Kaiser Permanente ends gender-affirming surgeries for patients under 19

Kaiser Permanente will no longer provide gender-affirming surgeries to patients under the age of 19 after facing legal pressure from the Trump Administration.

“After significant deliberation and consultation with internal and external experts including our physicians, we’ve made the difficult decision to pause surgical treatment for patients under the age of 19 in our hospitals and surgical centers,” the nonprofit said in a statement via Oregon Live Wednesday. “We recognize that this is an extremely challenging and stressful time for our patients seeking care, as well as for our clinicians whose mission is to care for them."

Kaiser will stop offering the surgeries as of August 29, but said that it will still offer other gender-affirming care, stating, "We will remain a voice and advocate for safe, high-quality, and evidence-based care for transgender patients.”

Gender-affirming surgeries among minors are incredibly rare. There is no evidence of surgeries being performed on trans youth under the age of 12, according to a recent study in JAMA, and only 2.1 out of every 100,000 trans youth ages 15 to 17 received surgery — the vast majority being chest surgeries. Out of 151 breast reductions performed on American minors in 2019, 146 (97 percent) were performed on cisgender males.

Gender-affirming care for prepubescent youth primarily focuses on socially transitioning — changing their hair, clothing, or potentially going by a new name and pronouns. Only after many months being evaluated in talk therapy could a pubescent child demonstrating gender dysphoria be prescribed puberty blockers. When the patient is old enough, usually ages 16 to 17 per Planned Parenthood, they can then be prescribed hormones to replace those produced by their body.

Donald Trump signed an executive order attempting to ban gender-affirming care for people under 19 shortly after taking office. A federal judge blocked the order in February, finding that it is likely unconstitutional. While the U.S. Supreme Court recently upheld Tennessee's ban on gender-affirming care for youth, the ruling does not interfere with states that have not criminalized the care.

Kaiser Permanente has facilities in California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, and Washington, several of which have enacted a shield law protecting youth who receive the care. The laws prohibit states that have banned the life-saving treatment from punishing those who travel to other states where it is legal by preventing the release of information or the arrest and extradition of someone based on another state's court orders.