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Aerial view of the University of Michigan Hospital Campus
Gender-affirming care remains legal in Michigan, but Donald Trump’s attack on trans people is making it harder to access.
The Trump administration’s intensifying campaign against transgender Americans’ access to health care has forced one of the nation’s largest hospital systems to retreat. The University of Michigan confirmed that it has suspended puberty blockers and hormone therapy for patients under 19 after receiving a subpoena from the Department of Justice last month.
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“The University of Michigan, including Michigan Medicine, is one of multiple institutions across the country that has received a federal subpoena as part of a criminal and civil investigation into gender-affirming care for minors,” the system said in a statement to Talking Points Memo. “In light of that investigation, and given escalating external threats and risks, we will no longer provide gender affirming hormonal therapies and puberty blocker medications for minors.”
Related: Trump DOJ demands private medical information of transgender patients
The July 14 subpoena warned administrators and doctors that both civil and criminal liability could follow. Physicians were instructed not to destroy records. One source told TPM the order was understood as a direct threat of prosecution.
The impact in Michigan is immediate. The university’s health system is one of only two major providers of gender-affirming care in the state. “It would leave a big hole in services,” Rachel Crandall Crocker, cofounder of TransGender Michigan, told TPM. “A lot of people would be out of luck.”
Michigan’s decision is part of a wider pattern. An NBC News analysis found that at least 21 hospitals and health systems have ended or restricted youth gender-affirming care since January. Some shuttered programs entirely; others removed public information about services from their websites. The common denominator is fear — fear of federal subpoenas, of drawn-out investigations, and above all, of losing the federal dollars that sustain nearly every major medical system in the United States.
The Justice Department has made clear that facilities accepting Medicaid or Medicare funding risk those reimbursements if they continue treating trans youth. Administrators warn that losing even a fraction of federal support could destabilize their operations.
Related: Children’s National Hospital caves under Trump’s pressure & ends gender-affirming care for trans patients
Children’s National Hospital in Washington, D.C., announced this summer it would discontinue medications for minors, citing “escalating legal and regulatory risks.” Children’s Hospital Los Angeles, home to one of the country’s oldest gender clinics, closed its youth program in July after leadership warned that federal agencies had already cut off “hundreds of millions of dollars from U.S. academic and research institutions for noncompliance with executive orders, often with little to no warning,” NBC News reports.
Attorney General Pam Bondi announced in July that the DOJ had issued more than 20 subpoenas nationwide, accusing providers of “mutilating children in the service of a warped ideology.” The orders have demanded extraordinary amounts of private information. One subpoena to the Children’s Hospital of Philadelphia sought billing documents, doctors’ notes, encrypted texts, and even patients’ Social Security numbers and home addresses dating back to 2020. Advocates called the demands “breathtakingly invasive.”
Related: Trump’s DOJ subpoenas doctors and medical clinics that care for transgender youth
Michigan Attorney General Dana Nessel, a lesbian, has joined a multistate lawsuit accusing the administration of overstepping its authority and unlawfully intimidating providers. “The Trump Administration is attempting to strip away lawful, essential healthcare from vulnerable youth,” Nessel said in a statement announcing the suit. “These orders are illegal and dangerous and have no medical or scientific basis. I will continue to protect families, defend doctors, and stop politicians from putting our kids’ lives at risk.”
The complaint argues that the DOJ’s tactics violate the Constitution by attempting to impose a national ban where Congress has not acted, usurping states’ authority to regulate medical care. Equality Michigan praised the move, saying the administration was “using funding as a weapon to force providers to abandon their patients and override parents’ rights to make health care decisions for their own children.”
The retreat by the University of Michigan captures the chilling reality: even in states where care is legal, the federal government’s threats are pushing hospitals to abandon patients. The result is not simply a shift in policy but a profound rupture in the doctor-patient relationship, one that forces families into exile or desperation.
The collapse of access is leaving families with wrenching choices. One Florida mother told NBC News she is moving to Germany so her 15-year-old daughter can continue treatment. After years of traveling across state lines to find care, the family concluded that leaving the country was the only option.
Christopher Street Project executive director Tyler Hack responded to the Trump administration’s ongoing threat to transgender people’s health care in a statement. The Christopher Street Project is a pro-trans political action group. “Playing political games to collect and weaponize Americans’ private healthcare information is not just an attack on trans people — it is an attack on every single American who benefits from basic patient-provider privacy and our most fundamental freedoms. Hospitals, administrators, and doctors have a moral obligation to stand up to this power grab and hold the line to protect their patients.”
Editor’s note: This article has been updated with additional reporting.
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