FBI Posts Ominous Call for "Tips" on Gender Affirming Care Providers

This is an alarming escalation by the Trump administration and it's campaign of eradication of trans people.

Today, the FBI tweeted a call for the public to report hospitals or clinics performing gender-affirming surgeries on minors. Framing these treatments as "mutilation," the Bureau directed tips to 1-800-CALL-FBI tipline, launching an unprecedented intrusion of federal law enforcement into personal medical decisions. Coming during Pride Month, this tweet marked a federal escalation against trans healthcare and struck many as authoritarian, drawing on past tactics where governments encouraged citizens to inform on one another.

This is not about legitimate law enforcement, but rather a blatant attempt at intimidating healthcare providers and forcing clinics to halt care even in states where it remains legal. Worse yet, the FBI was deeply involved in protecting gender affirming care clinics from death and bomb threats over the last three years. Not only will the FBI go after clinics, they will most certainly abandon efforts to investigate threats made to clinics and providers.

Gender-affirming surgeries, while rare in minors, are supported by the American Medical Association, American Academy of Pediatrics, and other professional bodies. These organizations consider such care medically necessary for some patients with gender dysphoria.

The legal basis appears rooted in 18 U.S.C. §116, a statute originally intended to combat female genital mutilation (FGM). That law criminalizes the non-medical cutting of a minor’s genitals but explicitly exempts procedures deemed "necessary to the health of the person" and performed by licensed professionals. Until now, it was never applied to gender-affirming care. It's unclear how it could even apply in this context. The only surgeries performed on trans teens under 18, in extremely rare circumstances, are top surgeries which don't even involve genitals. Outside of top surgery, there are essentially no reported instances of bottom surgery being conducted on trans minors.

The reinterpretation of FGM to target gender affirming care stems from President Trump's January 2025 Executive Order 14187, "Protecting Children from Chemical and Surgical Mutilation." The order calls for vigorous enforcement of laws against youth gender transitions, including §116. Though the statute is tailored to prevent involuntary cultural practices, the administration is attempting to redefine gender-affirming surgeries as non-medical and thus criminal.

It's not clear how this statute could apply at all given that it explicitly defines FGM as:

(e) For purposes of this section, the term “female genital mutilation” means any procedure performed for non-medical reasons that involves partial or total removal of, or other injury to, the external female genitalia, and includes—
(1) a clitoridectomy or the partial or total removal of the clitoris or the prepuce or clitoral hood;
(2) excision or the partial or total removal (with or without excision of the clitoris) of the labia minora or the labia majora, or both;
(3) infibulation or the narrowing of the vaginal opening (with or without excision of the clitoris); or
(4) other procedures that are harmful to the external female genitalia, including pricking, incising, scraping, or cauterizing the genital area.

The statute itself is extremely clear on what constitutes FGM. It shouldn't take a physician to understand that breasts are not genitals. It would be more difficult still to make a legal argument that a procedure carried out by medical professionals in a manner endorse by every major medical association, cannot logically be considered "non-medical" in nature. That doesn't mean they won't try. Using §116 in this way not only distorts the law's purpose but also violates fundamental constitutional protections.

The most concerning aspect is the potential for federal prosecution in blue states. Over a dozen states, including California, New York, and Illinois, have enacted shield laws protecting providers of gender-affirming care. These laws block cooperation with out-of-state investigations and prohibit extradition related to trans healthcare.

Unfortunately, federal law supersedes state protections. By invoking a federal criminal statute, the FBI could investigate and prosecute providers anywhere, even in states with strong legal protections. This amounts to a federal override of state healthcare policy and creates a chilling effect across the country.

Several clinics in blue states have already ceased providing care in anticipatory obedience of the executive order and threat of prosecution despite a court enjoining its enforcement in several states. reported increased fear and cancellations of appointments. Providers are unsure if routine procedures could now trigger federal scrutiny. While actual prosecutions may be rare, the threat alone can dissuade care.

The FBI’s actions can be linked to the executive order. The order labeled gender-affirming procedures as "maiming and sterilizing" children and called on federal agencies to deny funding to any institutions involved in this care. It directed the Attorney General to pursue criminal charges and review enforcement of existing laws. The only criminal charges mentioned in the Executive Order and ones that could be cited were the ones regarding FGM. However, the administration could also pursue fraud charges based on insurance billing as Ken Paxton has done in Texas. It would turn routine billing codes into criminal jeopardy.

On April 22, 2025, Attorney General Pam Bondi followed up with a memo instructing the FBI and U.S. Attorneys to pursue charges under §116. The administration's position is clear: gender-affirming care for minors should be treated as criminal conduct, not medicine.

Federal judges in Maryland and Washington have issued preliminary injunctions blocking parts of EO 14187, citing constitutional concerns. However, with the Skrmetti case days away from being decided by the Supreme Court, what little judicial check on anti-trans government actions may be obliterated. While the administration has argued in court that it has no "immediate plans" to use §116 this way, but the FBI's tweet directly contradicts that claim.

Regardless of whether charges are filed, the FBI's message is about intimidation. Encouraging anonymous tips casts a shadow over medical providers, potentially criminalizing doctors simply for following best practices endorsed by every major medical association. The administration is seemingly making the bet that when faced with abandoning trans youth or facing prison, providers will do the former. In many cases, they've already been proven right.

Trans youth and their families are the ones caught in the crosshairs. Suicide prevent hotline traffic has surged as families fear being targeted. Some are exploring out-of-state or even international options for care while others are actively fleeing the United States. Worse yet, many worry about whether their child’s medical records could be used as evidence in a federal criminal investigation.

The use of the FBI to police gender-affirming care recalls darker chapters in U.S. history. During the Lavender Scare, federal agencies purged LGBTQ+ employees as anonymous tips fueled a culture of suspicion and surveillance. The government now appears to be reviving those tactics under a modern re-implementation of the Lavender Scare.

This campaign also mirrors state-sponsored vigilante systems, like Texas 2022 attempt to ban care by fiat and requiring mandated reporters to report any trans child they came across. The goal is not just enforcement but fear. By deputizing the public to surveil and report on each other, the government creates a culture of silence and repression.

The current anti-trans campaign by the Trump administration is not about protecting children but about eradicating trans people from public life. Denying care, criminalizing providers, and vilifying families does not protect children—it endangers them.