A journey of transition

LINDSAY MAST, HOST: Coming up next, taxpayer funding and procedures to change sex characteristics.

Back in January, President Trump signed an order to protect children from these harmful medical interventions.

MARY REICHARD, HOST: Now federal agencies are taking action. They’re closing the door to funding irreversible procedures on minors confused about their sex.

Here’s WORLD Reporter Juliana Chan Erikson.

JULIANA CHAN ERIKSON: Forrest Smith was 24 years old when he realized he had made a terrible mistake.

SMITH: I was deliberating something that was actually impossible, right? You’re deliberating, “Can I become a member of the opposite sex?”

Smith dropped out of college in 2014 and went to Portland, Oregon to live like a female. He had been exposed to transgenderism through pornography, but thought it was ugly and not worth pursuing. That changed when he saw social media posts of men appearing to become attractive women with hormones and cosmetic surgeries. At an event hosted by the group Genspect on Capitol Hill last week, Smith explained what happened next.

SMITH: I was given a transgender road map by a social worker who was queer identified themselves, and it has every operation you can think of related to transgender operations, covered by public health insurance.

By September 2019, he had breast implants. The following June, he underwent surgery to remove his testicles. But within a month, he regretted it. When he started down the path of detransition, he learned something that wasn’t in the health insurance fine print. He explains in an interview with WORLD.

SMITH: It's like, well, they cover anything that's transgender, and they don't cover anything that is opposed to transgen—I don’t what the wording is, because I’m like I don’t want to cause any problems, I would just like to have as much restorative surgery as I can get within reason…and that was not covered, because I no longer identify as transgender.

Medical organizations in the U.S. continue to say so-called gender affirming procedures are safe…and do not acknowledge the regret and medical consequences detransitioners face. But political pressure challenging that narrative is growing.

ROSS: If you receive any federal funding as an institution, you are not eligible for that funding if you provide so-called gender care services to minors.

Dr. Jared Ross is an emergency medicine physician in South Carolina***, and a senior fellow with the research group Do No Harm.

On day one in office, President Trump signed an executive order stating that the U.S. government only recognizes two sexes, male and female. The order required all federal agencies to delete any references to gender identity on forms. Eight days later, Trump signed another order ending all government support for gender change procedures on children.

ROSS: …so we saw when that executive order came out that hospitals and institutions were backing away from this. They said, we just can't afford to, we can't afford to lose our NIH funding.

But then district judges in Maryland, Washington State, and the District of Columbia temporarily blocked the orders from going into effect. That gave medical providers political cover.

ROSS: they then said no, we'll continue doing this…

While the challenges continue, two federal agencies have specifically mentioned plans to curb pediatric gender procedures. The Department of Health and Human Services said it would take steps to protect children seeking these treatments. And the Centers for Medicare and Medicaid Services announced it had already alerted hospital providers about the dangers of what it called “chemical and surgical mutilation.”

Dr. Ross says since only about a third of cases are covered by public insurance, the executive branch policies do not go far enough.

ROSS: …that doesn't protect these children who are on private insurance from getting these medications and procedures at a clinic or hospital that isn't affiliated with the university, that isn't receiving federal funding for that.

Lawmakers are also trying to put the medical field on notice.

CRENSHAW: Good afternoon, everyone. Thanks for being here today on Detransitioner Awareness Day.

That’s Congressman Dan Crenshaw in a press conference on Wednesday. In January, the Texas Republican reintroduced a bill that would block federal funding for pediatric residency programs that offer procedures aimed at changing sex characteristics. He first put the bill forward in 2023, but didn’t get enough support to pass it and faces similar challenges this time.

CRENSHAW: We would need Democrats in the Senate to cross the aisle to get 60 votes.

Last month, 89 Democratic legislators signed a letter asking President Trump to rescind his executive order and allow children to receive these procedures. They say these medical decisions should be left to children, families and their doctors.

Detransitioners like Forrest Smith disagree.

SMITH: I’m not against science. One of the things I’ve come to a conclusion about is a lot of these surgeries exist for really rare cases of intersex conditions or just other deformities that happen naturally. It's amazing science, but it's being abused on healthy bodies. And one thing that I feel very certain about is that this should not be covered on public dollars.

When Smith realized he had made a mistake, he turned to the only people who would accept him as a detransitioner: his parents.

SMITH: Seeing how how how simple my family's care and love for me was my mother's whole extended family the way that I was welcomed with open arms, it was not the the story that I had been painting in my head about transphobes and homophobes and hateful people, was not at all true.

He paid for reversal procedures out of pocket…and must maintain his testosterone levels medically. But Smith has also found a different kind of healing…in the Roman Catholic church.

SMITH: I learned a prayer of “Christ join my suffering to yours”, that brought me a lot of meaning when I was in the depths of physical pain and humiliation and trauma, when I was struggling with hatred towards the people who'd injured me. And to pray to Christ then, that's when you really understand Christ. It was like I don’t want to live with this anger.

Reporting for WORLD, I’m Juliana Chan Erikson, in Washington.

*** Editors Note: Dr. Jared Ross lives in South Carolina. A previous version of this story misidentified where he lives and practices medicine.

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