Hospitals dodge questions on restoring trans youth care despite judge ruling they can keep providing it

Many hospitals that cut off youth from gender-affirming care over concerns around the Trump administration are remaining silent on whether they will resume care, despite a federal court giving their programs legal clearance.

Last December, Robert F. Kennedy Jr., President Donald Trump’s secretary of the U.S. Department of Health and Human Services, directed hospitals across the country to stop providing minors gender-affirming care, or risk losing funds from federal health programs like Medicaid. But on April 18, a federal judge in Oregon struck down the policy, ruling that Kennedy had overstepped the federal government's role and created inconsistencies with existing laws.

Health care experts and LGBTQ+ advocates widely panned Kennedy’s directive on gender-affirming care for minors as legally invalid. Still, several hospitals across the U.S. complied in advance of any funding repercussions, cutting off trans youth from care. And, despite the recent court decision, there have been few signs that these hospitals are outwardly reopening their gender-affirming care services to trans youth.

Related: Children’s National Hospital caves under Trump’s pressure & ends gender-affirming care for trans patients

“RFK Jr. literally made up a process where he could sign a declaration and declare gender-affirming care to be, in his view, unsound,” Adrian Shanker, who served as deputy assistant secretary for health policy under President Joe Biden, told The Advocate. “Unfortunately, many hospitals discontinued care preemptively.”

The Advocate reached out to several hospitals that eliminated gender-affirming care for minors under the Trump administration to ask about the future of their health programs for trans youth in light of the court decision.

That included University of Michigan Health; Fenway Health in Boston; Rady Children’s Health in San Diego; Yale New Haven Health and Connecticut Children’s Medical Center in Connecticut; NYU Langone and Mount Sinai in New York; and Children’s National Hospital in Washington, D.C.

Mount Sinai declined to comment on the court ruling when reached by The Advocate. None of the other hospitals returned requests for comment.

While the judge’s decision affirms that hospitals cannot lose federal funding for offering gender-affirming care to trans youth, it does not require them to offer these services or to reopen youth health programs they closed. Some states, like New York, may have laws requiring hospitals to provide access to gender-affirming care, but many do not, Shanker said.

“We’re not going to have a clear resolution about trans care in the United States very soon,” he said. “There’s going to be additional Trump administration actions [and] court cases leading to judicial decisions.”

There have been signs that gender-affirming care will return in some settings. Children’s Minnesota has already reestablished its trans health program for youth in light of the court decision, and New York Attorney General Letitia James has ordered New York hospitals to maintain access to gender-affirming services in order to comply with state nondiscrimination laws.

Related: University of Michigan latest hospital system to abandon trans minor patients & families after DOJ subpoena

Still, Kennedy’s push to restrict gender-affirming care comes as the Trump administration, and the Republican Party more broadly, take aim at transgender residents’ rights around health care, education, and even daily life.

In December, the U.S. House of Representatives passed a bill blocking Medicaid from covering gender-affirming care for youth, although the bill has not been voted on by the U.S. Senate. Meanwhile, hundreds of bills proposed in state legislatures this year alone target discussions of gender identity in the classroom, trans bathroom access, and gender markers on government ID cards, according to the American Civil Liberties Union.

Related: Maryland judge: Trump's DOJ can’t have trans youth hospital records

While hospitals debate the future of their gender-affirming care programs, trans youth across the country remain cut off from health services, or else must find alternate methods of receiving care.

“Despite the rhetoric from the Trump administration, we actually know that gender-affirming health care saves lives,” Shanker said. “Unfortunately, it’s patients who experience the worst impacts when care is not available.”

This article was written as part of the Future of Queer Media fellowship program at The Advocate, which is underwritten by a generous gift from Morrison Media Group. The program helps support the next generation of LGBTQ+ journalists.