In a year marked by fierce debate over gender identity and children’s rights, Alaska has stepped onto the national stage with a bold move: On August 23, 2025, the Alaska State Medical Board released a draft regulation that, for the first time, formally defines boys and girls strictly by biological sex at birth. The proposal would prohibit doctors from providing medical interventions that seek to alter a patient’s biological sex in anyone under 18, a decision that’s already sending ripples through the medical and political communities.
According to the draft, any physician offering medical or surgical interventions for gender dysphoria in minors—including puberty blockers, cross-sex hormones, mastectomy, phalloplasty, and genital modification procedures—would be engaging in what the board calls “unprofessional conduct.” Such a violation could lead to disciplinary action, up to and including suspension or revocation of a medical license. There are only two exceptions: treatment for congenital sex development disorders (intersex conditions) and non-elective procedures required after physical injury.
The board’s move is more than just a tweak to medical regulations. By embedding the prohibition into the “unprofessional conduct” section, the Alaska State Medical Board is equipping itself with the authority to discipline licensees who facilitate gender transition treatments for minors. The draft rules are now subject to the state’s regulatory process, which includes a public comment period. Only after reviewing those comments can the board make revisions and send the regulation for final approval and implementation.
These changes come on the heels of a year of intensifying national debates around transgender rights, particularly in schools. Across the country, many public school districts continue to implement transgender policies—even as former President Trump’s executive orders threaten federal funding cuts for schools that refuse to eliminate transgender ideology from their curricula and practices. These orders demand the removal of policies that allow males in girls’ sports and bathrooms, and that support social transitions, such as using new pronouns or permitting students to use facilities that align with their gender identity rather than their biological sex.
Some districts, especially in red states, have complied. In Nebraska, for example, Bellevue Public Schools reversed its 2015 transgender policy after calculating the risk of losing $10 million in federal funding. Superintendent Jeff Rippe explained, “$10 million is what we get in federal funding. And that means a lot to this school district. Speaking personally, we cannot afford to lose $10 million.” According to The Daily Wire, concerned parents played a significant role in the district’s decision to revert to requiring bathroom use based on biological sex, and to permit teachers to disclose a child’s transgender identity to parents.
But blue states like California, Maine, and Minnesota are openly defying Trump’s orders, resulting in a tangle of lawsuits. Minnesota was the first to sue the Trump administration in April over the transgender sports order. California, meanwhile, has chosen to follow its own laws regarding males in girls’ sports, even after the Education Department found the state in violation of Title IX. When California missed a federal deadline to comply, the Justice Department sued, signaling a possible end to the state’s education funding if it maintains its stance. As Sarah Parshall Perry of Defending Education told The Daily Wire, “Governor Gavin Newsom has not only not read the room right, he’s actually not following what both the Constitution’s Supremacy Clause and Title IX’s actual direct text indicate he needs to do.”
Similar battles are playing out in Maine, where Governor Janet Mills told Trump, “We’ll see you in court,” after he criticized Maine’s policy of allowing males in girls’ sports. The Education Department has since found Maine in violation of Title IX and is pursuing litigation to end the state’s federal education funding. Investigations are also ongoing in Massachusetts, Oregon, and several other states and districts—including Chicago Public Schools and four Kansas districts—for similar transgender policy violations.
In Virginia, the standoff reached a fever pitch this August. Five northern Virginia school districts, serving nearly 400,000 students and receiving over $50 million in federal funds, announced they would keep their transgender policies despite being found in violation of Title IX. Loudoun County Public Schools, already a flashpoint after a high-profile sexual assault case in a girls’ bathroom, led the charge. The board voted 6-3 to retain its policy, with other districts quickly following suit. The Education Department has threatened to pull federal funding from these districts, while an agency spokesperson stated, “The Virginia districts will have to defend their embrace of radical gender ideology over ensuring the safety of their students.”
Not all policy disputes are so public. More than 21,000 schools have or had policies to hide children’s transgender identities from parents, according to Defending Education’s database. Many of these policies remain in place, often quietly, as local administrators hope to avoid scrutiny. Corey DeAngelis, a school choice advocate, told The Daily Wire, “Top-down orders aimed at rooting out gender ideology from our schools are welcome developments. They’re a step in the right direction. But they are not efficient, because rogue public school employees will continue to skirt the law behind closed doors, and enforcement can prove to be very difficult.”
Back in Alaska, the Medical Board’s draft regulation also addresses abortion. The board approved a statement declaring that abortions performed just prior to delivery are typically unethical, even though Alaska law currently allows elective late-term abortions up to the moment of birth. The statement reads: “Alaska state law allows for elective late term abortions, up until the time of delivery. The Alaska State Medical Board believes this is not ethical medical practice and does not embody the values of Alaskans. Many Alaskans and even physicians are unaware of this. We encourage Alaskans to engage with their representatives and to advocate for new legislation to bring state law into alignment with community values on this issue.”
The regulatory changes come in the wake of the U.S. Supreme Court’s June 2025 decision to uphold Tennessee’s law banning medical treatments for minors seeking gender transitions. The Court ruled that such laws do not automatically violate the Constitution’s Equal Protection Clause, paving the way for similar state-level actions. Alaska’s medical board, earlier this year, had unanimously urged the legislature to outlaw chemical castration and surgical gender transition treatments for minors, though legislative action stalled amid political opposition.
Legal challenges are almost certain: the American Civil Liberties Union (ACLU) and other advocacy groups are expected to argue that the proposed Alaska regulation violates the state constitution’s privacy clause. If adopted, the policy would put Alaska at the forefront of a growing movement among conservative states to restrict transgender medical interventions for minors, while also highlighting the deep divides—both political and cultural—that continue to shape the national conversation about gender, children, and parental rights.
For now, Alaskans and school communities across the country are left waiting—watching as the regulatory process unfolds, and as the courts weigh in on what may prove to be one of the most consequential social issues of the decade.
