In a recent rally at the Myrtle Beach Convention Center in South Carolina, President Donald Trump made a startling claim: hospitals are now performing ‘reverse surgery’ on transgender individuals at his order. This statement has sparked confusion and debate, particularly as the nation grapples with policies surrounding gender-affirming care.
Trump’s remarks came during a campaign event for U.S. Sen. Darline Graham, who is running in a Republican primary runoff against Rep. Ralph Norman. Graham, appointed to the seat after her brother Lindsey Graham’s passing, will face Democratic nominee Dr. Annie Andrews in the general election. The event highlighted the contentious political climate surrounding transgender rights and healthcare.
Medical Experts Respond to Trump’s Claims
Adrian Shanker, former deputy assistant secretary for health policy and senior adviser on LGBTQI+ health equity at the Department of Health and Human Services, responded to Trump’s statements with skepticism. ‘I don’t really know what President Trump means by reverse surgeries,’ Shanker told The Advocate. ‘The reality is that he should leave medical decision-making up to the patient and their providers to discuss what medical care is right for a certain patient.’
Shanker emphasized that political interference in medical decisions is inappropriate. ‘These kinds of decisions really don’t have room for politicians in the middle of that conversation,’ he stated. He also criticized the lack of understanding among some politicians about the complexities of transgender healthcare. ‘Trans people deserve access to the care that their bodies need, not the care that President Trump thinks that they need.’
The Context of Graham’s Campaign and National Security Comments
The rally followed a televised debate where Graham admitted her lack of knowledge on national security issues. When asked about the importance of Taiwan and the South China Sea to American national security, Graham responded, ‘I’m just going to be honest here. I’m not that informed on national security.’ She later pivoted to discussing transgender athletes, stating, ‘People in South Carolina are more worried about making ends meet. They are concerned about boys in girls’ sports.’
Trump echoed this focus during his rally, attacking Andrews as a ‘far-left political hack who supports transgender for everybody.’ However, Andrews has explicitly stated she does not support gender-affirming surgery for anyone younger than 18, advocating instead for evidence-based care decided among physicians, parents, and patients.
The Reality of Gender-Affirming Care and Trump’s Executive Actions
Contrary to Trump’s claims, no presidential order requires hospitals to operate on transgender patients or reverse procedures they previously underwent. Trump’s executive actions have primarily focused on restricting access to gender-affirming care. His executive order directed federal agencies to withhold funding from institutions providing puberty blockers, hormones, or surgery to people younger than 19. This order did not mandate surgical reversals and faced legal challenges.
The Centers for Medicare and Medicaid Services finalized a rule this month ending federal Medicaid and Children’s Health Insurance Program payments for gender-affirming care provided to minors. This rule, set to take effect on October 13, allows federal funding for up to six months while some existing patients taper off hormones. It neither requires nor promotes surgery.
Trump’s imagery of children routinely undergoing gender-affirming surgery is not supported by national data. A 2026 study published in JAMA Network Open examined insurance claims covering nearly 23 million minors and found no gender-affirming surgeries among transgender children 12 or younger in 2019. The rate was 0.1 per 100,000 among those ages 13 and 14 and 2.1 per 100,000 among those ages 15 to 17. Of the 85 procedures identified among minors, 82 were chest-related.
The American Society of Plastic Surgeons now recommends delaying gender-related surgery until age 19. Major medical organizations, including the American Academy of Pediatrics, American Medical Association, American Psychiatric Association, and Endocrine Society, continue to support access to individualized gender-affirming care in accordance with clinical guidelines.
Trump’s Potential Confusion and Hospital Settlements
Trump may have conflated medical procedures with agreements his Justice Department has forced on two major hospital systems. These settlements require Texas Children’s Hospital and the Cleveland Clinic to establish or fund services for people who voluntarily seek to detransition. They do not order hospitals to perform surgery on anyone.
In May, Texas Children’s agreed to pay the state $10 million, end gender-affirming care for minors, and establish a ‘restorative care’ clinic for detransitioners. The Houston hospital also agreed to terminate five physicians connected to its transgender health program. The agreement came after allegations of improper billing, which were not proven in court.
The Cleveland Clinic pledged $2 million in services for people who received gender-affirming medical interventions before age 19 and later sought to detransition. These services may include hormonal care, surgical revision or reconstruction, fertility care, counseling, and insurance coordination. The clinic described the agreement as a commitment to continue providing existing care, not the creation of a new surgical program.
Neither settlement requires any patient to detransition or undergo surgery. ‘Reverse surgery’ is not one standardized operation. Some people who discontinue a transition seek individualized reconstructive treatment; others stop medication, change their name, or make no medical changes at all.
Shanker criticized the settlements, stating, ‘Hospitals really should not be agreeing to such nonsense. There’s a long-established standard of care around transgender medicine, and that’s what should be guiding the provision of care in this country, not unscientific decisions negotiated by a weaponized Department of Justice to harm trans people’s access to care.’
