rewrite this title California’s largest children’s hospital system ends gender-affirming care for youth

Two hospitals in California are discontinuing hormone treatments for transgender youth, citing Trump administration pressures. In the past year, many hospitals and clinics have scaled back that care.

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As of today, the largest children’s hospital system in California is no longer offering gender-affirming hormone therapy to those under 19. That’s after a series of actions from the Trump administration pressuring medical providers across the country to end care for transgender youth. Kevin Tidmarsh of member station LAist has more. And a warning – this story mentions suicide.

KEVIN TIDMARSH, BYLINE: San Diego father Brett (ph) says about four years ago, his child was in a deep depression. At first, he didn’t know why. Then his 11-year-old kid told the family he was a boy, not a girl. Brett spoke to NPR on the condition that we only use his first name. He’s concerned about his family being targeted by the federal government. Brett says things got better after his son came out.

BRETT: He just blossomed.

TIDMARSH: He had more energy. He made more friends. He threw himself into hobbies. And about a year and a half ago, he started getting hormone treatment at Rady Children’s Hospital, San Diego. Brett says they were happy with their doctor.

BRETT: She was really, really, overwhelmingly loving.

TIDMARSH: He says after starting hormone treatment, his son came out of his shell even more. Then, about two weeks ago, the health care system that runs the hospital where they got care, Rady Children’s Health, told families they were discontinuing gender-affirming hormone therapy for people under 19. It affects two big hospitals in Southern California and almost 1,500 patients.

BRETT: The whole world kind of dropped out from under me.

TIDMARSH: In a statement, Rady said this was because of escalating federal actions, including a recent referral to the U.S. Department of Health and Human Services Office of Inspector General for investigation. Over the past year, the Trump administration has taken numerous actions to limit youth access to gender-affirming care, arguing that it harms children. That includes two rule changes proposed in December by the U.S. Centers for Medicare and Medicaid Services. If adopted, they would cut federal funding for hospitals that provide gender-affirming hormone treatment or surgery to minors.

BRETT: The staff in the clinic are just unbelievably wonderful, but they don’t have real control over whether or not they care for us.

TIDMARSH: NPR reached out to the U.S. Department of Health and Human Services for comment. They said in an emailed statement that gender-affirming care did not meet professionally recognized standards of health care. The American Academy of Pediatrics, the Endocrine Society and the American Psychological Association have all opposed that view, saying that this care is evidence based and necessary for trans mental health. The American Society of Plastic Surgeons has recommended delaying gender-related surgeries until age 19, but only a small number of transgender minors seek surgery. The federal actions have led more than a dozen hospitals nationwide to end gender-affirming hormone therapy to youth in the last year.

KELLAN BAKER: That’s unfortunately a really scary situation.

TIDMARSH: Kellan Baker is with the Movement Advancement Project, a think tank that tracks LGBTQ policy. He says the proposed rules that would cut federal funding for hospitals that perform this care are particularly concerning.

BAKER: About 50% of the funding for hospitals in states across the country comes from federal programs like Medicare and Medicaid.

TIDMARSH: Half a dozen gender-affirming care providers contacted by NPR either didn’t respond or declined to comment. But Alex Sheldon, the executive director of the LGBTQ medical association GLMA, has been in touch with hundreds of providers all over the country. They say that some who work at institutions that discontinue trans youth care have heard from terrified patients, like one nurse who was told by a parent…

ALEX SHELDON: That if their young person dies by suicide because they cannot get access to treatment, that it would be that nurse’s fault.

TIDMARSH: Sheldon says private providers can help fill in the gaps, but they can’t replace large hospitals, which can see a lot more patients and research and develop best clinical practices. Brett in San Diego has been working with a local nonprofit to find a private provider, but…

BRETT: There’s only one in the county that we’ve been able to identify.

TIDMARSH: He’s not even sure if they can treat his son. His family is exploring the idea of moving abroad. Meanwhile, California’s attorney general, Rob Bonta, has filed a lawsuit trying to restore the care at Rady Hospital specifically with a permanent injunction. But for now, families are looking elsewhere for care. For NPR News, I’m Kevin Tidmarsh in Los Angeles.

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