In mid-October, Boston-based Fenway Health announced they'd no longer offer gender-affirming care to youth, out of fear they'd lose their federal funding streams. Now their younger patients are being referred to Northampton's TransHealth, the nation's only independent health center focused on care for trans patients.
The decision to suspend gender-affirming care for minors reflects new fears of federal reprisal, under an administration that has expressed hostility to the transgender community. Soon after taking office, President Donald Trump signed an executive order decrying "gender ideology extremism," largely targeting efforts by the previous administration to establish legal protections for transgender people.
TransHealth CEO Jo Erwin says despite a threatening federal atmosphere, there are no laws prohibiting gender-affirming care. They say the health center is dedicated to providing that care to anyone who needs it — including young people.
"We're a very mission-driven organization," Erwin explained. "And we have always felt that best-practice, evidence-based medical care for trans youth is absolutely vital. We know that without that care, there's an increase in mental health disorders, there's an increase in suicidal ideation."
Erwin describes much of the political discourse around transgender care as a moral panic, especially when it comes to minors. Opponents of gender-affirming care for youth have argued that it can lead to irreversible physical changes that patients could come to regret. Erwin explained that more intensive care options, like puberty blockers or surgery, involve consultation from mental health experts and parents.
"So this notion, that we're brainwashing kids into this 'woke' discipline so we can create as many trans people as possible... is literally insane," Erwin says.
But that notion is popular one, particularly with some federal officials. In April, Attorney General Pam Bondi sent out a memo describing gender-affirming care as "the mutilation of American children," fueled by a "radical ideological agenda." A recent national security memorandum from President Trump labels "gender ideology extremism" as an indicator of domestic terrorism.
"The problem we have is mis- and disinformation," Erwin says. "It is not about what's actually happening, and that's the biggest thing that I think we have to challenge. And I think, unfortunately, there aren't enough people that really understand the level of misinformation and disinformation that's going on."
Erwin stressed that trans people are people first and foremost, and as opposed to fueling any sort of violent ideological movement — they are far more likely to face discrimination and marginalization.
"The trans and gender diverse population is a very small piece of the overall population," Erwin explains. "But [anti-transgender rhetoric] plays on people's fears and concerns, and it's an effective way to other people who are already marginalized."
With a federal government so strongly opposed to transgender care, Erwin says they expect other federally-funded health centers in Massachusetts to suspend gender-affirming care in the future.
