A leading New York City hospital system has begun canceling appointments for transgender children following President Trump’s executive order threatening to withhold federal funding to hospitals that provide gender-affirming treatments, according to the children’s parents.
The hospital system, NYU Langone Health, has not made any public announcements. But word spread among parents of trans children after the hospital canceled appointments for two 12-year-olds who had been scheduled to receive implants that dispense puberty-blocking medication.
The father of one of the children said his child’s doctor had told him that because of “the new administration” — a reference to Mr. Trump’s executive order — the hospital would not able to proceed with the procedure. The child had been due on Thursday to have a small device that would release Supprelin LA, a puberty-blocking medication, implanted in the upper arm. The father said the doctor suggested that they try calling other hospital systems in New York City or one the doctor recommended in Philadelphia.
The second 12-year-old was scheduled to have the same procedure on Friday. That child’s mother said she was informed that her child’s appointment was canceled on Wednesday, one day after the executive order was issued. When she asked why, she said, she was told that the medical team was “awaiting more guidance.”
A spokesman for NYU Langone Health, Steve Ritea, declined to comment, saying he did not have any information he could share. NYU Langone is one of several major medical centers in the city with transgender health programs for youth and adolescents. About 3 percent of teenagers ages 13 to 17 in New York State said they are transgender, about twice the national average, according to one recent survey.
The executive order at issue is one of a flurry that President Trump has issued regarding gender and trans issues in his first two weeks in office. It takes aim at doctors and hospitals who provide trans youth under the age of 19 with gender-affirming medical treatment, which can include puberty blockers, hormone therapy and surgery.
“It is the policy of the United States that it will not fund, sponsor, promote, assist or support the so-called ‘transition’ of a child from one sex to another,” the executive order states, “and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”
One of Mr. Trump’s other executive orders addressed “restoring biological truth to the federal government” by, among other provisions, requiring federal prisons to house transgender women in men’s facilities. Another order seeks to stop schools from recognizing trans identities.
The order restricting gender-affirming care follows similar bans already passed by more than two dozen states, according to the Human Rights Campaign. Many of the bans are being challenged in court. Broader questions about medical treatment for young people who are seeking to transition have been the subject of debate in the United States and Europe.
Hospitals in New York City have been consulting with their lawyers to understand what this order means for their programs that provide medical care to trans children, according to officials at two hospital systems who declined to be quoted for this article.
One threatened consequence for hospitals and medical schools is the loss of significant federal research funding. The federal government provides research funds to major medical institutions. The order directs the government to ensure that institutions receiving such funding stop “the chemical and surgical mutilation of children,” which is how the order describes “gender-affirming care” for youth.
There is also the threat of prosecution and lawsuits. The order specifically directs the Justice Department to examine whether a federal law against female genital mutilation can be applied to some gender-affirming surgeries. That law was passed with another goal in mind: to outlaw the cutting of the clitoris or labia among girls of immigrant families in the United States. Rites of passage involving female genital cutting are common in some parts of the world.
At one clinic that provides gender-affirming care to trans youth, a doctor has been telling his patients that he will continue to provide them with puberty blockers and hormone therapy, even if it means prosecution.
“I’m willing to go to jail to continue to provide your care,” Dr. Jeffrey Birnbaum said he had been telling his young trans patients and their parents since the executive order. A pediatrician at the state-run University Hospital of Brooklyn, Dr. Birnbaum said he saw roughly 75 trans patients, including many teenagers.
A father of one of Dr. Birnbaum’s patients, Mark Armstrong, said the executive order had left his 14-year-old panicked that she would not be able to get the next shot of puberty-blocking medicine in March.
For some children with gender dysphoria — distress over the mismatch between their gender identity and their birth sex — puberty blockers can help them navigate their feelings and identity, reducing depression and distress, experts say.
“It decreases their dysphoria,” Dr. Birnbaum said, adding that the blockers have made some of his patients feel “less suicidal.”
Mr. Armstrong, a theater director who lives in Brooklyn, said he was relieved to hear that Dr. Birnbaum intended to continue his daughter’s treatment. “Obviously, there is a lot of free-floating anxiety in the trans parent community,” he said.
The mother of the second 12-year-old whose procedure at NYU Langone was canceled said that her child, who identifies as nonbinary, had begun puberty last year and that it had caused her child distress. The child had previously received an injection of puberty blockers, but had been scheduled to get an implant that would last for a year.
The mother said she was devastated that her child’s medical care was canceled over fear of retribution by the government. She and her family had been calling other hospitals and doctors in the hope of finding one that might treat the child. “I don’t think we have a lot of options,” the mother said.
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