NEW YORK (AP) — New York Attorney General Letitia James on Monday told hospitals that they would be violating state law if they stop offering gender-affirming care for people under age 19 in response to an executive order from President Donald Trump aimed at curtailing federal funding for such treatments.

Gender-affirming care includes medical treatments that help align a person's physical characteristics with their gender identity.

In a letter, James, a Democrat, told health care facilities that refusing to provide the treatments would violate New York's anti-discrimination laws.

"Regardless of the availability of federal funding, we write to further remind you of your obligations to comply with New York State laws," her letter reads.

Trump, a Republican, last week signed an executive order that directed agencies to take steps to make sure that hospitals receiving federal research and education grants “end the chemical and surgical mutilation of children.” The language in the order characterized such treatments as “maiming,” “sterilizing” and “mutilation.”

The letter from James came as some hospitals in Colorado, Virginia and Washington, D.C., said they were pausing gender-affirming treatments for young people while administrators evaluate the order. The White House on Monday released a statement that said the executive order was “already having its intended effect.”

A spokesperson for the Greater New York Hospital Association said they were in close contact with member hospitals about the gender-affirming care executive order.

“That work is ongoing,” Brian Conway said in an email.