As the national debate over gender-affirming care for minors intensifies, hospitals and healthcare providers across the United States are making dramatically different choices—some scaling back services under mounting political and legal pressure, others standing firm in their commitment to trans youth. In the midst of this shifting landscape, Boston Children’s Hospital has emerged as a rare outlier, doubling down on its support for gender-affirming care even as many peers retreat.
Earlier this August, Boston Children’s Gender Multispecialty Service (GeMS) program—the first of its kind in the nation for pediatric and adolescent trans health—issued a public statement that left little room for ambiguity. “Boston Children’s Hospital has always been and always will be committed to providing the best care for ALL of our patients, regardless of their gender identity,” the statement read, as reported by multiple outlets. The hospital reaffirmed its gender-affirmative care model, emphasizing that its practices are grounded in medical evidence and designed to help transgender and gender diverse youth “live, grow and thrive with love and support.”
This bold stance comes at a time when leading institutions such as Children’s Hospital Los Angeles, Phoenix Children’s Hospital, and Stanford Medicine have announced new restrictions on gender-affirming care for minors. Stanford, for example, stopped providing gender-related surgical procedures as of early June 2025, and Children’s Hospital Los Angeles closed its pediatric gender clinic on July 22, 2025. Meanwhile, Kaiser Permanente, one of the country’s largest healthcare providers, will pause gender-affirming surgeries for patients under 19 starting August 29, 2025, though it will continue to offer puberty blockers, hormone therapy, and mental health care, according to SF Gate and Healthcare Brew.
The decisions by these hospitals have not occurred in a vacuum. In June, the U.S. Supreme Court’s Skrmetti ruling upheld Tennessee’s ban on gender-affirming care for minors, emboldening policymakers and activists pushing for similar restrictions nationwide. The Trump administration has further escalated the pressure, issuing an executive order directing federal agencies to block funding for hospitals providing gender-affirming care to minors and to subpoena providers who do so. According to Kaiser Permanente spokesperson Kathleen Chambers, “In response to these federal actions, many health systems and clinicians across the country have paused or discontinued providing gender-affirming care for adolescents.”
For Boston Children’s, these mounting threats and political attacks are nothing new. The hospital was thrust into the national spotlight back in 2022, when it faced a barrage of bomb threats after false online claims accused its doctors of performing hysterectomies on minors—a procedure the hospital has never offered to patients under 18. The resulting harassment was so severe that extra security had to be hired to protect staff and patients. Undeterred, the hospital has continued to advocate for trans youth, supporting federal protections like the Equality Act and standing by families and staff affected by the ongoing culture war.
Not everyone agrees with Boston Children’s defiance. Right-wing commentators, including Chaya Raichik of Libs of TikTok, have called for the hospital to be “defunded and investigated.” Former college swimmer Riley Gaines has echoed these criticisms, repeating long-debunked claims about the nature of trans healthcare for minors. Yet, for many families and advocates, Boston Children’s unwavering stance offers a rare sense of security amid a climate of fear and uncertainty.
On the opposite coast, the situation is growing increasingly tense. Mental health workers at Kaiser Permanente—represented by the National Union of Healthcare Workers (NUHW), which counts 4,700 psychologists, social workers, and therapists among its members at Kaiser’s California and Hawaii locations—are protesting the new policy pausing surgeries for minors. The union, which includes trans members and parents of trans children, has a storied history of defending patient rights. Sal Rosselli, president emeritus of NUHW, told Healthcare Brew, “We’ll always defend the principle that medical choices should be made by patients in consultation with their doctors and loved ones, not by the federal government.”
Rosselli went on to highlight the union’s legacy, recalling how NUHW educated members during the HIV/AIDS crisis to ensure patients received appropriate care despite widespread fear and misinformation. The union also recently alleged that Kaiser was illegally using unlicensed clerks to direct mental health care. In the current moment, Rosselli said, “The federal government is trampling on the rights of patients to get care that could save lives.” He added, “They’re on the front lines, and they understand how the care is provided and how important it is, both for the child and their family, that they have control over medical conditions in consultation with their doctors.”
Kaiser Permanente, for its part, says the decision to pause surgeries followed “significant deliberation and consultation with internal and external experts, including our physicians,” according to Chambers. The provider acknowledged the challenging climate, noting, “This is an extremely challenging and stressful time for our patients, as well as for our clinicians whose mission is to care for them.” Kaiser has not, however, responded directly to the union’s demands, Rosselli said.
The human stakes of these policy shifts are profound. The Trevor Project, an LGBTQ+ advocacy organization, reported in 2024 that suicide attempt rates among minors soared to as high as 72% in states with laws limiting gender-affirming care for youth. Advocates argue that access to gender-affirming care can be a matter of life and death—a view echoed by Boston Children’s, which frames such care as essential for young people’s well-being.
Amid the legal and political crossfire, families are left navigating an increasingly fragmented landscape. In California alone, Stanford Medicine and Children’s Hospital Los Angeles have both rolled back services, leaving Kaiser’s partial pause as one of the few remaining options for some patients. Yet, even those services are now under threat, as federal actions continue to ripple through the healthcare system.
For trans youth and their families, the message from Boston Children’s stands out: the hospital will not abandon them, even as others pull back. “We believe in a gender-affirmative model of care, which supports transgender and gender diverse youth in the gender in which they identify,” the GeMS statement reiterated. That sense of unwavering support, both medical and moral, is increasingly rare—and, for many, desperately needed.
As the battle over gender-affirming care for minors rages on, the choices made by hospitals, unions, and policymakers will shape not only the medical landscape but the lives of countless young people and their families. The stakes could hardly be higher.
