It was shocking to see the news that Children's Hospital Los Angeles, or CHLA, on Tuesday stated it is pausing the initiation of gender-affirming hormonal care for trans patients under the age of 19 because it needs to assess President Donald Trump's executive order from January 28 targeting such care for young people. The hospital already has an existing pause on gender-affirming surgeries for minors. A hospital official did state that patients already on hormonal care may continue their treatment, the Los Angeles Times reported.
The development mirrors decisions made by hospitals in other parts of the country, including Colorado, Virginia, and Washington, D.C. The Associated Press reported that Denver Health stated it would pause all surgeries; it wasn't clear whether the hospital would continue providing hormonal treatment, according to the news service. Virginia Health and Children's Hospital in Richmond has stopped medication and surgeries, AP reported. Children's National Hospital in Washington, D.C. stated it's paused prescriptions of puberty blockers to people under 19. It already did not provide surgeries, the news service noted.
CHLA appears to be the first hospital in the Golden State to pause medications for gender-affirming care. A search of the websites for Kaiser Permanente and Benioff Children's Hospitals (in Oakland and at UCSF) found they had information on gender-affirming care available, including making appointments. Unfortunately, that might not be the case for much longer.
In related news, CalMatters reported that St. John's Community Health in Los Angeles stated it is losing federal funding for providing gender-affirming care. The news site reported that St. John's said the Centers for Disease Control and Prevention terminated a $1.6 million grant for its transgender health and social services program on January 31. The grant was funded through the CDC's HIV prevention program, so that gives us an idea about how dire things will become. More than 500 people received services annually, according to CalMatters. St. John's said it will not stop services and is preparing to sue over the withholding of federal money.
Trump used harsh language in his executive order, starting with the title, "Protecting Children from Chemical and Surgical Mutilation." "Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding," the order stated. "Moreover, these vulnerable youths' medical bills may rise throughout their lifetimes, as they are often trapped with lifelong medical complications, a losing war with their own bodies, and, tragically, sterilization.
"Accordingly, it is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures," the order stated.
Our allies, however, are taking action. New York state Attorney General Letitia James on Monday told hospitals to continue providing gender-affirming care for people under 19 or they would run afoul of state anti-discrimination laws, AP reported.
On Wednesday morning, California Attorney General Rob Bonta issued a statement with a coalition of 14 state attorneys general, including James, to protect access to gender-affirming care.
"As state attorneys general, we stand firmly in support of health care policies that respect the dignity and rights of all people. Health care decisions should be made by patients, families, and doctors, not by a politician trying to use his power to restrict your freedoms," the statement read. "Gender-affirming care is essential, life-saving medical treatment that supports individuals in living as their authentic selves.
"The Trump administration's recent executive order is wrong on the science and the law. Despite what the Trump administration has suggested, there is no connection between 'female genital mutilation' and gender-affirming care, and no federal law makes gender-affirming care unlawful. President Trump cannot change that by executive order," the statement continued.
Bonta's statement pointed to a federal court victory last week, which "directed the federal government to resume funding that had been frozen by the Trump administration," the statement read. "In response to the court's order, the Department of Justice has sent a notice stating that 'federal agencies cannot pause, freeze, impede, block, cancel, or terminate any awards or obligations on the basis of the [Office of Management and Budget] memo, or on the basis of the president's recently issued executive orders.' This means that federal funding to institutions that provide gender-affirming care continues to be available, irrespective of President Trump's recent executive order. If the federal administration takes additional action to impede this critical funding, we will not hesitate to take further legal action."
Equality California, the statewide LGBTQ rights group, called the action by CHLA "alarming."
"It is alarming that Children's Hospital Los Angeles has paused providing healthcare to incoming transgender patients due to Trump's executive order," stated EQCA Executive Director Tony Hoang, a gay man. "Decisions about medical care for young people should be made between doctors and families – not by politicians like Donald Trump. Every American, including transgender youth, has the right to access healthcare free from discrimination, and California law protects the families seeking this care and the medical professionals who provide it.
"Denying or delaying care has dangerous consequences for transgender young people and their families – and we strongly believe hospitals and providers in California must continue to fulfill their ethical and legal duty to care for their patients," Hoang added. "Every major medical association agrees that transgender health care is essential and that transgender youth and their families should be able to access medical care and make their own medical decisions with doctors – not the government."
Hoang added that the American Civil Liberties Union, Lambda Legal Defense and Education Fund, PFLAG, and the Gay Lesbian Medical Association have filed a lawsuit in the federal District Court of the District of Maryland to challenge Trump's executive order on trans youth, which he called "discriminatory and unconstitutional."
"We are hopeful the executive order will be halted and overturned, restoring essential healthcare rights to transgender youth nationwide," Hoang stated.
CHLA should rescind its recent action pausing medication treatment for gender-affirming care in light of the court order Bonta and the other attorneys general reference. Or, if the hospital fails to do so, Bonta should initiate legal action of his own given California's strong anti-discrimination laws and having declared itself a sanctuary state for trans people.
There's a recurring theme to all of Trump's executive actions, which, we should remind people, do not instantly go into effect. The tone of his orders makes it seem like they're the law of the land, and that's exactly what he wants people to think. His loyalists in the government are also acting quickly – look at what's happened to people being kept out of the USAID offices – but when it comes to gender-affirming care and other such orders, we don't see a reason why hospitals like CHLA need to pause medications. It should stand firm and wait for a definitive legal opinion. We urge CHLA to finish its assessment quickly and go back to providing the medication care for people under 19.
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