Hospitals across Colorado, Virginia, and Washington D.C. have announced a pause on gender-affirming care for minors following the recent executive order issued by President Donald Trump, aimed at severing federal support for such medical procedures. The order, signed on January 28, 2025, has created uncertainty for numerous institutions, prompting immediate action to halt treatments as they assess its broad implications.
Denver Health, one of the largest hospital systems affected, confirmed it will cease all gender-affirming surgeries for individuals under the age of 19. A spokesperson emphasized the necessity to comply with the new regulations to continue receiving federal funding. "We recognize this order will impact gender-diverse youth, including increased risk of depression, anxiety and suicidality," the spokesperson stated, reflecting concern about the mental health ramifications of the pause.
Other institutions, including VCU Health and Children’s Hospital of Richmond, have also suspended both hormone therapy and gender-affirming surgical procedures for minors. Meanwhile, Children’s National Hospital located in D.C. revealed it had paused prescriptions of puberty blockers and hormone therapies but clarified it never performed surgeries on minors. According to the hospital's report, care policies are under review amid the directives from the executive order.
Trump’s executive order seeks to reverse many of the healthcare protections previously implemented during the Biden administration—what many advocates see as detrimental to the well-being of transgender youth. The order directs federal agencies to put measures in place ensuring hospitals receiving federal research and education grants end what it refers to as the “chemical and surgical mutilation of children.” The contentious wording has drawn heavy backlash from medical professionals and organizations like the World Professional Association for Transgender Health (WPATH), which labeled it harmful to patients and their families.
While Trump’s directive creates immediate obstacles for gender-affirming care, some hospitals are gauging how they will adapt without sacrificing the well-being of their patients. Lurie Children’s Hospital of Chicago stated it is reviewing the executive order and determining its impact on clinical services. Their commitment to supporting medically necessary care remains intact, emphasizing their grounding “in science and compassion for the patient-families we are so privileged to serve.”
The phrasing of Trump's order, particularly terms such as “mutilation” and “sterilization,” starkly contrasts with established medical practices surrounding gender-affirming care, which advocates claim are safe and necessary for addressing the needs of transgender youth. Studies have shown the effectiveness of gender-affirming treatments, including their positive impact on mental health; yet, access remains limited. A recent research effort found fewer than 1 in 1,000 adolescents with commercial insurance received puberty blockers or hormones over the span of five years. Most gender-affirming surgeries are performed on adults, not minors.
The current restrictions result from the belief among some lawmakers and officials who argue against gender-affirming care, claiming it can lead to adverse outcomes for youth. Yet contrary to these claims, extensive research links access to gender-affirming treatments to decreased rates of depression, anxiety, and suicidal ideation. For example, one substantial study conducted by the Journal of Adolescent Health indicated transgender youth who received these treatments had significantly lower suicidal thoughts, illustrating the grave dangers of denying care.
Denver Health has voiced serious concerns about the repercussions of the executive order for their patients. "Denver Health is committed to and deeply concerned for the health and safety of our gender-diverse patients under the age of 19," they stated, reaffirming their dedication to providing primary and behavioral healthcare to these vulnerable groups.
The path forward remains uncertain as hospitals determine how they will comply with federal requirements versus maintaining the rights and health of transgender youth. Legal challenges could emerge, with some institutions potentially contesting the executive order on ethical or constitutional grounds, arguing it infringes upon federal healthcare protections. This backlash could mark the beginning of significant legal and political battles.
This order not only embodies a return to staunch conservative positions against transgender rights but could also lend momentum to more aggressive legislative efforts aimed at restricting healthcare access for transgender individuals nationwide. For transgender youth and their families, the repercussions of these recent developments are distressing as hospitals pause treatments and the overarching political climate rapidly shifts.
All said, as the federal policy on transgender healthcare evolves, hospitals are striving to navigate this increasingly complex environment. They find themselves balancing the compliance to federal guidelines with the ethical imperative to support and provide for their patients. The next steps for gender-affirming care will likely continue to face fierce scrutiny and remain coupled with the legitimacy of medical practices and the rights of individuals to receive comprehensive healthcare.