After Trump order, hospitals suspend some health care for trans youths

Children’s National Hospital this week suspended all new prescriptions, refills and medication administration for trans minors in an effort to comply with an executive order issued by the Trump administration that is prompting providers across the D.C. region and beyond to scale back care, hospital officials said.

The Northwest Washington hospital and others, including the University of Virginia and Virginia Commonwealth University health systems, paused prescriptions of puberty blockers and hormone therapy as providers and state officials assess the Tuesday order that seeks to end federal support for gender transition care for people younger than 19.

Outside of the region, Denver Health in Colorado has paused gender-affirming surgeries as well.

The mother of a middle-schooler who is receiving care at the Children’s National gender clinic and has an upcoming follow-up appointment said her family is scrambling to find another provider for care she described as critical to her daughter being who she is.

Another mother of a former clinic patient said she learned of the change on Wednesday when the parent of a child receiving treatment told her the child’s medication appointment was canceled.

Gender transition care, including medications, has been called lifesaving by patients and providers and is endorsed by most major medical associations. Certain medications give patients time to assess their situation before starting more intense interventions, such as hormones.

“We understand the change is upsetting, and recognize how difficult this is,” Children’s National officials said in a message to patients and families Thursday. “We hope we can work together to navigate this evolving situation. We know you have specific questions about your care, and we are working to understand the full impact of the order.”

Access to mental health counseling, social support and other resources will continue uninterrupted, the message says. Providers are still seeing patients in the clinic to discuss care and the hospital does not plan to cancel appointments, it continues.

“While we don’t have all the answers right now, we are taking the time to make thoughtful, measured decisions in the best interest of our patients, staff and organization,” the message says. “We thank you for your trust and patience while we navigate these changes and will update you as soon as possible.”

In Virginia, UVA Health and VCU Health systems scaled back or suspended care for patients under 19 to comply with the executive order. At UVA Health in Charlottesville, all gender-affirming care has been suspended, a hospital spokesman said in a statement.

“Like many health systems across the country, the University of Virginia and UVA Health are working to analyze and interpret the federal order and related state guidance, as well as monitoring other potential policy changes and impacts to ensure we are always delivering care in accordance with the law,” the statement says.

VCU Health and the Children’s Hospital of Richmond at VCU suspended gender-affirming medication and surgical procedures, according to a statement. The decision was made “in response to clear guidance from the state provided to VCU,” it adds.

Virginia Attorney General Jason Miyares (R) wrote in a memo on Thursday to UVA and VCU that any hospital or state agency that “continues to perform chemical and surgical mutilation of children,” risks losing all federal medical and research grants.

“Any institution that continues to engage in such mutilation unacceptably and unjustifiably endangers not only itself and the Commonwealth, but also the vulnerable children of this Commonwealth,” he said in the guidance.

But some LGBTQ+ advocates and others have challenged such moves.

“Premature actions from some hospitals to stop providing critical care for transgender youth cannot and must not be the response,” Omar Gonzalez-Pagan, senior counsel and health care strategist at the advocacy group Lambda Legal, said in a statement. “State attorneys general and other state officers should bear in mind the binding laws that prohibit this kind of discrimination. We will soon be challenging this latest travesty in court.”

The moves come as the Trump administration makes sweeping changes to roll back care and protections for transgender people. Hours after taking office, President Donald Trump signed an order to officially recognize only male and female sexes and directed agencies to issue government documents showing people’s sex at conception, among other changes. He also directed revisions to the Pentagon’s policy on transgender troops, which could lead to a future ban on their military service and has already been challenged in court.

In addition to attempting to cut Medicare and Medicaid funding to health providers that offer gender transition care to minors, the order titled “Protecting Children from Chemical and Surgical Mutilation” directs federal officials to ensure that medical schools and hospitals that receive federal grant money stop providing gender transition care to minors.

In the past five years, more than half of states have banned doctors from offering transition health care to minors, including medication. Most transgender children do not take medication to assist with their transition.

At Children’s National, the Gender Development Program does not provide gender-affirming surgery for anyone underage 18 and does not provide hormone therapy to children before puberty begins, according to the clinic’s website. Parental consent is required to provide gender-affirming medical care to a minor in the District.

The hospital’s Youth Pride Clinic provides primary and specialty care services to lesbian, gay, bisexual, transgender and questioning/queer (LGBTQ) patients in the Greater Washington region. A spokeswoman declined to say how many patients would be affected by the change.

There is no national data on the number of trans children who take medications, but data from a handful of hospitals shows many patients with gender dysphoria do not take them. About one-third of 3,300 patients receiving treatment for gender transition care at Ohio hospitals over 10 years were prescribed hormones and 65% never received any medication, according to the president of the Ohio Children’s Hospital Association.

The abrupt suspension of care because of the order and other measures to unwind protections left many families reeling, said parents who requested anonymity to protect their children’s identities amid attacks on trans people.

The mother of the middle-schooler said she worried before the election that her daughter’s care could be suspended because of comments Trump made during his presidential campaign.

“It’s heartbreaking because it’s hard enough to feel like you’re trying to be a girl and fit in,” she said, “but to have all of this hatred coming your way. She can’t even understand why people are so hateful, she just wants to be a girl.”

The mother of a son who received gender-affirming care at Children’s National for years said clinic providers assured parents in a virtual call weeks after the election that they have been working for years with hospitals around the country and would do their best to protect patients.

She praised the “extraordinary care” her son has received and said treatment “literally saved my kid’s life” after he was suicidal.

When her son came out as trans, she said, it never occurred to her and her husband that the government would start making their lives harder.

“In (the) last nine days, the government issued three disgusting pieces of paper on White House stationery saying the most disgusting things about trans people,” she said. If her son were younger, she said, “I don’t know that I would have let him out of my sight.”

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Casey Parks contributed to this report.