One afternoon in late 2024, a sixth-grader nicknamed Bug came home from school with an announcement to make. Bug, who was assigned female at birth, told his parents he was a boy \u2014 and would be using he\/him pronouns.<\/p>\n
\u201cOK, cool,\u201d his mother, J, remembered saying. (J asked to be identified by only her first initial, and Bug by his nickname, because the family fears harassment.)<\/p>\n
\u201c\u2018What do you need to be supported?\u2019\u201d she recalled asking next. \u201cHe asked to get healthcare.\u201d\u00a0<\/p>\n
This was the kind of moment J had been anticipating since the family had moved earlier that year from Texas to Massachusetts, for its more liberal and inclusive politics. She felt confident they could find the right medical experts. But she hadn\u2019t realized that access to gender-affirming treatment could disappear even when their state\u2019s laws and leaders supported it.<\/p>\n
Individual hospitals all over the U.S., in red and blue states, have responded to President Donald Trump\u2019s attacks on transgender healthcare by deciding to withdraw care on their own. At least 20 hospitals<\/a> did so in the first months of the Trump administration as it threatened to pull back federal funding or initiate fraud or wrongful-claim investigations, and such services have continued to drop off since.<\/p>\n Bug and his younger sister were born in Austin, Texas, but J and her husband became worried after the state outlawed abortion; dismantled diversity, equity, and inclusion programs; and limited medical and civil rights for queer and transgender people. The parents worried the support services they needed for the siblings, both of whom have autism, might be affected, too.<\/p>\n \u201cI had a fear of being like the frog in the boiling water and not realizing what was happening until it was too late,\u201d J said. \u201cI needed to get the kids out of Texas.\u201d<\/p>\n So when Bug came out as trans, J was relieved they\u2019d landed in a state that not only has a \u201cshield\u201d law<\/a> to protect providers<\/a> who offer gender-affirming care<\/a> but also is among 24 states<\/a> requiring commercial insurance, which Bug\u2019s family has, to cover it.<\/p>\n After Bug\u2019s gender announcement, J\u2019s queries led her to the largest hospital system in the region, Springfield, Massachusetts-based Baystate Health<\/a>, where they began the months-long process of getting set up to start hormone therapy.<\/p>\n Bug, an artistic 14-year-old who loves horses, cats, and making short films with friends, was too old for puberty blockers<\/a>, but he was excited about the prospect of starting on testosterone. That would cause his voice to deepen, facial hair to grow, and muscles to get bigger.<\/p>\n \u201cEvery part of it sounds fun,\u201d he said.<\/p>\n J (right) and her son, Bug, at their home in western Massachusetts. Bug, who came out as a trans boy in 2024, had turned to Baystate Health for treatment until the health system stopped providing gender-affirming medications to youths. (Karen Brown\/New England Public Media)<\/p>\n But this past February, two weeks before Bug was scheduled to start testosterone, Baystate announced it would no longer provide gender-affirming medications to minors, offering only counseling. A letter to patients\u2019 families did not explain why.<\/p>\n Baystate spokesperson Heather Duggan sent a statement that said the decision to end treatment for minors reflected the fact that Baystate could lose \u201chundreds of millions of dollars in government reimbursement\u201d as a result of the Trump administration\u2019s plans. \u201cNearly 70 percent of Baystate Health\u2019s patients rely on Medicaid and Medicare for coverage,\u201d it said.<\/p>\n All Bug knew was that the care he\u2019d eagerly awaited was about to vanish.<\/p>\n \u201cI felt frustrated that they would do that,\u201d Bug said.<\/p>\n \u201cI bet there\u2019s tons and tons of kids who are like: \u2018OK, I\u2019m going for trans-affirming healthcare. Yay!\u2019\u201d he said. \u201cAnd then, like, tons and tons of kids were disappointed and sad and frustrated.\u201d<\/p>\n J said it felt as if the floor had fallen out from under them. \u201cMaybe this is naive, but I didn\u2019t think that would happen in Massachusetts,\u201d she said.<\/p>\n Baystate is among the providers still choosing not to offer puberty blockers and hormones as the issue wends its way through the courts. This spring, in a lawsuit that Massachusetts joined<\/a>, a federal judge concluded that it was unlawful for the Department of Health and Human Services to threaten federal funding for providers that offered gender-affirming care to minors. In June, another federal judge cleared 16 states, including Massachusetts, to move forward<\/a> with another lawsuit against the administration over its push to criminalize gender-affirming care.<\/p>\n Baystate Medical Center in Springfield, Massachusetts. The Baystate Health system stopped providing gender-affirming medications to youths in February, after the Trump administration said it would pull Medicaid and Medicare funding from hospitals providing them. (Karen Brown\/New England Public Media)<\/p>\n The American Academy of Pediatrics declined an interview request but said in a past statement<\/a> that young patients and their families should make decisions about gender-affirming care with their doctors, \u201cdelivered with compassion, and offered without political interference.\u201d<\/p>\n One mother of a former Baystate patient said that before her child came out as a transgender girl, she had been severely depressed, battling suicidal thoughts. (The mother asked that only her first initial, L, be used, because the family also fears harassment.)<\/p>\n After Baystate doctors prescribed puberty blockers and estrogen, her daughter\u2019s mood and grades rose markedly, L said. So when she received the letter announcing Baystate was ending the medical treatment, she was furious. L said she and other parents filed civil rights complaints with the Massachusetts attorney general.<\/p>\n The attorney general\u2019s office did not respond to a request for comment.<\/p>\n \u201cThere\u2019s a sense of, \u2018How could you?\u2019\u201d L said. \u201cAnd there\u2019s also the awareness of the impact just pulling care could have on a youth \u2014 from a physical health perspective but also from a mental health perspective.\u201d<\/p>\n L and J both found alternatives for their children. L asked the family\u2019s primary care doctor to take over hormone prescriptions. Bug\u2019s family was referred to Transhealth, a private specialty clinic<\/a> in Northampton, Massachusetts, that said it has taken on about 50 of Baystate\u2019s former patients.<\/p>\n \u201cTranshealth has been staffing ourselves up for a while now in anticipation of the fact that this may be happening across the state,\u201d CEO Jo Erwin<\/a> said.<\/p>\n Erwin said Transhealth can weather the funding threats because the clinic gets large private donations and is not as dependent on Medicaid and Medicare as most hospitals. But Erwin said that doesn\u2019t entirely reassure the broader LGBTQ+ community, including transgender adults.<\/p>\n \u201cWhen you see something like that go down, people get scared that it\u2019s ultimately going to happen to everyone,\u201d Erwin said.<\/p>\n In May, Colorado\u2019s Supreme Court ordered a children\u2019s hospital<\/a> in that state to resume medical treatments for transgender youths, while in Texas a court settlement<\/a> compelled a children\u2019s hospital there to do the opposite \u2014 start the nation\u2019s first \u201cdetransition clinic.\u201d The Trump administration has continued to pressure providers, including by seeking the medical records<\/a> of transgender minors.<\/p>\n After Bug\u2019s false start at Baystate, he was able to start taking testosterone at the new clinic in the spring.<\/p>\n His mother, J, said that the treatment is going smoothly and that Bug has learned how to give himself the injections. But J is nervous that the federal government will find other ways to stop his treatment again. She sometimes second-guesses the family\u2019s move from Texas to Massachusetts, wondering whether they should have gone to Canada instead.<\/p>\n This article is from a partnership that includes New England Public Media<\/a>, NPR<\/a>, and KFF Health News.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/em><\/p>\n This <a target=”_blank” href=”https:\/\/kffhealthnews.org\/health-industry\/gender-affirming-care-trump-hospitals-transgender-massachusetts\/”>article<\/a><\/a>; first appeared on <a target=”_blank” href=”https:\/\/kffhealthnews.org”>KFF<\/a> Health News<\/a> and is republished here under a <a target=”_blank” href=”https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/”>Creative<\/a> Commons Attribution-NonCommercial-NoDerivatives 4.0 International License<\/a>.<img src=”https:\/\/kffhealthnews.org\/wp-content\/uploads\/sites\/8\/2023\/04\/kffhealthnews-icon.png?w=150"<\/a>; style=”width:1em;height:1em;margin-left:10px;”><\/p>\n
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