Minnesota’s self-proclaimed role as a “trans refuge” or sanctuary state for pediatric sex-rejecting treatments—enshrined in 2023 law (HF 146) that shields out-of-state families and providers from enforcement of restrictive laws elsewhere—is increasingly untenable and isolated. Major medical organizations are pulling back from endorsing irreversible treatments like cross-sex hormone therapy and disfiguring surgeries on healthy children. While federal pressure under the Trump administration accelerates the shift toward caution and evidence-based restraint, Minnesota’s state law is being exposed as the most embarrassing and dangerous law of its kind in the nation.
The American Medical Association (AMA), long a supporter of sex-rejecting therapy and surgeries, has now endorsed restrictions. As reported by The New York Times on February 4, 2026, the AMA recommends deferring gender-related surgeries until adulthood, citing insufficient evidence for benefits in minors. This follows the American Society of Plastic Surgeons’ (ASPS) February 3, 2026, position statement, which advises delaying breast/chest, genital, and facial surgeries until at least age 19 due to “low quality/low certainty” evidence and potential long-term harms.
These reversals leave Minnesota more of an outlier. Our state has attracted families fleeing bans elsewhere, but the tide is turning nationally. A JAMA Network Open study (analyzing 2016-2020 data) identified about 3,600 patients aged 12-18 receiving gender-related surgeries, predominantly mastectomies—highlighting the scale of interventions now under new scrutiny.
On January 28th 2025, President Trump issued an executive order “Protecting Children from Chemical and Surgical Mutilation” aimed at eliminating sex-rejecting procedures performed on children. Trump lays out several deliverables in ordering departments “take all appropriate actions to end the chemical and surgical mutilation of children.”
HHS issued guidance in December 2025 to ban federal payments to hospitals if they continue to perform procedures including “pharmaceutical or surgical interventions of specified types that attempt to align a child’s physical appearance or body with an asserted identity different from their sex.”
Children’s Minnesota announced a pause in sex-rejecting procedures for children. On February 3, 2026, the hospital announced it will temporarily pause prescribing puberty-suppressing medications and pubertal hormones (estrogen and testosterone) for patients under 18 in its Gender Health program, effective February 27, 2026, if federal actions persist. This decision, driven by threats to federal funding, protects the state’s premier pediatric system and vulnerable children from irreversible and disfiguring procedures and treatments.
Critics of sex-rejecting therapies have consistently argued against rushing minors into life-altering paths that ignore biology, regret risks, and weak evidence. Minnesota must repeal its radical sanctuary provisions, align with emerging medical findings, and protect kids first. The island is shrinking—it’s time to embrace science and safeguard our kids.
