directly defying President Donald Trump’s recent executive order restricting such procedures. The executive order, titled “Protecting Children from Chemical and Surgical Mutilation,” was signed on January 28, 2025, and prohibits federal funding to medical institutions that perform gender-affirming procedures on individuals under the age of 19.
James’s Directive to Healthcare Providers
In an official letter sent to hospitals and clinics, James claimed that New York state law takes precedence over the federal order when it comes to the availability of medical treatments. She warned that denying services to transgender minors would be considered discrimination under New York’s human rights laws and could lead to legal action.
“New York has its own legal standards, and hospitals must continue to provide the necessary care to individuals diagnosed with gender dysphoria,” James wrote.
Hospitals Caught Between State and Federal Orders
Several hospitals, including NYU Langone Health, had reportedly paused or canceled gender-transition procedures for minors following the announcement of Trump’s order. NYU Langone canceled appointments for hormone therapy and surgeries on minors, while other institutions began reviewing how the federal restrictions could impact their services.
However, with the directive from James, many hospitals in New York now face conflicting mandates. Some legal experts predict that the dispute could lead to prolonged legal battles between state and federal governments.
Trump Administration Stance: Protecting Children
The Trump administration has made it clear that the executive order aims to protect minors from making irreversible medical decisions before adulthood. The order halts taxpayer funding for gender-transition surgeries, hormone treatments, and puberty blockers for minors, describing these procedures as “experimental” and potentially harmful to long-term physical and mental health.
Trump has defended the measure, stating, “Children are being pushed into life-altering procedures without fully understanding the consequences. We’re not going to allow that to happen on our watch.”
Protests and Potential Legal Challenges
Following James’s announcement, activists supporting transgender medical care held demonstrations outside government buildings in New York, calling the executive order a “dangerous overreach.” Meanwhile, conservative groups have praised Trump’s move as a necessary step to protect vulnerable children from what they see as politically-driven medical practices.
Legal analysts predict that this clash between federal and state laws could end up before the Supreme Court, given the high stakes and the growing number of states enacting legislation either restricting or expanding gender-affirming care for minors.
What’s Next?
Hospitals in New York are now faced with a critical decision: comply with the federal mandate and risk state penalties, or follow New York’s directive and potentially lose federal funding. The outcome of this conflict will not only affect healthcare in New York but could set a national precedent in the ongoing debate over transgender issues and state-versus-federal authority.
Trump’s executive order remains a cornerstone of his administration’s broader efforts to roll back gender ideology in federal institutions, and this latest battle highlights how deeply divided the nation is on the issue of children’s access to gender-transition care. For now, hospitals remain at the center of a brewing legal and cultural storm.