(WASHINGTON) — Some major medical associations are pushing back against the Department of Health and Human Services’ updated definitions of biological sex in federal policy in the wake of President Donald Trump’s executive order.
HHS issued new guidance on Feb. 19 where it said it “recognizes there are only two sexes: male and female,” adding: “HHS will use these definitions and promote policies acknowledging that women are biologically female and men are biologically male.”
“There is extensive scientific research that supports the complexity of sex and gender beyond binary classifications,” American Psychological Association CEO Arthur C. Evans Jr., Ph.D., told ABC News in a statement. “The new restrictive definition of sex ignores decades of science, increasing harm to youth and families, while undermining critical mental health outcomes.”
The new HHS guidance for the federal government defines “sex” as “a person’s immutable biological classification as either male or female.” It further defines “female” as “a person of the sex characterized by a reproductive system with the biological function of producing eggs (ova)” and “male” as “a person of the sex characterized by a reproductive system with the biological function of producing sperm.” It additionally defines the definition of a “woman” as “an adult human female” and a “man” as “an adult human male.”
The updated HHS guidance also includes definitions for “father” as describing a “male parent” and “mother” as describing a “female parent.”
The HHS guidance doesn’t mention intersex individuals — people born with sex characteristics that don’t fit typical definitions of male or female. The National Institutes of Health estimates that about .018% of the population is considered intersex.
The federal government previously defined “sex” in broader terms.
The Centers for Disease Control and Prevention, one of HHS’ agencies, defines sex as “an individual’s biological status as male, female, or something else. Sex is assigned at birth and associated with physical attributes, such as anatomy and chromosomes.”
The CDC’s website defines gender as “the cultural roles, behaviors, activities and attributes expected of people based on their sex.”
After Trump took office, the administration ordered the CDC and the Food and Drug Administration to remove certain public health websites, including the CDC’s page with more gender-inclusive definitions, which were then taken offline. A judge granted a temporary restraining order to restore the pages after organizations filed lawsuits.
A banner at the top of the CDC page currently states: “Per a court order, HHS is required to restore this website as of 11:59PM ET, February 14, 2025. Any information on this page promoting gender ideology is extremely inaccurate and disconnected from the immutable biological reality that there are two sexes, male and female.”
The HHS did not include its own definition of gender in its updated guidance posted Feb. 19.
The second Trump administration has issued a number of executive orders targeting the transgender population, and a number of lawsuits have been filed to challenge them.
Human biology is complex, and not all individuals fit neatly into binary categories, Evans told ABC News.
“We cannot just ignore the biological science that some people are born with a difference of sex development (DSD),” Evans said in his statement. “DSD are congenital conditions where the development of anatomical, chromosomal or gonadal sex is atypical. It is important that we support access to psychological and medical interventions for such individuals who do not fall into the male or female category, putting them at a higher risk of depression and anxiety.”
Evans also said the new HHS definitions excluded the concept of gender identity.
“It is crucial to recognize the psychological science on the validity of gender identity, as it allows for a more accurate understanding of individual experiences beyond the binary framework of biological sex,” he said. “Research consistently shows that affirming both sex and gender identity is vital for promoting mental health and well-being.”
In its updated guidance, HHS Secretary Robert F. Kennedy Jr. said the Trump administration “is bringing back common sense and restoring biological truth to the federal government. The prior administration’s policy of trying to engineer gender ideology into every aspect of public life is over.”
The American College of Obstetricians and Gynecologists said in a statement that it will not change its current definitions of sex and gender, and will use inclusive language “to recognize and affirm all people who seek and receive care from obstetrician-gynecologists.”
The ACOG also called on researchers to diversify studies by including gender-expansive participants and to report study participant characteristics inclusively by using language beyond traditional binary descriptors.
The American Academy of Family Physicians noted its long-standing policy on care for transgender and nonbinary patients, saying in a statement that it will continue to recognize that “diversity in gender identity and expression is a normal part of human existence and does not represent pathology.” It further asserted that “medical decisions are best made by patients, their families and their physicians, supported by medical evidence.”
The American Academy of Pediatrics said it will comply with all applicable executive orders as the law requires. “The AAP continues to hold that medical decisions are best made by patients, their families and their physicians, supported by medical evidence,” the organization said in a statement.
The American Medical Association’s policy on the Medical Spectrum of Gender, first enacted in 2018, appears to remain unchanged. It “affirms that an individual’s genotypic sex, phenotypic sex, sexual orientation, gender and gender identity are not always aligned or indicative of the other, and that gender for many individuals may differ from the sex assigned at birth,” according to the policy.
HHS spokesperson Andrew Nixon told ABC News the department has no comment.
ABC News has reached out to the White House for comment.
White House press secretary Karoline Leavitt said on Thursday, a day after HHS updated its guidance, that Trump “reestablished the scientific and biological truth that there are only two sexes in this country — male and female — that those are biologically based determinations. They are not based and can never be based on gender identity.”
Dr. Allia Vaez is a family medicine resident at Southern Regional AHEC and a member of the ABC News Medical Unit.
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