Project 2025 creator calls for nationwide ban on gender-affirming care for trans adults

Heritage Foundation president Kevin Roberts has publicly endorsed outlawing gender-affirming care for transgender adults, extending a campaign that has already helped drive bans on such care for minors across much of the United States.

Speaking on the PBD Podcast, Roberts said the right-wing think tank is “running the numbers” on an alleged link between gender-affirming surgeries and acts of violence. His proposed policy response was blunt: “You outlaw it.”

Roberts claimed there is internal debate only over how to treat adults, asserting that “so-called transgender surgery is bad for anybody because of what you saw in Rhode Island yesterday,” a reference to a recent mass shooting in which three people, including the gunman, were killed and three others critically injured. Law enforcement officials have described that attack as a targeted, domestic incident and have not tied it to gender identity or medical treatment.

“There does seem to be a mounting body of evidence that suggests a correlation between that surgery at any age, mental health issues, and increasingly, although we’re running the numbers on this at Heritage, acts of violence,” Roberts added, without citing any peer-reviewed research. Existing data directly contradicts his suggestion.

A review by the U.S. Secret Service National Threat Assessment Center of 172 mass attacks between 2016 and 2020 found that 96 percent of perpetrators were cisgender men. Reporting by The Advocate has further shown that among more than 4,600 mass shootings from 2014 to 2024, at most six involved transgender suspects—about 0.128 percent. With trans people making up roughly one percent of the U.S. population, they are statistically less likely than the general public to be mass shooters.

By contrast, the medical and scientific consensus strongly supports gender-affirming care as safe, effective, and often life-saving for both adults and youth. The American Medical Association, American Psychiatric Association, American Academy of Pediatrics, American Academy of Child & Adolescent Psychiatry, World Medical Association, and World Health Organization all recognize gender-affirming care as evidence-based and medically necessary.

Multiple studies have found that trans youth who are allowed to socially transition and receive appropriate treatment for gender dysphoria experience significant reductions in depression and anxiety. Numerous longitudinal studies of trans adults likewise show substantial, sustained improvements in mental health and quality of life following gender-affirming care. A review of 55 peer‑reviewed studies found no evidence that transition produces overall negative outcomes.

Despite this, the Movement Advancement Project reports that 26 states now ban gender-affirming care for minors. In 11 states, coverage is already curtailed for adults through Medicaid exclusions and related restrictions. Roberts said he favors going further.

“We like that idea, too,” he said of expanding bans to adult care. “We often work toward an ultimate goal via incremental steps—sometimes people will call us radical incrementalists. We’re willing to take a quarter of the enchilada if we can keep working there. So if that’s the kind of thing that policymakers can agree on left and right, Heritage would be fully supportive of that, knowing that ultimately we have an ideal position that would be much stronger than that.”

The Heritage Foundation, a powerful conservative policy shop, has extensive ties to former President Donald Trump and his movement. According to Media Matters for America, the group boasts that Trump adopted more than 64 percent of its policy recommendations and that over 60 of its experts served in his administration. LGBTQ+ media advocacy group GLAAD has designated Heritage an anti-LGBTQ+ hate group.

Heritage is the driving force behind Project 2025, a sweeping blueprint to remake the federal government along hard-right lines. The agenda includes purging career civil servants, installing ideological loyalists, restricting abortion and contraception access, dismantling the Department of Education, eliminating diversity and inclusion programs, and rolling back LGBTQ+ rights. Many of its proposals are already being pursued by aligned lawmakers and advocacy networks.

Roberts himself has longstanding ties to far-right Catholic traditionalism, including reported involvement with the secretive group Opus Dei, whose members are known for practices such as corporal mortification, including self-flagellation. He has faced accusations—denied by Roberts but reportedly corroborated by former colleagues at New Mexico State University—that he once bragged at a dinner party about killing a neighbor’s dog with a shovel while working there as a history professor.

LGBTQ+ advocates and major medical bodies warn that the push to criminalize or dismantle gender-affirming care for adults as well as minors represents an accelerating campaign to strip transgender people of basic healthcare, bodily autonomy, and equal participation in public life—despite overwhelming scientific evidence that such care improves, rather than harms, mental health and safety.