As Children’s Hospital LA closes its gender-affirming care center, advocates worry kids’ lives are ‘on the line’

Along Sunset Boulevard in East Hollywood, a longstanding community health clinic for transgender youth and young adults will close its doors by next week, under growing pressure from President Donald Trump’s budget cuts.

Executives at the Children’s Hospital Los Angeles (CHLA) announced in June that its Center for Transyouth Health and Development, which provides gender-affirming care, including hormone therapy and surgeries, is shutting down by July 22. 

The hospital is one of the oldest, largest public providers of gender-affirming care, especially for lower-income patients, in the U.S.

The imminent closure follows Trump’s executive order, issued early on in his second term, for hospitals to end gender-affirming surgeries for people under age 19 — a move to block federal funding for gender transitions and care for trans youth, in line with his administration’s policies advocates say target the larger transgender community, from athletes to those who serve in the military.

In his order, the President called science-backed, medically-supported gender-affirming care methods “chemical and surgical mutilation,” and by restricting them, a way to “protect children.” He also signed an order defining sexes as “male and female.”

At a recent weekly rally condemning the closure, L.A. resident Jesse Thorn was emotional. Thorn has two trans children, ages 13 and 11, who are patients at the center.

“Getting the news (of the closing) was brutal, it was a punch in the stomach,” Thorn said. “There’s no way to care for a transgender kid that isn’t built on an incredible amount of trust, because these are kids who have experienced not having autonomy over a fundamental part of who they are. That requires a caregiver who understands these kids need special patience and support.”

Having to find a new doctor and start all over again is very scary for his children, the 44-year-old father added.

“My oldest has been out for eight years and in that time, she has been aware that there are people in the world who think she should not be able to live as who she is, and that there is danger to her in the world,” Thorn said. “For it to come from this institution (hospital) that we ask them to trust is a very dark betrayal.”

Children’s Hospital LA executives declined to comment on the situation, but in June told media outlets that without federal aid, it could only sustain current operations for around 50 days. They provided a copy of the June 12 internal email, which said the hospital “continues to face significant operational, legal, and financial risks, stemming from the shifting policy landscape at both the state and federal levels.”

“Over the past several months, California’s deepening budget crisis, President Trump’s executive orders, proposed federal legislation and rulemaking, and growing economic uncertainty have made the situation even more dire,” the email sent to staff said.

Around 65% of CHLA’s budget — $1.3 of $2 billion — relies on federal funding, and is “uniquely vulnerable to regulatory and policy changes impacting Medicaid participation and reimbursement,” the email said.

In a statement about the imminent Center for Transyouth closure, posted to the CHLA website, officials acknowledged that the clinic has provided “high-quality, evidence-based, medically essential care for transgender and gender-diverse youth,” on public insurance, for over 30 years.

“Center team members were heartbroken to learn of the decision from hospital leaders, who emphasized that it was not made lightly, but followed a thorough legal and financial assessment of the increasingly severe impacts of recent administrative actions and proposed policies,” the statement said. “We realize the deep impact it will have on members of our team and community.”

As part of gender affirming medical treatments, which have long been endorsed by major medical associations, younger patients who haven’t gone through puberty yet receive counseling, which continues throughout the care process. For some, the next step is puberty-blocking medication, and others receive hormone replacement therapy. Surgeries are rarely offered to those under age 18, research from the Harvard T.H. Chan School of Public Health shows, though they have happened and have shown positive, even “life-saving” outcomes.

For local organizations focused on uplifting LGBTQ+ people, the CHLA center’s upcoming closure is a major loss of resources — and more importantly, lives.

Many advocates worry the decision could lead to an increase in suicides among vulnerable transgender communities, particularly with the federal targets — from funding to exclusion — on transgender people, they say. The closure also follows the Supreme Court’s recent decision to uphold Tennessee’s ban on gender-affirming care for minors, adding another setback to transgender rights. The decision was denounced by a number of organizations including the American Academy of Pediatrics, the American Medical Association and others.

Small and lively crowds have been showing up to the weekly rallies in front of the hospital, co-hosted by the Los Angeles LGBT Center alongside other LGBTQ+ organizations. Around 60 people showed support and called for continued services at a July 3 rally, some holding signs that say “Let Trans Kids Become Trans Adults,” and “Trans Youth Deserve to Live.”

Maria Do, the L.A. LGBT center’s community mobilization director, denounced the closure, and said there is “nothing operational, legal or financial about people’s lives being at risk and people’s lives being on the line.”

“The bigger risk is the risk of losing our trans and nonbinary siblings,” Do said at the rally.

2023 study from the Williams Institute at UCLA School of Law found that 81% of transgender adults in the U.S. have had suicidal ideation, 42% of trans adults have attempted suicide, and 56% have engaged in self-injury over their lifetimes. Suicide is the third leading cause of death among young people ages 15 to 24, L.A. County mental health officials said, and LGBTQ+ youth are particularly vulnerable. They are more than four times as likely to attempt suicide than heterosexual peers, according to The Trevor Project.

Community advocates were left shocked that CHLA will still shutter its trans youth clinic — even after it briefly reversed its decision to stop taking new patients for gender-affirming surgeries, following Trump administration pressure, in February. At that time, California Attorney General Rob Bonta said that the state’s anti-discrimination laws still allow this kind of specialized care.

“California supports the rights of transgender youth to live their lives as their authentic selves,” Bonta said in a press release. “We will not let the President turn back the clock or deter us from upholding California values. Let me be clear: California law has not changed, and hospitals and clinics have a legal obligation to provide equal access to healthcare services.”

The Attorney General also filed a suit to stop the government from rescinding funding, pointedly telling hospital officials that closing the Center for Transyouth — and its gender-affirming services — would be discrimination.

Others expressed their support for the center’s closure, and an end to gender-affirming care. Businessman John D. Garland, who works in the film industry, believes minors shouldn’t be able to make “permanent changes to their bodies” other than mental health treatments, he said, and avoid “irreversible changes” to their bodies.

2021 study by the Journal of the American Society of Plastic Surgeons found that, of 7,928 transgender patients surveyed who underwent any type of gender-affirming surgery, only 1% regretted it in later years.

“I don’t think a minor has enough social development or enough insight to make a determination about their gender. We don’t allow children to drink, to smoke, to have sex legally until a certain age, how do we justify not limiting surgery age for these children?”

Garland said he is fine with minors thinking and exploring however they identify, and should receive mental health resources until they are an adult; then they can consider procedures.

The Trump administration also announced its July termination of the 988 National Suicide and Crisis Lifeline’s mental health support to LGBTQ+ youth. which officials said has provided life-saving options for over 1.3 million youth. California Gov. Gavin Newsom and L.A. County leaders have condemned the decision.

Between this and the cutting of this “groundbreaking” transgender youth clinic, community members, allies, and former patients at the Children’s Hospital’s Transyouth clinic were outraged.

“It’s really hard to put into words, just how devastating this decision is,” said Felix Moreno, who received services — including hormone replacement therapy and surgery at 18 — at the center. “It’s so difficult to see something that turned my life around, and was the one thing that really kept me from ending my life, to stop providing those services.”

Moreno, who identifies as a nonbinary trans man and uses he/they pronouns, said the care he received at CHLA was nothing short of life-saving.

California Senate candidate Maebe Pudlo, a drag performer running for the 26th District, also serves as a representative for the Silver Lake Neighborhood Council. Pudlo helped to start the regular hospital protests months ago, and was “angered” when the clinic’s closure was announced during June’s Pride Month.

“It also happened in the midst of all the ICE raids and protests happening in Los Angeles, when people are distracted,” Pudlo said. “For this to be happening in the center of Los Angeles, which is supposed to be a progressive haven, I think it crushes the hopes of trans people everywhere. Families are devastated… it makes a lot of children themselves worried.”

Pudlo and other advocates expressed concerns that trans and gender-nonconforming people who are also immigrants are now “extra vulnerable” under Trump’s policies restricting immigration. At the July 3 rally in front of the hospital, they chanted, “No borders, no nations, we want trans liberation!”

Pudlo, holding a large “Protect Trans Kids” banner at the rally, advocated for cisgender minors who receive gender-affirming care and procedures, but noted how anti-LGBT+ legislation “specifically applies” to transgender people.

Jack Brenner — a nurse at CHLA — joined the hospital protest after a shift, calling the closure “personal,” and said gender-affirming care “saved my life.” Brenner is a trans nonbinary person who uses they/them pronouns.

Through community resources and care, Brenner shared their experience exploring gender identity, getting low-dose testosterone therapy and later, top surgery — a process of removing breast tissue and reshaping, sometimes for a more masculine chest area.

“I didn’t see a future for myself and didn’t know how to move forward,” the 33-year-old nurse said. “Now, I finally feel like I like my body, I’ve never felt that way before.”

As a nurse, Brenner works “regularly” with trans and nonbinary youth, but not at the Center for Transyouth clinic.

“The only thing I can do now is show up as myself and show trans kids that there is a future as a trans adult, and that I can see and affirm their identity, treat them respectfully and call them the right name and pronouns,” they said. “Even if their families don’t, even if their healthcare providers don’t — in a society that otherwise rejects them, I will never reject them.”

For anyone struggling with suicidal thoughts, resources are available at The Trevor Project, which has a 24/7 LGBTQ+ youth hotline at 1-866-488-7386.

For text or web chat options, visit www.thetrevorproject.org/get-help. The National Suicide Prevention Lifeline, providing confidential emotional support, is available by dialing 988.

The Associated Press contributed to this report. 

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