- A federal judge temporarily blocked President Trump’s executive order that aimed to stop gender-affirming care for transgender youth.
- The judge’s decision comes after several clinics nationwide paused care due to the executive order, causing fear and confusion among patients and providers.
- While gender-affirming surgery for minors is illegal in Arizona, the executive order targeted all forms of gender-affirming care, including hormone therapy.
A federal court ruling against President Donald Trump means more Arizona kids can get gender-affirming medical care, at least for now.
A federal district court judge on Thursday issued a temporary restraining order blocking enforcement of a Trump administration executive order that attempted to shut down gender-affirming medical care for transgender people under the age of 19.
The decision means Prisma Community Care in Phoenix (formerly the Southwest Center for HIV/AIDS) will resume all of its gender-affirming care, including hormone medication, for its young patients, according to a written statement the clinic issued Friday.
In Phoenix, Prisma Community Care and Phoenix Children’s Hospital previously had confirmed that they paused hormone medication for transgender teens because of Trump’s executive order. Prisma Community Care officials began notifying its patients of the pause during the week of Feb. 3.
Officials with Prisma say they are “relieved” to lift the suspension on caring for patients under the age of 19 due to Trump’s “discriminatory executive order.” The Jan. 28 executive order says that the United States 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.”
Officials with Phoenix Children’s Hospital on Friday did not immediately clarify whether or not they will resume care at their gender clinic.
Leaders at Prisma say the court ruling was the green light to fully restore care.
“Our health care providers have resumed normal operations, ensuring the delivery of evidence-based, patient-centered care. We are in the process of notifying the affected patients to resume their care,” Prisma’s statement says.
“We will persist in advocating for our 2SLGBTQIA+ community, celebrating this development as a significant step forward in supporting comprehensive gender-affirming care for all ages and fighting for the health and dignity of our community.”
The acronyms LGBTQIA+ and 2SLGBTQIA+ are umbrella terms for a wide range of gender expressions, identities and sexual orientations.
Fear drove clinics, hospitals to pause care for transgender youth
Trump issued the executive order about transgender youth on the heels of a Jan. 20 executive order that also targets people whose gender identity does not align with their gender at birth. That executive order declares that “it is the policy of the United States to recognize two sexes, male and female. These sexes are not changeable and are grounded in fundamental and incontrovertible reality.”
While legal experts with the national nonprofit Human Rights Campaign, which advocates for the LGBTQIA+ community, have said that Trump’s Jan. 28 order should not have had an effect on the ability of providers to care for transgender kids, some hospitals and other providers of gender-affirming health care, fearing repercussions, put treatment on pause anyway.
Arizona transgender kids weren’t the only youth affected by Trumps’s order. Clinics and hospitals across country, including in Massachusetts, Maryland, Washington, Colorado, and Virginia, abruptly halted medical care for transgender people under age 19, prompting protests.
The American Civil Liberties Union, Lambda Legal, the ACLU of Maryland, and law firms Jenner & Block and Hogan Lovells on Feb. 4 filed a federal lawsuit challenging Trump’s order on behalf of transgender young adults and adolescents and their families whose health care has been disrupted.
“Across the country, this unlawful order from the president has sown fear among transgender youth and confusion among their providers,” Joshua Block, a senior staff attorney for the ACLU’s LGBTQ & HIV Project, said in a written statement after Thursday’s decision.
Block said the decision should restore access to health care for transgender youth, as well as protections under the Constitution.
“Providers who’ve suspended healthcare for their transgender patients should be left with no doubt that they can lift those suspensions and continue to provide healthcare and act in their best medical judgment without risking their funding or worse,” Block said.
Gender-affirming surgery for kids is rare; in Arizona it’s illegal
Leaders with the ACLU and Lambda Legal say the judge’s order “prohibits federal agencies from conditioning or withholding federal funding based on the fact that a health care entity or health professional provides gender-affirming medical care to a patient under 19.”It’s already against the law for any child younger than 18 to get gender-affirming surgery in Arizona and even in states where it’s legal, such surgeries are rare, several studies have shown.
A study by researchers at Johns Hopkins University, published Sept. 25, 2023, in the Cureus Journal of Medical Science, identified 108 such surgeries over three years in U.S. kids ages 17 and younger. The study looked at gender-affirming surgeries between 2018 and 2021 through the American College of Surgeons National Surgical Quality Improvement Program Pediatric database and found more than 90% were chest masculanization surgeries.
Prisma and Phoenix Children’s Hospital historically have provided hormones such as estrogen, progesterone and testosterone for a small number of kids whose gender identity does not match with their gender at birth. At Prisma, the number of kids who get gender-affirming care is small: fewer than 20 people, which represents less than 2% of the clinic’s patients.
Prisma always has referred patients who want puberty blockers to Phoenix Children’s Hospital. Puberty blockers are a type of medication that can temporarily pause puberty and are reversible, the Human Rights Campaign says.
“Phoenix Children’s is bound by all federal laws and regulations for the provision of care to its patients,” a written statement from the pediatric health system said. “For this reason, Phoenix Children’s is indefinitely pausing hormone therapy services within the Gender Clinic to ensure we are in full compliance with the recent executive order.”Bans on gender-affirming care linked to poor mental health outcomes.
The American Medical Association, American Psychological Association and other major medical organizations in the U.S. support gender-affirming care and say that access to such care leads to dramatically reduced rates of suicide attempts, depression, anxiety and substance use, and to improved HIV medication adherence and reduced rates of harmful self-prescribed hormone use.
The American Academy of Child and Adolescent Psychiatry has said that blocking access to timely gender-affirming care has been shown to increase youths’ risks for suicidal ideation and other “negative mental health outcomes.” The organization recommends youth and their families formulate an individualized treatment plan with their clinician that addresses the youth’s mental health needs, “under the premise that all gender identities and expressions are not inherently pathological.”
Gender-affirming care programs typically include both a medical side, as well as mental and social wellness components.
Reach health care reporter Stephanie Innes at [email protected] or follow her on X, formerly Twitter: @stephanieinnes.
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