Report to the President on Protecting Children from Surgical and Chemical Mutilation Executive Summary

4/28/2025

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Action Summary

Purpose: Prohibit and halt chemical and surgical interventions on children, which are characterized as ideologically driven, financially motivated, and lacking a sound scientific basis.
Background:
- During the previous administration, over 7,000 children received puberty blockers and cross-sex hormones while more than 4,000 underwent sex-trait modification surgeries.
- These practices were promoted using discredited standards and misleading scientific claims.
Executive Order 14187:
- Signed on January 28, 2025, by President Trump to stop Federal funding, sponsorship, assistance, or facilitation of chemical and surgical mutilation of minors.
- Directs a broad cessation of these practices across Federal agencies.
Restoring Scientific Integrity:
- Section 3(i): Instructs agencies to rescind or amend policies based on “Standards of Care Version 8” from WPATH and disavow pseudo-scientific guidance previously issued by Admiral Levine.
- Section 3(ii): Requires HHS to publish an evidence-based literature review on best practices for the health of children with gender dysphoria, with coordination by respected scholars within a 90-day deadline.
Promoting Accurate Information:
- Section 3(b): Directs HHS to use all available methods to increase data quality and ensure that Federal data collection reflects biological reality.
- Highlights accountability measures regarding withheld study results funded by the NIH for political reasons.
Stopping Taxpayer-Funded Child Experimentation and Mutilation:
- Section 4: Mandates that HHS ensure medical institutions receiving Federal grants end the chemical and surgical mutilation of children.
- Reports the elimination of 215 grants, saving taxpayers over $477 million, with examples cited from major research centers.
Ensuring Proper Medical Treatment:
- Section 5: Orders HHS and CMS to issue safety alerts and guidance, emphasizing adherence to high standards of care and sound medical ethics.
- Notes additional actions such as increasing access to detransition care and modifications by the Department of Defense and Office of Personnel Management.
Ensuring Equal Protection and Rule of Law:
- Section 8: Directs the Department of Justice to enforce laws relating to misleading claims and female genital mutilation, including coordinating with State Attorneys General.
- Initiatives include drafting legislation for a private right of action and establishing a Parental Rights Task Force to protect constitutional rights concerning parental consent.

Risks & Considerations

The Executive Order 14187, “Protecting Children from Chemical and Surgical Mutilation,” could significantly impact research and educational programs related to gender dysphoria and transgender health at Vanderbilt University. The prohibition of federal funding for these areas may limit resources and opportunities for research and development.
Vanderbilt University may face challenges in aligning its medical and health-related programs with the new federal directives, particularly if they have been involved in research or practices now deemed as “chemical and surgical mutilation” by the Executive Order.
The emphasis on rescinding policies based on the World Professional Association for Transgender Health (WPATH) standards could affect the university’s medical curriculum and clinical practices, necessitating a review and potential overhaul of current guidelines and educational materials.
There is a risk of reputational impact if Vanderbilt is perceived as non-compliant with the new federal directives, especially in the context of public and political scrutiny surrounding gender-affirming care.
The Executive Order’s focus on ensuring “proper medical treatment” and “equal protection and rule of law” may require Vanderbilt to reassess its legal and ethical frameworks, particularly in relation to patient rights and parental consent in medical decisions.

Impacted Programs

Vanderbilt University Medical Center may need to review its policies and practices regarding transgender health care to ensure compliance with the new federal guidelines and avoid potential funding cuts.
School of Medicine at Vanderbilt might need to adjust its curriculum and research focus to align with the Executive Order’s directives, potentially impacting faculty and student research projects.
The Office of Research could face challenges in securing federal grants for studies related to gender dysphoria and transgender health, necessitating a shift in research priorities or seeking alternative funding sources.
Vanderbilt’s Legal Department may need to provide guidance and support to ensure that the university’s policies and practices comply with the new legal requirements and protect the institution from potential legal challenges.

Financial Impact

The elimination of federal grants related to transgender health research could result in a significant financial shortfall for Vanderbilt University, affecting ongoing and future research projects.
Vanderbilt may need to invest in revising its medical and educational programs to align with the new federal directives, which could incur additional costs.
There may be a need to explore alternative funding sources, such as private grants or partnerships, to support research and programs affected by the loss of federal funding.
The potential reduction in federal funding could impact the university’s ability to attract and retain top talent in the fields of medical research and education related to gender dysphoria and transgender health.

Relevance Score: 5 (The order presents critical risks involving legal or regulatory issues that could significantly impact Vanderbilt’s programs and funding.)

Key Actions

Vanderbilt University Medical Center should review its policies and practices regarding gender-affirming care for minors to ensure compliance with the new federal directives. This includes evaluating any ongoing research or clinical practices that may be affected by the prohibition of federal funding for such procedures.
The Office of Federal Relations should closely monitor developments in federal policies and guidance related to gender dysphoria and gender-affirming care. Engaging with policymakers and providing input on evidence-based practices could help shape future regulations and maintain the university’s standing as a leader in medical research and ethics.
Vanderbilt’s Research Administration should conduct an audit of current federally funded projects to identify any that may be impacted by the elimination of grants related to gender-affirming care. This will help mitigate financial risks and ensure compliance with federal funding requirements.
The Department of Pediatrics should consider developing programs focused on alternative support and care for minors with gender dysphoria, in line with the new federal emphasis on evidence-based practices. This could include research into detransition care and other supportive measures.
Vanderbilt’s Legal Affairs Office should prepare for potential legal challenges or changes in state laws related to parental rights and gender-affirming care. Understanding the implications of the DOJ’s actions and proposed legislation will be crucial for advising the university community.

Opportunities

The executive order provides an opportunity for Vanderbilt’s School of Medicine to lead in research on best practices for treating minors with gender dysphoria. By contributing to the evidence-based review of literature, the school can enhance its reputation and influence in the field of pediatric care.
Vanderbilt’s Center for Biomedical Ethics and Society can play a pivotal role in the national conversation on the ethics of gender-affirming care for minors. Hosting forums and discussions on the topic can position the center as a thought leader in medical ethics.
The focus on transparency and accountability in federally funded research offers Vanderbilt’s Research Integrity Office an opportunity to showcase its commitment to ethical research practices. By aligning with federal standards, the university can strengthen its research credibility and attract future funding.

Relevance Score: 4 (The executive order necessitates major process changes in Vanderbilt’s medical and research practices due to federal funding and compliance impacts.)

Average Relevance Score: 3.6

Timeline for Implementation

90-day deadline – HHS must publish an evidence-based review on best practices for the health of children with gender dysphoria by this deadline (Section 3(ii)).
Plan Year 2026 – The Office of Personnel Management will exclude coverage for the mutilation of children of the Federal civilian workforce starting in this plan year (Section 7).

Relevance Score: 2

Impacted Government Organizations

Department of Health and Human Services (HHS): Tasked with rescinding policies based on unsound scientific standards, publishing evidence-based reviews, and revising federal data collection practices related to gender dysphoria.
National Institute for Health (NIH): Involved through its funded study, its handling of research transparency is highlighted as part of the broader accountability measures.
Centers for Medicare & Medicaid Services (CMS): Issued a Quality and Safety Special Alert to guide providers and ensure adherence to the highest medical standards regarding treatments for minors.
Substance Abuse and Mental Health Services Administration (SAMHSA): Sent informational letters reinforcing the directive to cease chemical and surgical interventions for minors.
Health Resources and Services Administration (HRSA): Participated in disseminating guidance about the dangers of the flagged medical interventions.
Office of the Assistant Secretary for Health: Involved in the earlier stages of policy formation, and now subject to directives to reverse controversial guidance.
Department of Defense (DoD): Required its health services contractors to discontinue providing child mutilation as a covered benefit.
Office of Personnel Management (OPM): Excluded coverage for the cosmetic or surgical interventions for the children of federal civilian employees, starting in the next benefits cycle.
Department of Justice (DOJ): Preparing enforcement guidance for laws related to female genital mutilation and other chemical/surgical procedures, while coordinating with State Attorneys General and pursuing private rights of action.

Relevance Score: 3 (A moderate number of Federal Agencies—nine in this case—are directly impacted by the executive order.)

Responsible Officials

Department of Health and Human Services (HHS) – Tasked with rescinding policies tied to WPATH’s Standards of Care, publishing an evidence-based literature review on gender dysphoria, enhancing data quality for minor health practices, and ceasing federal funding for research and education grants that support chemical/surgical interventions.
Centers for Medicare & Medicaid Services (CMS) – Charged with alerting medical providers to the dangers of chemical and surgical interventions on minors and exploring avenues to increase access to detransition care.
Department of Defense (DoD) – Directed to have its health services contractors discontinue covering procedures related to child mutilation.
Office of Personnel Management (OPM) – Responsible for excluding coverage for such procedures for the Federal civilian workforce beginning in Plan Year 2026.
Department of Justice (DOJ) – Charged with enforcing equal protection laws through guidance on 18 U.S.C. § 116, coordinating with state attorneys general, investigating misleading information regarding these interventions, and establishing a Parental Rights Task Force.

Relevance Score: 4 (Directives affect agency heads at cabinet-level positions, significantly impacting the execution of federal health, defense, personnel, and legal policies.)