Trans Youth Are Rattled by Efforts to Ban Gender Care. So Are Hospitals.

The Trump administration’s executive order seeking to bar hospitals from providing certain kinds of care for transgender youth has inspired anxiety among parents, at least one lawsuit, and demonstrations by transgender activists and progressive politicians.

But among some hospitals, the response has been rapid compliance. They could lose federal research funding if they don’t comply, but there are also troubling ethical concerns about patient abandonment: A doctor has an ethical and legal duty to keep treating patients in need of immediate care.

“Hospitals ultimately are pragmatic,” said Dr. Marci Bowers, a transgender woman and surgeon who played a key role in building a Manhattan hospital’s transgender medicine and surgery program over the last decade. “They’re acquiescing to what they need to do to stay alive.”

New York City is a leader in what the medical establishment refers to as gender-affirming care, and most major hospitals have well-established transgender medicine programs. But at hospitals around the city, administrators have so far declined to publicly say what they intend to do. NYU Langone Health has begun to postpone planned surgeries like mastectomies for older teenagers and to cancel appointments for patients scheduled to receive long-lasting puberty blocker medications.

“They are very uncertain as to how to proceed at the moment,” said Dr. Robert Klitzman, a psychiatrist and professor who was a founder of Columbia University’s Center for Bioethics. “Hospitals are trying to figure out what to do.”

Though New York City hospitals have said little about the executive order, from Colorado to Washington, D.C., some hospitals have issued clear-cut statements declaring they would not issue new prescriptions for hormone therapy or puberty blockers to transgender youth, or would only do so through the end of this month. Some, like Children’s Hospital Los Angeles, said they would continue providing hormone therapy to existing trans patients, but would not start new pediatric patients on hormones.