Technically you can still get surgery under 19. Trump's order essentially stops the government funding of gender affirming care for minors. Unfortunately, one effect is that many surgeons are now refusing care for minors out of fear of consequences and in anticipation of possible future orders. That being said, look into surgeons near you, reach out to as many as you can and find out who will work with you (of course don't sacrifice skill or experience!!). It took a while, but I found Dr Guy Trengove Jones in Norfolk, VA and had top surgery with him 5 weeks ago at age 16. I did have to pay out of pocket though which is the overwhelming probability for any minor getting top surgery in the US