At least 21 hospitals and health systems across the United States have either suspended or significantly restricted gender-affirming care for minors since January, according to an analysis by NBC News. The changes come amid heightened political pressure, federal investigations, and threats of funding cuts.
Twelve hospitals announced they would stop prescribing puberty blockers and hormone therapy for patients under 19. Four hospitals discontinued transition-related surgeries for minors, while another said it ended all gender-affirming care for teenagers.
Additionally, four institutions temporarily paused care earlier this year in response to an executive order from former President Donald Trump, before resuming after a federal judge blocked portions of the measure in March.
Beyond these cases, five hospitals have removed online information about youth transgender care. Of those, one confirmed it still provides treatment, one stated it continues to comply with “all applicable laws and regulations,” and three declined to comment.
In Iowa, a health center ceased providing hormone therapy for adults following a Trump-era order barring the use of federal funds to “promote gender ideology,” according to the Iowa Capital Dispatch.
Hospitals now face an increasingly complex legal landscape. While federal law prohibits discrimination against transgender patients, recent federal guidance has warned that institutions risk losing funding or facing civil or criminal penalties for providing care to patients under 19.
Meanwhile, state legislatures continue advancing their own restrictions. Since 2021, 27 states have passed bans on puberty blockers, hormone therapy, or surgeries for transgender minors.
Families Forced to Leave the U.S. for Care
For families relying on gender-affirming care, the consequences have been devastating. One Florida mother, fearful of harassment and federal intervention, has purchased one-way tickets to Berlin so her 15-year-old daughter can continue treatment abroad.
Her family has already endured years of navigating shifting restrictions. When her daughter first sought care in 2021, Florida lawmakers moved to restrict it, forcing the family to drive 11 hours to Alabama.
After a court upheld Alabama’s care ban in 2023, they began traveling to Washington, D.C., where Children’s National Hospital provided treatment. That hospital, too, announced in July that it would stop prescribing gender-affirming medications as of Aug. 30, citing “escalating legal and regulatory risks.”
The mother said she has lost confidence in finding stable care in the U.S.
“Where can we go?” she asked. “We were always told America is the greatest country in the world. Now we’re fleeing so my child can get the health care she needs — for her safety and ours.”
Supporters vs. Medical Experts
Supporters of restrictions argue the treatments lack sufficient long-term study and that minors cannot give informed consent. Medical experts counter that puberty blockers and hormone therapy have been safely prescribed to minors for decades for other conditions, such as precocious puberty.
Nearly every major U.S. medical association, including the American Medical Association, has condemned government restrictions on gender-affirming care, calling them “a dangerous intrusion into the practice of medicine.”
Recent research underscores how rare these treatments are. A 2024 Harvard T.H. Chan School of Public Health study found the rate of adolescents ages 15 to 17 undergoing gender-affirming surgery was just 2.1 per 100,000. A separate JAMA Pediatrics study reported that fewer than 0.1% of adolescents with private insurance receive puberty blockers or hormones.
Safe Havens and Migration for Care
States such as California, Colorado, Oregon, Illinois, Washington, Connecticut, and Pennsylvania — where gender-affirming care remains legal — have seen a surge in out-of-state patients. Some families are relocating permanently to ensure access.
Hospitals like Children’s Hospital Los Angeles, home to one of the nation’s oldest gender clinics, have become vital safe havens for families seeking care amid growing national restrictions.
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