Members of Minnesota's transgender community are reeling after President Donald Trump's executive order that would end gender-affirming medical treatments for children and teenagers under the age of 19.
It's the latest move targeting members of the trans community. On Monday, Trump signed an executive order to ban transgender troops from serving. He also signed an order recognizing two sexes, male and female.
"You know, the experience of this has been very hard on all of us, including myself, but we're not going anywhere and we're gonna fight every step of the way to protect our rights," says Minnesota DFL State Representative Leigh Finke (St. Paul), who is transgender.
Finke has led the fight for protections in Minnesota, even seeing people move here because of the state's sanctuary status. Finke is the first openly transgender legislator elected to the Minnesota Legislature. She said she was motivated to run because of anti-trans bills state Republicans introduced in 2021.
Anti-trans momentum has been growing for several years, with Republican-governed states enacting dozens of laws restricting trans people’s options for medical care, sports participation and public restroom access.
"This negative attention (we) expected, but it's much more difficult to see it happen than it is to predict that it will happen," Finke explains, adding there are 10 other states in the country that offer gender-affirming care.
"They're trying to scare us and it's working," says Finke who spoke to WCCO's Susie Jones. "And they're trying to create a campaign to terrorize us."
Finke says her message to those in the community is that they are protected as Minnesota is a sanctuary state
"We are still a trans refuge state," Finke said. "We still have protected access to gender-affirming care for people of all ages. Despite everything that the new president is signing in his executive orders, he can't just unilaterally change our state laws."
Finke says the President is trying to cut federal funds for federal agencies like Medicare from providing gender-affirming care.
Will this stop Medicaid from paying for gender-affirming care?
Medicaid, a joint federal-state health insurance program for lower-income people, covers gender-affirming care in some states.
Former President Joe Biden’s administration adopted a rule to make it do so nationally. But judges put that on hold.
So far, it’s unclear what might happen to the coverage in states that chose to offer it.
Lindsey Dawson, director of LGBTQ health policy at the health policy research organization KFF, said that eliminating the coverage where it’s already in place would likely involve a long process — and, like others, would probably face court challenges.
Defining male and female based on cells that don’t exist at conception
The order declares that there are just two sexes, male and female. It rejects that people can transition from one gender to another or be considered something other than male or female such as nonbinary, which describes people who don’t identify as strictly men or women, or intersex.
The position reflects what many social conservatives have called for — and conflicts with what the American Medical Association and other mainstream medical groups say: that extensive scientific research suggests sex and gender are better understood as a spectrum than as an either-or definition.
Trump’s order says it is intended to protect women’s spaces from those who “self-identify” as women.
It defines the sexes in an unconventional way, based on the reproductive cells — large cells in females or small ones in males. And it suggests that humans have those cells at conception.
Biologists say that’s a problem because egg cells develop many weeks later, and sperm cells are produced at puberty, not at conception.
“At that stage, sexual differentiation has not started to take place,” said Carl Bergstrom, a University of Washington evolutionary biologist. “I can’t see any logically coherent way to interpret the definition in this executive order, given the addition of the phrase ‘at conception.’”
Bergstrom said a scientific explanation could specify sex chromosomes, but the executive order seems to deliberately avoid that, presumably to sidestep the range of variations that include intersex people, who have physical traits that don’t fit typical definitions for male or female categories.
What parts of the order are in effect?
The order has been signed, but much of it requires more federal action.
“Nothing is in effect,” said Heron Greenesmith, deputy director of policy at the Transgender Law Center.
The executive order tells one White House staff member to draft a bill for Congress within 30 days that would codify the definitions into law.
Federal agencies must tell the president within 120 days what they’ve done to comply with the order. Some parts might require going through the regulatory process or passing new laws.
Omar Gonzalez-Pagan, a Lambda Legal lawyer, said on a call with journalists this week that the order does not change current law but rather creates “a clear signal and road map of where this administration’s policies lie when it comes to transgender people.”
State laws on participation in sports, bathroom use, gender-affirming care and other issues are not directly affected.
What does it mean for federally issued documents?
The order calls for passports, visas and Global Entry cards to reflect the administration’s definition of sexes.
The State Department, which is responsible for passports, declined to answer questions about the current state of policy. The order suggests getting rid of the “X” designation that has been available on passports since 2021 after a long legal battle waged by an intersex activist.
A department webpage that described how people could change their gender marker was taken offline, and Chase Strangio, an ACLU lawyer, said it’s unlikely that any new application to change the gender marker on a passport will be approved.
A White House spokesperson told the news outlet NOTUS this week that passports that have not expired will remain valid. But people will have to comply with the new order when they apply for a new passport or renew an old one.