Abstract
The antitransgender executive orders and legislation enacted by the Trump administration since January 2025 have focused on enforcing a gender binary and restricting access to gender-affirming care for youths. These actions have had sweeping effects on health policy and access to care in an already strained health care system. Here we contextualize these attacks on transgender health by exploring the historical pathologization and policing of transgender bodies in the United States and Europe while tracing the legacy of medical gatekeeping alongside evolving standards of care. We critique the scientific inaccuracies within the administration's executive orders while outlining the harmful impact of related and recent legislation, including United States v Skrmetti. Restrictions on gender-affirming care and the rights of transgender people to exist not only exacerbate health disparities but also undermine the ethical responsibility of medical practitioners and institutions to provide patient-centered, evidence-based care. We must not capitulate to political efforts that attempt to harm and erase an already marginalized population. (Am J Public Health. 2026;116(2):256-260. https://doi.org/10.2105/AJPH.2025.308265).