In an executive order about medical care for transgender youth, President Donald Trump called to end “reliance on junk science.” But the order itself included claims about gender-affirming care that clash with leading medical research and practice.

The Jan. 28 order declared that the U.S. government “will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”

It demanded ending federal funding to any hospitals or medical schools that provide gender-affirming medical care to youth. It also directed the Department of Health and Human Services “take all appropriate actions” under law to end access to care.

It defined a child as anyone younger than 19, including 18-year-olds whom federal and state laws generally presume to be adults.

Some U.S. hospitals, including in states in which gender-affirming care for youth is legal, have responded to the order by suspending its care offerings.

Here are five misleading claims from the order, which will likely face legal challenge.

The White House did not respond to a request for comment.

Claim: ‘Across the country today, medical professionals are maiming and sterilizing a growing number of impressionable children.’

It’s inaccurate to characterize gender-affirming care as “maiming” or “sterilizing” and this statement gives a misleading impression about the kind of care that medical professionals provide to transgender children.

Gender-affirming medical care seeks to support transgender and nonbinary people’s gender identity. For prepubescent patients, that basically amounts to “social transition,” which is presented in social ways — wearing new clothes or going by different pronouns or names — not medical ways — through surgery or medicine.

After puberty’s onset, and after consulting mental health providers, doctors and parents, trans adolescents can be prescribed puberty blockers, which temporarily pause the body from producing the hormones that cause pubertal changes. Once an adolescent stops taking them, puberty resumes. Blockers alone do not cause infertility.

Since the 1980s, doctors have prescribed and studied puberty blockers for children who start puberty too young, known as precocious puberty.

Medical guidelines from the Endocrine Society and American Academy of Pediatrics say older adolescents can be prescribed hormones, such as testosterone and estrogen, that cause body changes — some reversible, others not — in line with those adolescents’  gender identities. Extended hormone use can impact long-term fertility — but not always.

Medical guidelines instruct doctors to inform and discuss fertility risks before prescribing hormones. Trans adolescents’ use of cross-sex hormones has generally shown positive or neutral effects on mental health and well-being.

Gender-affirming surgery in patients younger than 18 is very uncommon, especially “bottom surgeries” that alter genitalia or reproductive organs.

Claim: ‘Countless children soon regret that they have been mutilated.’

That’s misleading. Some adolescents who receive gender-affirming care may decide to stop treatment or regret the care they received. This can happen with all medical care.

But research shows the numbers of people who “regret” gender-affirming care are small.

Recent studies of adolescents who have received gender-affirming medical treatment show the rates of people stopping treatment, regretting treatment, or reverting to their birth-assigned sex range from 1% to 9%, with most being on the lower end of that range.

For example, a 2024 American study surveyed 220 youth who took puberty blockers or hormones. Of the 220, nine (4%) expressed regret about one of the treatments. Of those nine, five stopped gender-affirming medical care or planned to stop. The other four continued care.

Numbers of detransition or regret are often even lower for adults, research shows.

The reasons people “detransition” — or stop gender-affirming medical care — are increasingly diverse, and don’t always mean people’s identities have has reverted to their birth-assigned sex, experts told us. Some people may transition to a nonbinary identity, meaning they identify as neither a man nor a woman, or stop medical intervention after they have achieved a certain appearance.

Other people may change their gender presentation or pronouns, without regret. Detransitioners may see their transitions as an important part of their gender exploration, or detransition because of social, familial, or economic pressures, experts said.

A 2024 study based on a survey of almost 4,000 LGBTQ+ young people ages 15 to 29 found that of the 720 people who started gender-affirming medical treatment, 16.8% reported ever stopping treatment. About 37% of the people in that group that stopped said they wished they hadn’t stopped, and 80.2% who stopped still identified themselves as transgender or having another “gender-diverse identity.”

Claim: Gender-affirming care is ‘spurred by guidance from the World Professional Association for Transgender Health (WPATH), which lacks scientific integrity.’

This lacks context and omits key facts, including that numerous health care organizations inform medical care standards for transgender youth.

The World Professional Association for Transgender Health, aka WPATH, publishes internationally used standards of care for treating transgender youth and adults. And its most recent standards of care, known as Version 8, support access to treatments such as puberty blockers and hormones for adolescents. But the standards also provide guidance on how to evaluate youth to ensure such care is appropriate and how to properly administer care, involve parents, consult mental health professionals, and ensure adolescents understand the care’s potential risks.

The New York Times in June reported that emails between Biden administration officials and WPATH experts showed Biden’s health officials requesting the organization to remove age limits from its surgical recommendations for fear of political fallout.

Dr. Marci Bowers, WPATH’s then-president, told The New York Times, “It wasn’t political, the politics were already evident … WPATH doesn’t look at politics when making a decision.”

Separately, a nonprofit known as Environmental Progress, released screenshots from WPATH’s internal message boards that it criticized as showing that WPATH “advocates for many arbitrary medical practices, including hormonal and surgical experimentation on minors and vulnerable adults.”

Bowers, told The Economist in response to the report that “WPATH is and has always been a science- and evidence-based organisation.”

But WPATH is not the only health organization supporting legal access to treatment for transgender youth.

The following American medical organizations support access to gender-affirming care for youth:  American Medical Association, American Academy of Pediatrics, Endocrine Society, Pediatric Endocrine Society, American Psychological Association, American College of Obstetricians and Gynecologists, American Psychiatric Association, American Academy of Child and Adolescent Psychiatry.

Claim: Gender-affirming care is comparable to ‘female genital mutilation’

In calling on the Justice Department to increase enforcement of female genital mutilation laws, Trump’s order drew an equivalency between gender-affirming surgery and female genital mutilation.

But experts in both fields told PolitiFact they are not the same.

Female genital mutilation is a nonconsensual procedure that can include the partial or total removal of the clitoris, labia minora or the narrowing of the vaginal opening. The World Health Organization said it is mostly forced on girls younger than 15. More than 200 million women have been affected in 30 countries in Africa, Asia and the Middle East.

The procedure aims to reduce or eliminate sexual function and pleasure. It is widely considered a human rights violation.

Bowers, the former WPATH leader who is also a gynecological surgeon, told PolitiFact for a previous story that gender-affirming surgeries do not amount to genital mutilation — the two are entirely different.

“Transgender surgery is done with full consent of the individual,” Bowers, who does gender-affirming genital surgeries and restorative surgeries for female genital mutilation survivors, told PolitiFact in November 2023.

Female genital mutilation is usually forced on girls younger than 15 in nonmedical and unsterile conditions. Gender-affirming surgeries, however, are performed in hospitals by trained professionals, and are rarely performed on people younger than 18, Bowers said. When gender-affirming surgery is performed on minors, it is “only under the most severe conditions of gender dysphoria,” she said.

Representatives from End FGM network in the U.S. and Europe, and Sahiyo, an organization working in Asia to end female genital mutilation, have told PolitiFact gender-affirming health care does not equate to genital mutilation and the two should not be conflated.

Claim: ‘So-called sanctuary States … facilitate stripping custody from parents.’

Trump’s order directed the attorney general to “prioritize investigations and take appropriate action to end child-abusive practices by so-called sanctuary States that facilitate stripping custody from parents.”

That likely referred to bills passed in several states that aim to shield state residents from laws in other states that criminalize or restrict access to gender affirming care.

But they don’t strip custody from parents.

These shield laws often include provisions expanding a state’s power to take “temporary emergency jurisdiction” in cases in which a child is present in the state to receive gender-affirming care.

But, these laws do not mean the state can take custody of children or take children away from their parents if they don’t support gender-affirming care. Jurisdiction refers to control over a legal case, not control of a child’s custody. We’ve fact-checked this claim several times before.

The change allows a state to issue a temporary custody order with a short-term expiration date, but one state wouldn’t be able to change another state’s existing custody orders.

This fact check was originally published by PolitiFact, which is part of the Poynter Institute. See the sources for this fact check here.