At least nine hospitals or health systems have stopped providing gender-affirming hormones and puberty blockers to young trans people since the start of the year, in the wake of federal rules proposed in December that would withhold Medicare and Medicaid funding from clinics that continue pediatric care for transgender people.
A STAT analysis of news reports shows that more than 40 hospitals nationwide have paused or ceased to offer some type of gender-affirming care to young people since President Trump launched his first strike at the field one week into his second administration with an executive order that sought to use federal power to end such treatment for minors. Several clinics have cited increased federal pressure, including recent referrals for investigation by the Department of Health and Human Service’s Office of Inspector General.
“We will not stop until every single child is protected from the destruction of the integrity of God’s chosen human body,” Mike Stuart, HHS general counsel, posted on X Tuesday as he announced the latest referral of a hospital for investigation for continuing to provide the care.
While STAT identified action from 42 hospitals and health systems since January 2025, Stuart asserted that more than 30 have stopped care “in recent weeks,” though he didn’t name the institutions.
Hospitals are stopping the services even though the proposed Centers for Medicare and Medicaid Services rules aren’t final, and the executive order has been challenged multiple times in court and portions of it have been blocked while the cases proceed. Advocates and local communities have decried hospitals’ decisions to preemptively comply with restrictions. Hospitals shuttering their offerings likely “don’t want to be made the example to enforce the rule on day one,” said Carmel Shachar, director of the Health Law and Policy Clinic at Harvard Law School. “Whether that’s the right risk calculus is really difficult to say from the outside.”
Many clinics have provided estrogen, testosterone, and puberty blockers to trans adolescents for years. Major medical organizations have historically recommended that surgeries be offered to transgender minors on a case-by-case basis, but few providers have ever performed them. As federal action continues, numerous hospitals have announced that they’ll stop providing the medications to patients, including Rady Children’s Health, a large California health system, and Children’s Minnesota, a stalwart provider for transgender patients in the Midwest. (Children’s Minnesota, referred for investigation in early January, called the pause temporary in a statement to local media this week.)
Some facilities have stopped providing care only for new patients, like Lurie Children’s in Chicago, which is one of many that have been referred for investigation. Fifteen stopped for all minors, and 14 stopped for anyone under 19, according to STAT’s analysis. At least three major children’s hospitals — which sometimes care for people into their early twenties — have closed to all patients, no matter the age. While a handful of hospitals reinstated the care after a short pause, that hasn’t precluded some from suspending it again under further federal pressure, as Children’s Hospital Colorado did last month.
It’s unclear how the proposed rules from the Centers for Medicare and Medicaid Services — available for public comment until Feb. 17 — have played into hospital decisions. In a statement to the Colorado Sun, the Colorado children’s hospital cited its referral for investigation as posing a risk to Medicare and Medicaid funding.
“It’s been a really challenging year for hospitals, for the medical profession, for science,” Shachar said. “That probably drives some of the risk analysis.”
One of the proposed CMS rules ties participation in Medicare and Medicaid to a commitment not to provide young trans people with puberty blockers, hormones, or gender-affirming surgery. The announcement was accompanied by a far-reaching declaration from health secretary Robert F. Kennedy Jr. that the entire field does not meet medical standards of care, which legal experts believe could have far-reaching consequences.
“If I’m general counsel, I’m having a lot of heartburn about all of this,” Shachar said about the variety of ways the administration is targeting transgender health care. “This is an issue that is absolutely a priority for the administration, in ways that even limiting access to abortion care has not been.”
But other politicized health services — including mRNA vaccines and other reproductive care like contraception — could be targeted next if HHS successfully links the conditions of participation in Medicare and Medicaid to the provision of transgender care, Shachar said.
For now, young transgender patients — more than half of whom live in states that restrict their rights in some way — will find fewer doctors able to counsel them about medical care like hormones and surgery. And the field, which critics disparage for low-quality evidence of efficacy and inadequate standards of care, will have fewer opportunities to gather additional evidence and improve patient care.
