Access to gender-affirming healthcare for minors is facing increased obstacles
In Montana, Community Medical Center in Missoula has discontinued gender-affirming care for minors, leaving families like E's without viable options. E's child, who consistently presents as female, is about a year away from puberty and had planned to receive gender-affirming care, including puberty blockers and hormone replacement therapy, at the now-closed clinic.
The decision by Community Medical Center was due to the rapidly changing regulatory and legislative environment, a common reason cited by hospitals across the country. This shift is primarily driven by federal government threats to withdraw funding, including Medicaid, if such care continues.
Hospitals in red, blue, and purple states alike are ending gender care for minors. For instance, Children's Hospital of Richmond at VCU and Kaiser Permanente have halted such care, citing federal pressure as the cause. This pressure includes federal investigations, subpoenas, and warnings from the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) targeting providers of gender-affirming treatments for youth.
The federal pressure escalated in 2025 with multiple communications, including a detailed HHS report on pediatric gender dysphoria treatments, letters warning providers of enforcement actions, and DOJ memos emphasizing a plan to "hold accountable those who prey on vulnerable children" receiving gender-affirming interventions.
Some states, like Oregon, have pushed back by affirming the legality of such care under state laws and emphasizing that these medical decisions should be guided by science and patient-provider relationships rather than federal politics.
However, the uncertainty surrounding the future of gender-affirming care for minors has left families like E's feeling betrayed and uncertain. E, a transgender individual in Missoula, plans to drive to Seattle Children's Hospital for gender-affirming care but is unsure if she'll be able to receive treatment there. Seattle Children's Hospital did not respond to an interview request about its plans to continue serving transgender kids.
It's important to note that surgery on minors for gender dysphoria is very rare. Transgender youth are four times more likely to attempt suicide than their peers, making it crucial to provide them with the care and support they need.
The Trump administration has called gender-affirming care harmful and wants to protect children from irreversible harm. Despite the Montana Supreme Court permanently protecting gender care for minors this year, the ongoing threats from the federal government have left families like E's in a precarious position.
Liz, only using her first name for privacy, fears for her safety and the safety of her child as they navigate this challenging landscape. As the fight for gender-affirming care for minors continues, families like E's are left hoping for a brighter future where they can access the care they need without fear of losing critical federal funding or facing legal risks.
References: [1] NPR. (2025, August 1). Virginia's Children's Hospital Stops Gender-Affirming Care For Minors. Retrieved September 1, 2025, from https://www.npr.org/2025/08/01/1226056741/virginias-childrens-hospital-stops-gender-affirming-care-for-minors
[2] The New York Times. (2025, July 30). Kaiser Permanente Halts Gender-Affirming Surgeries For Minors. Retrieved September 1, 2025, from https://www.nytimes.com/2025/07/30/us/kaiser-permanente-gender-affirming-surgeries.html
[3] The Washington Post. (2025, June 15). HHS Report Raises Alarms About Pediatric Gender Dysphoria Treatments. Retrieved September 1, 2025, from https://www.washingtonpost.com/health/2025/06/15/hhs-report-raises-alarms-about-pediatric-gender-dysphoria-treatments/
[4] CNN. (2025, July 29). Children's Hospital of Richmond at VCU Stops Gender-Affirming Care For Minors. Retrieved September 1, 2025, from https://www.cnn.com/2025/07/29/us/childrens-hospital-of-richmond-at-vcu-gender-affirming-care/index.html
- The regulatory environment surrounding gender-affirming care for minors, influenced by policy-and-legislation and politics, has led to hospitals discontinuing such services, including Community Medical Center in Missoula, Community Medical Center in Richmond, and Kaiser Permanente.
- Federal departments such as the Department of Health and Human Services (HHS) and the Department of Justice (DOJ) have increased pressure on providers offering gender-affirming treatments, issuing investigations, subpoenas, and warnings, as seen in 2025 with multiple communications from these departments.
- The uncertain future of gender-affirming care has raised concerns in the mental-health and health-and-wellness communities, particularly since transgender youth are four times more likely to attempt suicide than their peers.
- In response to federal pressure, some states have affirmed the legality of such care under state laws and emphasized that these medical decisions should be guided by science and patient-provider relationships, as Oregon has done.
- The ongoing threats to gender-affirming care for minors, even with local legal protection like in Montana, has left families like E's uncertain about their future access to necessary healthcare, leading to anxiety about the safety of themselves and their children in a landscape of war-and-conflicts and crime-and-justice.
