In April 2025, Attorney General Pam Bondi issued a memo titled “Preventing the Mutilation of American Children,” directing the Justice Department to target clinicians who provide gender affirming care. Let’s be clear: this memo is political, not scientific or legally binding. Clinical decisions continue to be guided by evidence-informed consensus—not political overreach.

What the Bondi Memo Does—and Doesn’t Do

What It Does:

• Directs DOJ attorneys to interpret gender affirming care as akin to female genital mutilation, using a federal statute intended for non-medical cultural practices to target clinicians. (https://www.healthlawadvisor.com/attorney-general-issues-guidance-to-u-s-department-of-justice-regarding-transgender-healthcare-for-children) 

• Orders investigations under the Food, Drug & Cosmetic Act (for alleged “misbranding” of puberty blockers or hormones) and the False Claims Act, targeting billing practices related to gender affirming care—even if that care is clinically indicated.(https://hooperlundy.com/doj-orders-investigations-into-gender-affirming-care-for-minors/) 

• Labels WPATH guidelines as “junk science” and instructs DOJ not to use them. (https://www.swlaw.com/publication/u-s-attorney-general-issues-memorandum-to-doj-regarding-enforcement-of-prohibitions-on-healthcare-for-transgender-children/) 

What It Doesn’t Do:

• It is not law—it cannot override state statutes or consensus clinical guidance.

• It doesn’t change hospital governance, insurer policies, or local scope-of-practice statutes.

• It lacks any scientific foundation and explicitly disregards the medical standards that clinicians rely on to deliver ethical, safe, affirming care.

Why the Memo Isn’t a Game-Changer for Clinical Care

1. Clinical standards live elsewhere
   Decisions are guided by bodies like the Endocrine Society, WPATH, UCSF—groups whose consensus is grounded in empirical evidence, community accountability, and patient autonomy.

2. Oversight is legal, not clinical
   The Bondi Memo mobilizes law enforcement, not care standards. Its investigative reach may force some institutions to pause services—but the guidance for individual care remains unchanged.

3. It creates a chilling effect, not clinical change
   Clinics like Children’s Hospital Los Angeles and Kaiser have paused services, not because of evidence, but due to fear of legal and financial retribution. (https://www.reuters.com/legal/government/us-states-sue-over-trumps-targeting-providers-transgender-youth-medical-care-2025-08-01/) 

What’s Real Power, and What You Can Do

What Clinician-Care Providers Can Do Right Now

• Document with clarity and values: Use language that centers evidence, autonomy, and patient goals, and that references clinical guidelines where relevant.

• Lean into peer networks and clinician-led groups: Share the reality—that the memo lacks scientific credibility—and build community resilience.

• Know your legal protections: Work with your risk, compliance, or legal collaborators to understand how state laws or court rulings may shield your work.

• Center human rights: Reaffirm—within care notes, discussions, and institutional planning—that decisions belong to patients and their care teams, not political offices.

The Bondi Memo wields intimidation. It sidesteps evidence, ignores consensus, and weaponizes law enforcement against care. But it cannot silence clinician-led, evidence-aligned, ethically grounded gender affirming care. Your work continues—rooted in shared decision-making, scientific consensus, and the values of body autonmy.