Attorney General Pam Bondi issued a significant memo this week targeting access to transgender healthcare for minors across the United States. The directive signals the Justice Department’s intent to increase scrutiny on medical professionals, hospitals, clinics, and even drug manufacturers and distributors involved in providing or facilitating such care. Bondi stated the department would leverage a variety of existing federal laws to investigate and potentially prosecute those involved in offering gender-affirming treatments to individuals under 18.
Specifically, the memo directs U.S. attorneys to explore using laws designed to combat female genital mutilation (FGM) to investigate doctors, alleging they “mutilate” children “under the guise of care.” Bondi emphasized that performing FGM on a minor is a felony with a maximum prison sentence of 10 years and urged prosecution “to the fullest extent possible.” Furthermore, she instructed the DOJ’s Civil Division branches to investigate potential violations of the Food, Drug and Cosmetic Act regarding alleged misbranding of medications like puberty blockers and hormones, and the False Claims Act concerning submitted bills to federal healthcare programs for services deemed “non-covered” or characterized as “radical gender experimentation.”
Legal analysis suggests that Bondi’s memo does not introduce new laws but rather outlines how the administration intends to utilize existing statutes in an unprecedented manner against providers of gender-affirming care. Experts, such as assistant professor Robin Maril, argue that while Medicaid fraud or misbranding are already illegal, the memo’s primary aim is to create a “chilling effect.” By encouraging investigations and potentially characterizing standard medical care as mutilation or fraud, the memo seeks to deter physicians from providing necessary treatments, even in states where such care remains legal.
It is crucial to understand what gender-affirming care for minors typically involves according to major medical associations, which widely support access to such care. Treatment often begins with talk therapy for younger children, and for adolescents experiencing puberty, may include reversible puberty-blocking medications or hormone therapy for older teens. While Bondi’s memo specifically mentioned surgery, this is generally not recommended for minors, though in rare cases, older teens might undergo procedures like a double mastectomy. Bondi’s characterization of this care as “radical gender experimentation” and her reliance on research from advocacy groups opposing such treatment starkly contrast with the consensus of leading medical organizations.
This memo represents the latest federal action in a broader political and legal landscape increasingly restricting transgender rights and access to healthcare. It follows closely after President Donald Trump signed a sweeping executive order targeting federal funding for minor gender-affirming care just over a week into his second term, although that order has faced temporary blocks from at least two judges. Coupled with laws enacted in 27 states restricting access to care for minors and a pending Supreme Court decision on a similar restriction in Tennessee, Attorney General Bondi’s directive signals a significant escalation in the administration’s efforts to curtail transgender healthcare.
