Despite Federal Bans, Maryland Continues to Support Gender-Affirming Care

There lies a little girl on the streets of Bethesda, who imagines a life where she must no longer hide or feel uncomfortable in her own skin—a life where she can transition from being a girl into a boy. The process is long and requires not only surgeries, but medications that can cost anywhere from $30 to $500 every month. Yet, it is a wish that now seems further and further from being a reality. 

On Jan. 28, President Donald J. Trump signed into effect Executive Order 14187, “Protecting Children From Chemical and Surgical Mutilation.” This executive order called for a nationwide ban on gender-affirming care for individuals, under 19 years old, who are transitioning their bodies into their gender identity. The executive order aims to ban these practices of surgical operations and hormone therapy by defunding the Department of Health and Human Services, as well as other federal departments and agencies that oversee gender transitioning practices in the medical field. 

According to the Human Rights Campaign Foundation, as of this year, 27 states with Republican legislatures have issued laws that limit or cease gender-affirming care. For instance, Alabama passed the Vulnerable Child Compassion and Protection Act, which prohibits experimental sex-change procedures in the state for minors.

In 2022, six pseudonymous plaintiffs challenged the act in the case of Boe v. Marshall on the grounds that it violated the 14th Amendment’s Equal Protection Clause. However, they ultimately decided to drop their charges due to the emotional toll of the case and the state government’s claim that they had uncovered strong evidence that went against their claim. Alabama Attorney General Steve Marshall declared this to mean his state’s victory.  

“Three years ago, multiple sets of plaintiffs, represented by the American Civil Liberties Union (ACLU), Southern Poverty Law Center (SPLC) and some of the nation’s largest law firms, filed suit against Alabama to challenge our [Vulnerable Child Compassion and Protection Act] protecting vulnerable kids from life-altering sex-change procedures,” Alabama Attorney General Marshall said. “We fought back. We defeated a preliminary injunction and conducted court-ordered discovery into the so-called ‘standards of care’ that these groups claimed were evidence-based.”

Even in Democrat-led areas like Washington, D.C., Children’s National Hospital announced it would no longer prescribe transition medications starting Aug. 30. Many other hospitals, including UChicago Medicine and the University of Pittsburgh Medical Center, have ended pediatric transition care. Yet in February, the American Civil Liberties Union (ACLU), Lambda Legal, the ACLU of Maryland and law firms Hogan Lovells and Jenner & Block filed a lawsuit against President Trump’s order. The lawsuit represents seven transgender adolescents and PFLAG and the Gay & Lesbian Medical Association, two non-profit organizations dedicated to trans rights. The case, PFLAG v. Trump, has reached the U.S. Court of Appeals for the Fourth Circuit and remains open.

“PFLAG parents are good and decent people who love their trans kids and want them to grow up to become thriving, happy, healthy adults,” PFLAG National’s Chief Executive Officer Brian Bond said. “Yet, President Trump and other politicians maliciously harm our families by denying them access to physician-prescribed, medically recommended care. This order puts trans and nonbinary young people and their families at risk—and we’re not putting up with it.”

Indeed, providing gender affirming care can be lifesaving for trans students. In a 2011 National Institutes of Health study, researchers found that trans youth given cross-sex hormones and gender-reassignment surgery experienced reduced anxiety and depression, and ultimately physical and mental well-being similar to non-trans-youth of the same age. This is significant as according to The Trevor Project’s 2023 survey, nearly 1 in 3 LGBTQ young people said that they had poor mental health due to anti-LGBTQ policies and legislation. The Trevor Project is an LGBTQIA+ organization that has worked to end suicide among LGBTQIA+ youth for 27 years. 

State governments like Maryland’s have also taken action against this executive order. In a video published on Sept. 15, nine attorneys general, including Maryland’s Anthony Brown, publicly expressed their support of trans students in response to President Trump’s executive order. The National Women’s Law Center-published “We Have Your Back”: A Message to Trans Students From State Attorneys General video has close to 6,000 views as of Nov. 30. 

“In Maryland, we do not tolerate hate and we do fight back,” Brown said in the video. “In Maryland, we have led a coalition of attorneys general in supporting a group of courageous trans children fighting for their access to lifesaving medical care.”

On March 10, the Maryland Commission on LGBTQIA+ Affairs, part of Maryland’s Department of Justice, published a six-page statement addressing the executive order and recent rollbacks on laws that protected trans rights. This statement outlines the protections that Maryland has put into place for trans students by increased state funding for transgender support services. Additionally, Maryland still upholds their Trans Health Equity Act, which passed in Jan. 2024 to protect gender-affirming treatment. The University of Maryland Medical System, MedStar Health in Maryland and Johns Hopkins Medicine still offer a range of gender-affirming services, including hormone therapy, various surgeries and mental health support for transgender minors. This has made Maryland a place where transgender and LGBTQIA+ populations, including Montgomery County’s, can still receive the care they need and are protected from legislation from the White House.  

“Maryland has always been a state that values fairness, dignity and inclusion,” the March statement said. “Now is the time to reinforce Maryland’s commitment to equity, not only in words but in policy and practice. To every transgender, nonbinary, Two-spirit [a term that refers to an Indigenous American who identifies with both male and female essences], gender diverse and intersex Marylander: You are seen. You are valued. You are not alone. The Maryland Commission on LGBTQIA+ Affairs remains committed to working alongside community leaders, advocates and policymakers to ensure that Maryland remains a safe and affirming home for LGBTQIA+ communities.” 

Written by Ava Van Vuren

Graphic courtesy of Ava Van Vuren