HHS Returns to a Binary System for Gender Definitions

By Tiffany Ferguson, LMSW, CMAC, ACM

The U.S. Department of Health and Human Services (HHS) recently announced policy changes in response to President Trump’s executive order aimed at gender classifications and restricting gender-affirming care for minors.

These actions are a 180-degree change from the Biden Administration, which had previously expanded policies and rights for transgender and non-binary individuals, after the Supreme Court’s ruling in Bostock v. Clayton County (2020).

In alignment with Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” HHS issued guidance establishing strict sex-based definitions for gender classifications. According to this guidance, sex is defined as an immutable biological characteristic, categorizing individuals strictly as male or female.

The definitions specify that a female is “a person whose reproductive system is designed to produce eggs,” while a male is “a person whose reproductive system is designed to produce sperm.” This move aims to influence policies across various federal agencies, ensuring that distinctions based on these definitions are recognized and enforced.

Newly confirmed HHS Secretary Robert F. Kennedy Jr. emphasized in a press release the administration’s commitment to what it terms “biological truth,” stating that “this administration is bringing back common sense and restoring biological truth to the federal government.” The guidance also includes definitions for terms such as woman, man, girl, boy, mother, and father, all rooted in biological characteristics.

In conjunction with Executive Order 14187, “Protecting Children from Chemical and Surgical Mutilation,” HHS is implementing policies to prohibit federal support for gender-transition treatments for individuals under 19. This includes withholding federal funding from medical institutions that provide surgeries, hormone therapies, puberty blockers, and other gender-affirming treatments to minors.

Furthering the administration’s agenda, Executive Order 14201, “Keeping Men Out of Women’s Sports,” directs HHS to implement policies ensuring that athletic competitions are segregated based on the newly established biological definitions of sex. This order aims to prevent transgender women and girls from participating in female sports categories, a move proponents argue is necessary to maintain fairness in women’s athletics.

As these policies begin to take effect, the nation remains deeply divided over issues of gender identity, medical autonomy, and the role of government in personal healthcare decisions. The current administrative actions are dramatically different than the prior HHS philosophy. This will likely end up with further legal proceedings over discrimination protections and restricted access to healthcare for transgender individuals, particularly youths.