Termination of Gender-Affirming Care Grants at the National Institutes of Health

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Abstract
Importance: Gender-affirming care (GAC) improves the mental health and well-being of transgender and gender-diverse people. In January 2025, the Trump administration announced major National Institutes of Health (NIH) grant terminations, specifically aimed at defunding research related to transgender populations. Objective: To examine the scope, timing, and financial impact of NIH GAC grant terminations. Design, Setting, and Participants: This was a cross-sectional study of terminated and active federal research grants administered by the NIH, identified through the Grant Witness and NIH RePORTER databases. Inclusion criteria required that grants involve GAC outcomes or research related to its access or provision. Data were collected on May 12, 2025, and included funding status, dates of termination, and grant characteristics. Exposure: Termination of NIH grants related to GAC. Main Outcomes and Measures: Primary outcomes included the number and proportion of terminated grants, total funding lost, date of termination, and study focus. Results: Of 64 identified NIH grants related to GAC, 41 (64.1%) were terminated within a 3-week span ranging from March 3 to March 21, 2025. Among these terminated grants, 46.9% of their combined funding remained unspent at the time of cancellation, amounting to nearly $22 million lost in research dollars. Of the research topics that were terminated, the largest proportion focused on the interaction of GAC with physical health conditions (eg, breast cancer, HIV, cardiovascular outcomes). Conclusions and Relevance: Findings of this study illustrate the scope and depth of a targeted disruption to a vital area of scientific inquiry and health equity, emphasizing the need for insulated funding streams to preserve ongoing GAC research.

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