Two California hospitals have stopped providing gender-affirming hormone therapy to patients under 19, citing escalating federal pressure. Rady Children’s Health, which operates Rady Children’s Hospital in San Diego and another large Southern California hospital, told families recently that it would discontinue hormone treatment for minors. The change affects nearly 1,500 patients.
Parents and providers say the decision follows a series of actions by the Trump administration aimed at limiting youth access to gender-affirming care. Federal moves include a referral to the Department of Health and Human Services Office of Inspector General for investigation and proposed rule changes by the Centers for Medicare and Medicaid Services that, if adopted, could cut federal funding to hospitals that provide hormone treatments or surgery to minors.
Brett, a San Diego father who spoke to NPR on the condition his last name not be used, said his 11‑year‑old began hormone treatment at Rady about a year and a half ago after coming out as a boy. He described rapid improvements in his child’s mood, social life and engagement in hobbies after treatment began, and praised the clinic staff as “overwhelmingly loving.” He said the hospital’s announcement left his family stunned: “The whole world kind of dropped out from under me.”
Federal officials have defended their actions. HHS told NPR in an emailed statement that gender-affirming care did not meet “professionally recognized standards of health care.” Major medical organizations — including the American Academy of Pediatrics, the Endocrine Society and the American Psychological Association — disagree, saying gender-affirming care for youth is evidence-based and important for mental health. The American Society of Plastic Surgeons has recommended delaying gender-related surgeries until age 19, but only a small number of transgender minors seek surgical interventions.
Advocates warn of broader impacts. Kellan Baker of the Movement Advancement Project said the proposed CMS rules are particularly worrisome because about half of hospital funding in many states comes from federal programs like Medicare and Medicaid. More than a dozen hospitals across the country have ended gender-affirming hormone therapy for minors over the past year, advocates say.
Providers and families describe fear and uncertainty. Alex Sheldon, executive director of GLMA, an LGBTQ medical association, said clinicians at institutions that end youth care have heard desperate messages from patients and families. Sheldon recounted reports of a nurse being told by a parent that if a young person died by suicide because they lacked access to treatment, it would be the nurse’s fault.
Private clinicians may be able to take some patients, but they cannot fully replace large pediatric systems that provide high-volume care, research and clinical guidance. In San Diego, Brett said his family has located only one private provider in the county and is unsure whether that practice can treat his son; they have even discussed moving abroad for care.
California Attorney General Rob Bonta has filed a lawsuit seeking a permanent injunction to restore gender-affirming hormone therapy at Rady. For now, affected families are seeking care elsewhere or considering legal and travel options as the dispute plays out.
