As the legal battle over transgender healthcare for minors unfolds, a New York doctor has vowed to continue providing gender-affirming treatments despite an executive order from former President Donald Trump. The controversial order aims to restrict transition-related medical care for individuals under 19, sparking fear and uncertainty among transgender youth and their families.
Dr. Jeffrey Birnbaum, a pediatrician and adolescent medicine specialist based in New York City, is unwavering in his decision to continue offering transition-related care to his patients. He emphasized that such care is life-saving, stating, “Until somebody calls me away, I’m just going to keep doing it.”
New York Attorney General Letitia James has reinforced Birnbaum’s stance, reminding healthcare providers that state law requires them to continue offering gender-affirming care. Despite this legal backing, many patients remain anxious about their future treatment. Birnbaum estimated that around 20 of his patients could be affected by the executive order and said many are fearful of losing access to care that has been crucial to their well-being.
The order, titled “Protecting Children From Chemical and Surgical Mutilation,” prevents federal funds from being used for transition-related treatments such as puberty blockers, hormone therapy, and gender-affirming surgery for those under 19. Additionally, medical schools and hospitals that receive federal research or education grants must halt such treatments or risk losing funding.
In response to the order, hospitals in multiple states—including New York, Colorado, Virginia, Illinois, Pennsylvania, and Washington, D.C.—have either suspended or begun reviewing their transgender care programs for minors. Recently, Children’s Hospital Los Angeles also announced a pause on initiating hormone therapy for gender-affirming care patients under 19.
Dr. Birnbaum criticized the executive order and broader attempts to limit transgender care, arguing that they disregard medical research and the lived experiences of transgender people. “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,” he said.
Opponents of gender-affirming care claim that such treatments may lead to regret later in life. Trump’s executive order argues that minors must be protected from “irreversible medical interventions,” citing concerns about fertility loss and other long-term effects. However, medical research suggests that the number of minors accessing these treatments is small. A 2024 study published in JAMA Pediatrics found that less than 0.1% of adolescents with private insurance in the U.S. were prescribed puberty blockers or hormone therapy.
For young transgender individuals, gender-affirming care can be transformative. Akoni Drysdale-Ash, a 17-year-old transgender boy from Brooklyn, described how starting testosterone nearly three years ago dramatically improved his quality of life. He first recognized his gender identity in middle school, but experiencing puberty in a body that did not align with his identity caused distress.
Akoni likened the potential loss of access to testosterone to trying to power a car without the right fuel. “It does leave you with fear because it’s like you’re taking away my visibility,” he 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?”
The debate over transgender healthcare for minors remains a contentious issue in the U.S. While some states have enacted bans on gender-affirming care, others—like New York—have strengthened legal protections for transgender youth and their medical providers. With lawsuits already challenging Trump’s executive order, the future of such policies remains uncertain.
Despite the ongoing political and legal battles, Dr. Birnbaum and other medical professionals remain committed to their patients. For them, providing gender-affirming care is not a political statement it is a matter of health, dignity, and survival.
