Is the Federal Ban on Gender-Affirming Care Legal? A Lawyer’s Personal and Legal Perspective
On August 15, 2025, the Trump administration issued a directive through the U.S. Office of Personnel Management (OPM) that effectively creates a federal ban on gender-affirming care for millions of federal employees and their families. Beginning in 2026, all federal health plans under FEHB and PSHB will be barred from covering hormone therapy or surgeries for both minors and adults. In their place, the directive mandates coverage for “faith-based counseling” for gender dysphoria—a euphemism for conversion therapy.
As an attorney, I see this as legally vulnerable under civil rights laws. As a survivor of conversion therapy, I know the profound harm this causes.
This post explains the legal implications of the OPM directive, why conversion therapy is not healthcare, and what steps affected individuals can take. Whether you’re directly impacted or simply concerned about civil rights, this is an issue that touches us all.
The Legal Case Against the OPM Gender-Affirming Care Ban
The OPM directive represents a sweeping rollback of transgender healthcare rights. It conflicts with established federal law:
Section 1557 of the Affordable Care Act: Prohibits sex-based discrimination in healthcare. Courts have consistently recognized that this includes gender identity.
Title VII of the Civil Rights Act: In Bostock v. Clayton County (2020), the Supreme Court held that discrimination based on gender identity is a form of sex discrimination. Extending that reasoning to health benefits is a natural step.
Insurance Directory Restrictions: By requiring insurers to strip gender-affirming providers from their networks, the directive further isolates transgender individuals from legitimate care.
Legal advocacy groups like Lambda Legal and the ACLU have already signaled that lawsuits are forthcoming. From my perspective, this directive is highly likely to be challenged in federal court.
My Story: Why Conversion Therapy Is Not Care
As someone who was subjected to “faith-based counseling” as in college, I know firsthand the harm of conversion therapy. I was told that who I was could be “fixed.” What it actually created was years of shame, anxiety, and internal conflict.
Every major professional body in the U.S.—from the American Psychological Association to the American Academy of Pediatrics—has condemned conversion therapy as dangerous and ineffective. Yet the federal government is mandating coverage for it while banning science-based, affirming care.
Conversion therapy is not healthcare. It is trauma disguised as treatment.
Why This Matters Beyond the Transgender Community
This directive is not only about transgender rights—it is about civil rights. Federal employees are teachers, postal workers, scientists, and service members. Their families deserve healthcare guided by medical evidence, not political ideology.
When policy allows ideology to override science, it weakens protections for everyone. This precedent could ripple beyond transgender healthcare and into other areas of civil rights law.
What to Do if This Ban Affects You
If you or a family member are covered by a federal health plan, this directive is alarming—but it is not the final word. Here are immediate steps you can take:
Understand Your Rights. This directive will be challenged. Existing protections under Section 1557 of the ACA and Title VII provide a strong legal basis for lawsuits.
Organize Your Documentation. Keep a file of your medical records, treatment plans, insurance correspondence, and any denial-of-care notices. This evidence will be vital in any legal challenge.
Connect with National Advocacy Groups. Organizations like Lambda Legal and the ACLU are leading the legal fight. Following their updates may give you opportunities to join class-action litigation.
Consult an Attorney. Don’t wait for coverage to be denied. A lawyer with experience in civil rights and healthcare law can help you prepare a strategy tailored to your situation.
Frequently Asked Questions (FAQ)
Is the OPM directive banning gender-affirming care already in effect?
Not yet. It is scheduled to begin in 2026, but lawsuits are expected to challenge it before then.
Does this apply to both minors and adults?
Yes. The ban applies to coverage of gender-affirming care for both minors and adults under federal health plans.
Is conversion therapy legal in Nebraska?
Nebraska has not yet passed a statewide ban on conversion therapy for minors, though medical professionals widely condemn it. Mandating its coverage while banning affirming care raises significant constitutional concerns.
Can private employers still offer coverage?
Yes. This directive applies specifically to federal employee health benefit programs (FEHB and PSHB). Private employers can still provide gender-affirming care coverage.
What should I do if my claim is denied under this policy?
Document everything and seek legal advice. Denials may form the basis for legal claims under the ACA or Title VII.
Closing Thoughts
As an attorney, I am prepared to support legal challenges to this directive. As a Nebraskan, I call on our leaders to speak out. And as a survivor, I share my story so that others know they are not alone—and that affirming, science-based care is their right.
If you believe you may be affected by this directive, or if you have questions about your rights, please reach out.