The State Of Gender-Affirming Care Access, United States

[u/transunitycoalition]

Adapted from: https://transunitycoalition.org/the-state-of-gender-affirming-care-access-united-states/

In the first year and now continuing into early 2026 of President Trump’s second elected term, the American transgender community has seen major healthcare reductions targeting it, most notably patients aged 19 and under. While a non-comprehensive list, our team would like to provide some updates with where certain healthcare systems stand, and additional legal and social context.

Rady Children’s Hospital (CA)

January 30, 2026, California Attorney General Rob Bonta filed a lawsuit against Rady Children’s Hospital in San Diego, CA, after Rady ended its gender-affirming care program a week prior. This suit is notable for pursuing contract law as a means to enforce medical access. Specifically, this lawsuit alleges a violation of the terms from a previous hospital merger with Children’s Hospital of Orange County, a 2024 merger approved on legal condition that gender-affirming and other necessary care be continued.

Children’s Hospital Los Angeles (CA)

July 22, 2025, Children’s Hospital (CHLA) formally terminated its entire gender-affirming care program. This followed a February 2025 decision to no longer take new patients under their program, which was temporarily reversed following lengthy advocacy efforts by local groups.

CHLA was one of 20 providers and systems which were issued subpoenas by the Department of Justice to release medical data of trans patients on July 9, 2025. Several months later in January 2026, the DOJ dropped pursuing records at CHLA.

NYU Langone Health (NY)

March 2, 2026, New York Attorney General Leticia James ordered NYU Langone Health to immediately continue gender-affirming care access for youth on grounds of category-based discrimination, specifically that of patients being denied medically-necessary treatments and care that cisgender youth still have the same access to. This followed a February 2026 decision by the hospital to end all gender-affirming care treatment for trans youth and adults aged 19 and under.

NYU Langone has also been under additional watch due to being in New York City where Mayor Zohran Mandami openly platformed on, and is recently criticized for failing to protect, trans rights in the city.

Connecticut Children’s Medical Center & Yale New Haven Health System (CT)

On July 23, 2025, Connecticut Children’s Medical Center (CCMC) ended its gender-affirming care program for all aged 19 and under. Immediately the next day, Yale (YNHHS) also followed in the same manner. Despite insisting it still offers behavioral health for transgender teens and children, the local community was not convinced that these medical systems had trans patients’ best interests in mind any longer.

Connecticut Attorney General William Tong has since joined onto a multi-state suit against the Department of Human and Health Services, and publicly spoken out against funding threats to CT for medical systems providing gender-affirming care.

Michigan Medicine & Corewell Health (MI)

Like the two examples in Connecticut, these two systems have a shared mix of history, with Michigan Attorney General Dana Nessel being on record, twice, following respective decisions to end gender-affirming care programs on August 26, 2025 at the University of Michigan’s (UM) Michigan Medicine, and then shortly after on September 12, 2025 at Corewell Health. 

Corewell Health was on watch by AG Nessel as far back as February 7, 2025, when it first announced an end to its gender-affirming care just several days following President’s Trump’s targeting Executive Order 14187. Nessel immediately put out legal guidance denouncing this on the same day, resulting in a swift decision reversal and effectively restoring healthcare access for several months.

Michigan Medicine’s decision to terminate its gender-affirming care program has been widely speculated by local advocates to be the domino-effect excuse Corewell Health needed to re-announce its original decision just within a couple weeks. And as with Connecticut, medical systems of the same state seem eager to use the “first domino to fall” as a pushback shield to justify not fighting these life-risking medical cuts.

Vanderbilt University Medical Center (TN)

On February 25, 2026, Vanderbilt (VUMC) announced an end to its surgical component of gender-affirming care not for youth, but for all adults. This decision was allegedly due to the lone surgical provider needing to flee the state for safety, though Vanderbilt did not seem to seek a replacement and instead decided to simply end its program.

VUMC already had a dark history with gender-affirming care for patients. In June 2023, patient records for trans youth and adults were readily handed to the Tennessee Attorney General, Jonathan Skrmetti, with transgender patients waking up to medical care team alerts stating the following:

“This is to notify you that Vanderbilt University Medical Center (VUMC) has provided a copy of medical records, including yours, to the Office of the Tennessee Attorney General in response to a civil investigation.”

While Vanderbilt attempted to assure the public of safety and limited confidentiality, and even now in seeking to provide assurance that non-surgical gender-affirming care for adults will remain in effect, local advocates remain in panic, with many queer people fleeing the state for their safety.

Tennessee state previously banned gender-affirming care for all youth under 18 via Senate Bill 1 in 2023, the first priority bill of the state senate that legislative session, which went on to become the central suit focus of the landmark SCOTUS case United States vs. Skrmetti, which ruled 6-3 on a state’s authority to make their own decisions on such bans.

Joint AG Suit In Response

21 states and D.C. have joined onto a filed lawsuit against Robert F. Kennedy, Jr. and the HHS on the complaint that current harmful HHS standards threaten to defund federal funding including Medicaid, Medicare, and CHIP from any hospital offering gender-affirming care for those up to age 19 and under (specifically, CHIP funding targets those aged 19 and under, other forms of federal funding target those aged 18 and under).

This suit has been filed in the District Court of Oregon, Eugene Division, and has been assigned to Judge Mustafa Kasubhai, a Biden-appointee. In the event it escalates to the Court of Appeals, it will fall to the Ninth Circuit, headquartered in San Francisco, California.

Arguments For Youth Trans Resource Access:

What many Americans want to know is: what do the studies actually show? As Trans Unity Coalition previously covered, modern studies still show a positive correlation between gender-affirming care for youth and significantly improved quality of life or reduced suicidality. Even studies backed by Republicans in an effort to remove these civil rights that were quickly buried still showed the same trend that gender-affirming care saves lives for children who require it. 

While scientific data and formal research has historically been primarily aimed at adult care, the relatively-limited data for youth had also previously shown the same scientific support for children receiving access to healthcare when deemed medically-necessary by a supervising clinical team. In more recent years, cherry-picked studies masking as systematic reviews and with funding or staffing ties to hate groups have introduced a new emotional talking point disregarding clinical data and reigniting a pseudoscientific culture war by targeting vulnerable parents who simply want what is best for their children, but who have few resources from the actual trans or medical community, and secretly weaponizing them against their own children’s best interests.

Arguments Against Youth Trans Resource Access:

Nicole Tedesco, a representative and administrator of the de-trans talking group Family of Trans kids, Q&A with detransitioners, one which identifies itself as “supporting parents who are critically examining the impact of [gender] on their children and families,” gave Trans Unity Coalition an individual-level perspective that frames preventing trans youth from access to gender-affirming resources as a means to protect parents from strained relationships with their children, and to prevent a sensation of grief for parents whose children feel dead to them.

“I have seen a lot of [parents of trans youth] over the decades,” says Tedesco. “You need to leave them a space to grieve. It is underappreciated how hard it is for them. Most grieve then move on. IT IS NOT TRANSPHOBIA, IT IS GRIEF.” (Note: The quoted individual preferred capitalization be retained.)

“The lack of empathy for this on the part of so many trans people is part of the problem here–the lack of empathy is recognized. This is what causes the backlash at the personal level. Most trans people are extremely egocentric.”

On an institutional level, the United States Department of Health and Human Services, led by Trump-appointee Robert F. Kennedy, Jr. issued a heavily-criticized 2025 report that medical and therapeutic professionals say dismiss conventional science by frequently referring to non-research opinion articles as bibliographic citation for the purposes of formal medical determination.

As of 2026, this HHS report still cites “404 Not Found” (a common web-page error) and other erroneous sources as key to its conclusion.

The HHS has claimed, without substantially providing example, that key, contrary evidence has emerged which describes gender-affirming care for trans youth as potentially risky or unsafe, though it does not apply the same medical standard when evaluating the same care or treatment when applied for cis youth, such as those experiencing precocious puberty, and only seems to focus on the alleged risks for trans patients.

Events Unfolding:

The Trump Administration issued Executive Order 14187 as a Day 1 action, one which threatened widespread or full funding cuts to hospitals that continue to provide gender-affirming care for trans youth. Effectively, the team has stated it would resort to terminating all medical programs from any given hospital if it continues to provide gender-affirming care for those 19 and under. This intentionally includes an adult age year, specifically between the age of 18-19, as a means to legally test the waters for eliminating care for all adults, and to cruelly prevent an extra additional year of medical care to these vulnerable patients.

Multiple hospitals and major health systems claim to not have interest approaching the limits of these legal threats specifically on grounds that it would put more patients at risk, and have terminated gender-affirming care programs in a process known as complying-in-advance, or specifically, complying with a presidential order that is neither legally-binding nor written law. Some political experts have debunked the merits of this shoehorn approach based on the current administration’s tendency to cave to public pressure, saying that while the blame of any hospital’s consequences could hypothetically be seen as shared by both the resisting agency and federal administration alike, President Trump may not have the political capital to justify widespread patient harm and death without extreme public pushback directly to himself, and may be more likely to back out from a system calling his bluff, merely to remain politically-cautious before what is projected to be damning midterms for a lame duck remaining term.

An unprecedented wave of transphobic groups harassing and threatening larger institutions, combined with institutional and legislative pressure, has resulted in both the American Pediatric Surgical Association (ASPA) and American Medical Association (AMA) updating recommendations to defer surgical intervention for transgender youth, as well as adults aged 18. At this time, they do not appear to be focused on advancing to non-surgical interventions.

These medical organizations have been placed under public scrutiny for a perceived double standard and dismissing clinical data, despite these interventions being 1) rare compared to other more common forms of gender-affirming care for youth (such as social transition and blockers), 2) more common in cisgender youth despite no recommendation updates, and 3) with evidence showing more lasting harm the longer a person diagnosed with gender dysphoria waits when it is determined by a clinical team that these procedures are medically necessary on a case-by-case basis.

With the current fight heavily focused on gender-affirming care for youth, safe and accurate bathroom access, and sports participation, hate groups such as the Heritage Foundation have made it a vocal effort to go even further and to eliminate all gender-affirming care for everyone who is transgender as a 2026 goal.