Overview

Federal Two-Sex Policy and Transgender Restrictions

Scope of the Executive Order

The January 20 order reshaped the federal government's stance on sex and gender by redefining "sex" strictly as male or female, based on an individual's immutable biological classification, and placing new requirements on federal agencies and contractors. Implementation was rapid and broad. Federal agencies began immediate implementation, with the State Department suspending the "X" gender marker on passports within days, the EEOC removing pronoun displays and LGBTQ+ workplace materials, and health agencies including the CDC, FDA, and NIH purging thousands of transgender and LGBTQ+ health resources from their websites by a January 31 deadline.

All government agencies were directed to ensure that official documents, including passports, visas, and Global Entry cards, accurately reflect the holder's sex; federal prisons, migrant shelters, and rape shelters were directed to protect single-sex spaces; and employee records were required to adhere to the new definitions. The executive order also prohibited transgender prisoners from being held in facilities based on their gender identity. In February 2026, the Bureau of Prisons established a policy intended to forcibly detransition transgender people living in federal prisons.

Healthcare and Gender-Affirming Care

An executive order issued on January 20, 2025 directed federal agencies to restrict access to affirming medical care for transgender people in federal custody, and a follow-on order issued on January 28 threatened funding for healthcare providers that treat transgender youth. Multiple hospitals stopped offering gender-affirming care to transgender youth under the age of 19, and as of February 2026, at least 40 hospitals had stopped providing medically necessary puberty-delaying medications and hormone therapy to young transgender people. In 2026, the administration escalated its actions against hospitals providing healthcare for transgender youth, with the Department of Justice serving both criminal and civil subpoenas seeking protected health information.

The Military Ban

Executive Order 14183, titled "Prioritizing Military Excellence and Readiness" and signed on January 27, 2025, banned transgender people from military service. The order required Secretary of Defense Pete Hegseth to put into effect a ban on "individuals with gender dysphoria," a policy more expansive than the 2019 version from Trump's first term, with no exceptions for current service members; it mandated identification and removal of transgender service members within 60 days. Hegseth directed the Pentagon to pause new accessions for people with a history of gender dysphoria and halt medical procedures for transgender troops; the Defense Department then issued a policy in February 2025 formally disqualifying people with gender dysphoria from military service unless they obtained a waiver. Advocates estimated that as many as 15,000 transgender people were then serving in the U.S. military out of a population of 1.3 million active-duty service members.

Significance and Impact

The two-sex policy and its companion orders constitute the most comprehensive federal rollback of transgender recognition in American history. Prior administrations had expanded, incrementally, the recognition of gender identity across federal programs; the Biden administration had explicitly extended that framework in passports, healthcare, employment guidance, and military service. The Trump second-term actions reversed this trajectory across multiple agencies simultaneously, using executive orders rather than legislation to achieve the shift.

The State Department immediately stopped allowing transgender, nonbinary, and intersex people to update the sex designation on their passports; new and renewed passports showed the sex assigned at birth regardless of gender identity, legal name change, or other documentation; and the "X" gender marker option, available since 2022, was eliminated. The practical consequences for affected individuals were immediate: passport renewals, prison placements, access to federal health coverage, and military careers were all disrupted.

The scale of federal agency action was also significant in institutional terms. The simultaneous directive to the State Department, Bureau of Prisons, Department of Defense, Department of Education, and health agencies to realign policies amounted to a coordinated effort to rewrite how sex and gender are treated across the administrative state. The order also directed the Attorney General to issue guidance to agencies to correct what the administration characterized as a misapplication of the Supreme Court's decision in Bostock v. Clayton County.

Reactions and Debate

The orders drew immediate and sustained legal challenges. On passports, within 48 hours of the order, the State Department paused processing of some passport applications from transgender, intersex, and nonbinary people, and over 214,000 public comments in opposition to the new policy were collected by the ACLU and Advocates for Transgender Equality. A federal court issued a preliminary injunction in June 2025 temporarily blocking the passport policy, but in November 2025, the U.S. Supreme Court allowed the administration to enforce the policy while the legal challenge continued.

On the military ban, courts were similarly divided. In March 2025, U.S. District Judge Ana Reyes granted the plaintiffs' request to block enforcement of the policy, issuing a ruling that found the Trump administration's policy was driven by unconstitutional animus. In May 2025, the Supreme Court issued a ruling in Shilling v. Trump allowing the transgender military ban to take effect while multiple legal challenges moved forward. By June 2026, a divided D.C. Circuit appeals court panel ruled that the administration's ban on transgender military service had no legitimate basis, with the majority largely upholding the district court's earlier findings.

Critics argued that the orders caused direct harm to affected individuals and were legally vulnerable. Supporters, including administration officials, framed the orders as restoring clarity to federal law and protecting sex-based spaces and standards. In a dissenting opinion in the military ban case, Judge Justin Walker argued that courts lack the power to second-guess decisions to exclude transgender troops, writing that the Constitution assigns that authority to Congress and the Commander in Chief. The administration's broader argument, echoed in the executive orders themselves, held that sex is a biological and immutable reality and that prior policy had eroded protections for women.

Public opinion on transgender military service showed some shift: a Gallup report found that 58 percent of Americans approved of allowing openly transgender people to serve in the military in early 2025, down from 71 percent in 2019 and 66 percent in 2021. The cultural debate over gender identity policy, of which these orders are a part, remained one of the most contested fronts in American domestic politics throughout the period.

Outlook

As of August 2026, the federal two-sex policy is in effect across most of the domains it targeted, but its legal future remains unsettled. The military ban faces ongoing litigation after the D.C. Circuit's June 2026 ruling against it; the matter is likely to return to the Supreme Court for a definitive constitutional ruling. In June 2026, a federal court ruled to certify class status in Talbott v. Trump, extending protections to all transgender service members. The passport policy remains enforceable under the November 2025 Supreme Court stay, though lower courts continue to hear the underlying challenge.

In December 2025, the HHS Office of Civil Rights proposed a rule to modify regulations defining disability under Section 504 of the Rehabilitation Act and exclude gender dysphoria from that definition — a change that, if finalized, would significantly affect transgender people in federal prisons seeking medical care. That rulemaking remains pending. In healthcare more broadly, the administration's use of subpoenas and funding pressure to deter hospitals from providing gender-affirming care to minors has raised unresolved questions about the limits of executive authority over medical practice.

The policy cluster as a whole is best understood as the opening phase of a longer political and legal contest. Whether the courts ultimately sustain, narrow, or overturn the core provisions of the two-sex framework will depend on evolving constitutional doctrine around equal protection and sex discrimination — questions the Supreme Court has not yet fully resolved in this context. In the meantime, the orders have already materially changed the experience of transgender Americans interacting with federal institutions, and have set a policy template that future administrations will have to address directly.