Mass. clinics still provide trans care for kids. The future is uncertain

Hospitals and clinics that treat transgender and nonbinary youth in Massachusetts said that care will continue while they review a funding ban signed by President Trump.

The order, issued Tuesday, seeks to stop medical facilities that accept federal grants and payments from providing gender-affirming care for children ages 18 and younger. The types of treatment referenced in the directive include medications that delay puberty, hormones and surgeries.

“Care will continue as normal and we do not anticipate any changes,” said a spokesman for Mass General Brigham, in a statement. “Should agencies issue regulations implementing these changes and/or legal challenges are exhausted, we will communicate any changes to our operations at that time.”

Other Boston-area hospitals and clinics confirmed plans to continue care while they evaluate the order. It would not take effect until agencies that oversee funding to hospitals, clinics and medical schools revise their regulations. Several groups are considering legal challenges based on the Equal Protection Clause in the 14th Amendment.

“Transgender people need health care,” said Chris Urchill, senior staff attorney at GLAD Law. “The care that’s at issue here is essential. There’s no disagreement among any legitimate medical organization.”

The American Academy of Pediatrics and the American Medical Association are among the organizations that recommend the use of gender-affirming care. Trump’s order calls this care “chemical and surgical mutilation of children” and the current recommendations for minors “junk science.” It gives the federal secretary of Health and Human Services 90 days to publish a review.

“This dangerous trend will be a stain on our Nation’s history, and it must end,” the order says.

Leaders within the U.S. Conference of Catholic Bishops praised the President’s order.

“Helping young people accept their bodies and their vocation as women and men is the true path of freedom and happiness,” wrote Bishop Robert Barron, chairman of the U.S. Conference of Catholic Bishops’ Committee on Laity, Marriage, Family Life, and Youth, in a statement.

The Massachusetts Catholic Conference declined a request for comment on the order.

The substance and language of Trump’s message horrified some parents of trans and nonbinary children.

“The cruelty is beyond my comprehension,” said Melody, the mother of a nonbinary teenager taking medications to delay the onset of puberty while wrestling with questions about their gender. WBUR agreed not to use full names of family members interviewed for this story due to concern they could become the targets of online or in-person attacks.

“It is cruel to people who are brave, to parents who are trying to do right by their children, and to children who would suffer if they didn’t have access to this care,” Melody said. She described her child as thriving while in treatment after years of struggling in school and at home.

Trump’s order says “countless” children regret hormone therapy and other care and are “trapped with lifelong medical complications.” Those assertions are at odds with most medical experts in the field. Researchers say regret is rare. Puberty blockers are a short-term and largely reversible treatment. They are rarely used, even among children who identify as nonbinary or transgender.

Some parents whose teenagers begin a gender transition using estrogen or testosterone struggle to balance concerns about the long-term effects — including the potential loss of fertility — against higher rates of depression, addiction and self-harm among trans children who don’t get treatment.

Ann, whose transgender son is on puberty blockers, said parents are doing the best they can. She said the order feels like a ticking time bomb as her family waits for updates about how the teenager will continue living the identity they’ve known for most of their life.

“This is making it exponentially harder for me to keep my child safe,” said Ann. “It really put a target on my kid’s back.”

The order also unnerved many transgender health care providers in Massachusetts, a state with one of the highest concentrations of trans health services in the country. It recommends that Congress work on legislation to allow parents and their transgender children to sue clinicians who provided care the patient regretted later on. The order also suggests charging parents who support transgender care with child abuse and stripping their right to custody of the child.

“We don’t yet know how or if these policies will be implemented, but we’re working to ensure that access to care remains strong in Massachusetts,” said Dallas Ducar, the executive vice president of donor engagement and external relations at Fenway Health. “We know many patients are anxious.”