Yale follows Connecticut Children's in gutting pediatric gender care

HARTFORD, Conn. — Under threat from the Trump administration, Connecticut hospitals are ending gender-affirming care for transgender and gender diverse youth, potentially leaving hundreds of young people without lifesaving care.

Connecticut Children’s began making phone calls to parents of patients Tuesday while Yale New Haven Health followed suit with letters to patients Wednesday. In a statement, Connecticut Children’s said it’s “winding down” its program for patients under 19, the age dictated by an executive order dated Jan. 28 that blocks federal funding for hospitals that provide such care. Court injunctions have temporarily blocked that order.

Yale said its pediatric gender program will continue to see patients under 19 to provide mental health services and “support in a compassionate care environment to all our impacted patients” but will no longer provide medication treatment including puberty blockers and hormones.

Puberty blockers, which cause no permanent changes, are used to pause irreversible physical changes while families consider what care is appropriate for a child with gender incongruence. The drugs, which are routinely prescribed to cisgender children experiencing premature puberty, have been shown to relieve psychological distress, suicidality and depression in children who don’t identify with the gender assigned at birth.

Hormone therapy, in which a transgender person is prescribed hormones to induce physical development in accordance with their gender identity, is often delayed until 16 years old. Psychological evaluations, therapy and consistent evidence of gender dysphoria are required.

No provider in Connecticut performs gender confirmation surgery on minors and parental consent for gender care is required.

“We remain committed to offering mental health services and support in a compassionate care environment to all our impacted patients,” Yale said.

Both hospitals allude to federal pressure as the reason behind the decision to end services for youth.

“In recent months, we have been carefully reviewing the long-term sustainability of our gender care program in light of an increasingly complex and evolving landscape,” Connecticut Children’s said. “After thoughtful consideration and guidance from medical and legal experts, we have made the difficult decision to begin winding down this program for patients under the age of 19.”

Yale’s letter was similar.

“We have been carefully monitoring federal executive orders and administrative actions relating to gender-affirming care for patients under age 19. After a thorough assessment of the current environment, we have made the very difficult decision to modify the pediatric gender program to eliminate the medication treatment component of the gender-affirming program for patients under 19.”

Trump’s executive order, issued in January, said, in part, “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, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.” The order stated that funds would be withdrawn from institutions providing drugs or surgery to anyone younger than 19.

The Trump order also said there is “blatant harm done to children” by chemical and surgical procedures that are cloaked “in medical necessity.”

Gov. Ned Lamont, who has consistently shown support for transgender youth, issued the following statement:

“It’s disappointing for hospitals in Connecticut to be forced to make the difficult decision to end gender-affirming care for minors in response to the federal executive order. These decisions are not based on Connecticut values or Connecticut law—they are part of a series of relentless federal demands that have created fear, confusion, and legal uncertainty for our healthcare providers. To transgender youth and their families in Connecticut: you are not alone. We see you, we support you, and we are working closely with the Attorney General and hospital leaders to understand the full impact. In Connecticut, we do not turn our backs on kids in need.”

Attorney General William Tong, who has filed numerous lawsuits against the Trump administration on behalf of the state, blamed the administration and issued a warning.

“The Trump Administration continues to attack American institutions and American families by sowing fear and confusion around medical decisions. This is the next ugly front in the ongoing war on American patients, doctors, nurses, and healthcare providers,” he said. “This is about scaring patients from seeking care and scaring doctors from providing care, regardless of who is harmed and the lives that will be lost. It’s unconscionably reckless and yet another disturbing intrusion of partisan politics on our private lives and choices.”

State Sen. Matt Lesser, D-Middletown, wrote a letter to Connecticut Children’s CEO Jim Shmerling expressing “serious concern” in his role as Senate co-chair of the Human Services Committee, suggesting that ending care for transgender youth constitutes discrimination.

“I am concerned that your decision endangers your patients, violates established standards of care and, to the extent that your decision discriminates against a class of your patients, violates state law,” Lesser’s letter said.

“Connecticut law is explicit: just this month, Governor Lamont signed into law Public Act 25-154, which passed unanimously through the legislature, which makes it expressly illegal for ‘any health care provider to knowingly discriminate in the provision of health care services on account of a person’s… gender identity or expression[.]”

Lesser mentioned subpoenas, which news reports show have been sent by the Department of Justice to hospitals that have provided pediatric gender care, and asked how the hospital intended to protect patients. The subpoenas reportedly sought patient information and preceded a wave of closures of gender programs at some of the most prominent children’s hospitals in the country.

“You are clearly in a tough position. However, that fact does not absolve you of responsibility for your decisions nor does it permit you to violate state law,” Lesser said.

Connecticut doctors who care for gender diverse people have worried since the election that restrictions on treatment would harm patients’ mental health and put them at risk of suicide. Lesser questioned Connecticut Children’s obligation.

“Studies have clearly established that transgender youth, who are stigmatized in every corner of our society, are at vastly higher risk of attempting and dying by suicide, and that gender affirming care can reduce that risk.1 Furthermore, your administrative decision appears to contravene the standards of care promulgated by leading professional organizations, including the American Academy of Pediatrics, the Pediatric Endocrine Society and the Society of Pediatric Psychology. To deny care seemingly violates those standards of care.”

Sen. Ceci Maher, D-Wilton, issued a statement referencing the recent defunding of a suicide prevention hotline for LGBTQ+ people and said the federal government is engaged in a chilling effort to rip “away care and support for vulnerable people.”

“Trans and queer youth in Connecticut and across America aren’t going away any time soon. Creating a climate of fear does not make people any less than who they are. Regardless of attempts by some to silence and intimidate them, the LGBTQ+ community will continue to have our support,” she said.

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