Trump wildly claims hospitals are performing ‘reverse surgery’ on trans patients ’at my order'

President Donald Trump falsely claimed Friday that American hospitals are performing “reverse surgery” on transgender people because he ordered them to do so.

“In fact, hospitals now are doing reverse surgery at my order,” Trump told supporters at the Myrtle Beach Convention Center in South Carolina. “They’re doing reverse surgery. Nobody ever heard about it.”

Trump made the claim while campaigning for U.S. Sen. Darline Graham ahead of Tuesday’s Republican primary runoff against Rep. Ralph Norman. Graham was appointed to the seat after her brother, Lindsey Graham, died in July. The winner will face Democratic nominee Dr. Annie Andrews, a pediatrician, in November.

Adrian Shanker, who served in the Biden administration as deputy assistant secretary for health policy and senior adviser on LGBTQI+ health equity at the Department of Health and Human Services, tells The Advocate that Trump’s confusion demonstrates why politicians should not make personal medical decisions.

“I don’t really know what President Trump means by reverse surgeries, but 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 says. “These kinds of decisions really don’t have room for politicians in the middle of that conversation.”

Trump’s “wild statement,” Shanker says, is evidence that politicians do not belong in the “patient-provider dyad.”

“For the party of small government, maybe they would consider trying to leave people’s health care decisions alone,” he says. “Trans people deserve access to the care that their bodies need, not the care that President Trump thinks that they need.”

Related: Donald Trump claims schools are performing gender-affirming surgeries on transgender kids. That's not true.

Graham turns a national security stumble into transgender obsession

The rally came days after Graham’s disastrous performance in a televised debate. Asked whether Taiwan and the South China Sea matter to American national security, Graham conceded that she did not understand the issue.

“I’m just going to be honest here,” Graham said. “I’m not that informed on national security.”

“National security is not my thing, not my area of expertise,” she continued. “But I do support the military.”

Graham also incorrectly said South Carolina had 50 million residents. The state’s population is about 5.5 million.

When Graham appeared on Sean Hannity’s Fox News program afterward, she attempted to recover by pivoting from her lack of national security knowledge to transgender athletes, as The Advocate reported.

“Of course, Taiwan is our friend,” Graham said. “But I think people in South Carolina are more worried about making ends meet. They are concerned about boys in girls’ sports.”

Trump continued that strategy Friday by making transgender people a central part of his argument for Graham. He attacked Andrews as a “far-left political hack who supports transgender for everybody” and accused her of telling “confused children they’re trapped in the wrong body.”

But Andrews has explicitly said she does not support gender-affirming surgery for anyone younger than 18. She supports evidence-based care decided among physicians, parents and patients. Andrews said last year that her position had not changed, WCSC reported.

Related: Trump orders NIH to study gender transition ‘regret.’ Here's what we already know about it

Trump’s orders restrict care — they do not mandate surgery

No presidential order requires hospitals to operate on transgender patients or reverse procedures they previously underwent. Trump’s executive actions have instead focused on cutting off care.

His January 2025 executive order targeting gender-affirming care directed federal agencies to withhold funding from institutions providing puberty blockers, hormones or surgery to people younger than 19. It did not direct hospitals to perform surgical reversals. Federal courts subsequently enjoined portions of its funding directives.

The Centers for Medicare and Medicaid Services separately finalized a rule this month ending federal Medicaid and Children’s Health Insurance Program payments for gender-affirming care provided to minors. The rule, scheduled to take effect October 13, permits federal funding for up to six months while some existing patients taper off hormones. It neither requires nor promotes surgery.

Dr. Demetre Daskalakis, chief medical officer at Callen-Lorde Community Health Center in New York City, rejects the idea that Trump should be directing clinical care. During the Biden administration, Daskalakis led the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases after directing its Division of HIV Prevention. He also served as deputy coordinator of the White House National Mpox Response.

“Medical decisions should be between medical providers and their patients and their parents,” Daskalakis tells The Advocate. “I am not familiar with nonclinicians, like the president, ordering clinical interventions at hospitals.”

Trump’s imagery of children routinely being operated on also bears little resemblance to available national data. A 2024 study published in JAMA Network Open examined insurance claims covering nearly 23 million minors. Researchers 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.

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.

The Endocrine Society’s guidance, for example, recommends against puberty blockers or hormones for prepubertal children and calls for trained mental health professionals and multidisciplinary medical teams to evaluate adolescents before treatment. None of those organizations describes children receiving routine surgery on demand.

Related: Second major U.S. hospital agrees to fund detransition services under settlement with Trump DOJ

What Trump may be confusing

Trump may have conflated those medical procedures with agreements his Justice Department has forced on two major hospital systems. Those 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 what federal officials called the country’s first “restorative care” clinic for detransitioners. The Houston hospital also agreed to terminate five physicians connected to its transgender health program and permanently revoke their privileges, as The Advocate reported.

The agreement came after federal and Texas officials accused the hospital of improperly billing insurers and government health programs for transgender-related care. Those allegations were not proven in court, and the settlement did not constitute an admission of liability.

Texas Children’s described the settlement as an act of institutional survival after producing more than 5 million documents and undergoing several investigations. In a statement subsequently deleted, the hospital accused state and federal officials of conducting “an unconscionable campaign of mistruths and mischaracterizations” and said it settled to protect its resources from “endless and costly litigation.”

Related: Trump administration caves to public pressure after avalanche of opposition to anti-trans hospital rule

The Justice Department secured a second agreement in June from the Cleveland Clinic, which pledged $2 million in services for people who received gender-affirming medical interventions before age 19 and later sought to detransition. Those services may include hormonal care, surgical revision or reconstruction, fertility care, counseling and insurance coordination.

But the Cleveland Clinic said it already offered such care and described the agreement as a commitment to continue providing it, not the creation of a new surgical program. It also agreed to pay $308,000 to resolve billing allegations it denied and to refrain from providing most gender-affirming care to minors for 20 years, although Ohio law already severely restricts that care.

Neither settlement requires any patient to detransition or undergo surgery. “Reverse surgery” is also 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.

“Hospitals really should not be agreeing to such nonsense,” Shanker says. “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.”