by Karen Brown, New England Public Media
One afternoon in late 2024, a sixth grader nicknamed Bug comes home from school with an announcement. Bugs, who was assigned female at birth, told his parents he was a boy — and would use the pronoun s/he.
“Okay, cool,” her mother, Jay, remembers saying. (Jay is asked to identify himself only by his first initial and Bug by his nickname, as the family fears harassment.)
“‘What do you need to support?'” he recalled asking next. “He asked to get health care.”
It was a moment when Jay expected the family to move from Texas to Massachusetts for its more liberal and inclusive politics. He felt confident that they could find the right medical specialist. But she didn’t realize that access to gender-affirming treatment could disappear even if their state’s laws and leaders supported it.
Individual hospitals across the US in red and blue states have responded to President Donald Trump’s attacks on transgender health care by deciding to withdraw their own care. at least 20 hospitals It did so in the early months of the Trump administration as it threatened to withdraw federal funding or launch fraud or wrongful-claims investigations, and such services have continued to close ever since.
Bugs and her younger sister were born in Austin, Texas, but Jay and her husband became worried after the state banned abortion; dismantled diversity, equity, and inclusion programs; and limited medical and civil rights for queer and transgender people. Parents worry that support services needed by their siblings, who both have autism, may also be affected.
“There was a fear of being like a frog in boiling water and not realizing what was going on until it was too late,” Jay said. “I needed to get my kids out of Texas.”
So when the bug came out as a trans, Jay was relieved that they’d landed in a state where there just wasn’t one “Slope” law from Protect providers who offer Gender-specific care but is also Among the 24 states Commercial insurance is required, which Bug’s family has, to cover this.
After Bug’s gender was announced, Jay’s questions led him to the region’s largest hospital system, the Springfield, Massachusetts-based Baystate Healthwhere they began the months-long process of being set up to begin hormone therapy.
Bug, an artistic 14-year-old who loves making short films with horses, cats and friends, is much older. Puberty blockersBut he was excited about the prospect of starting testosterone. This will deepen his voice, grow facial hair and enlarge his muscles.
“Every part of it sounds fun,” he said.
But this past February, two weeks before Bug started testosterone, Baystate announced it would no longer provide gender-affirming drugs to minors, offering only counseling. A letter to patients’ families did not explain why.
Baystate spokeswoman Heather Duggan sent a statement saying the decision to end treatment for minors reflects the fact that Baystate could lose “hundreds of millions of dollars in government reimbursements” as a result of the Trump administration’s plan. “Approximately 70 percent of Baystate Health’s patients rely on Medicaid and Medicare for coverage,” it said.
All Bug knew was that the care he had been eagerly waiting for was disappearing.
“I felt disappointed that they would do this,” Bugg said.
“I bet there’s a lot of kids who are like: ‘Okay, I’m going for trans-farming health care. Yeah!'” he said. “And then, like, tons and tons of kids were disappointed and sad and disappointed.”
Jay said it felt like the floor had fallen out from under them. “Maybe it’s naive, but I didn’t think it would happen in Massachusetts,” he said.
Baystate is among providers that have decided not to offer puberty blockers and hormones yet as the issue winds its way through the courts. This spring, in A case involving MassachusettsA federal judge has concluded that it is illegal for the Department of Health and Human Services to threaten federal funding for providers who provide sex-affirming care to minors. In June, another federal judge cleared 16 states, including Massachusetts, to move forward Another case against the administration is for criminalizing gender-affirming care.
The American Academy of Pediatrics declined an interview request but said in one past statement That young patients and their families should make decisions about gender-affirming care with their doctors, “delivered with compassion and without political interference.”
A mother of a former Baystate patient says that before her child came out as a transgender girl, she suffered from severe depression, struggling with suicidal thoughts. (Mom said only her first initial, L, would be used, because the family also feared harassment.)
After Baystate doctors prescribed puberty blockers and estrogen, her daughter’s mood and grades improved significantly, El said. So when he received the letter announcing the discontinuation of Baystate’s treatment, he was furious. Ell said she and other parents have filed a civil rights complaint with the Massachusetts attorney general.
The attorney general’s office did not respond to requests for comment.
“There’s a sense of, ‘How can you?'” El said. “And there’s an awareness of the impact that just pulling out of care can have on a young person — from a physical health perspective but also from a mental health perspective.”
Both L and J found alternatives for their children. L asked the family’s primary care doctor to get a hormone prescription. The family of bugs mentioned TransHealth, a private specialty clinic in Northampton, Massachusetts, said it had taken in about 50 of Baystate’s former patients.
“TransHealth has been recruiting for a while now in anticipation of this happening across the state,” CEO Joe Erwin said
Erwin said TransHealth can address funding threats because the clinic receives large private donations and is not as dependent on Medicaid and Medicare as most hospitals are. But Erwin says that doesn’t fully reassure the broader LGBTQ+ community, including transgender adults.
“When you see something like that, people fear that it’s going to happen to everybody eventually,” Erwin said.
In May, the Colorado Supreme Court A children’s hospital ordered That state to resume treatment for transgender youth while in Texas A court settlement A baby there forced the hospital to reverse — start the nation’s first “detransition clinic.” The Trump administration continues to pressure suppliers, including Looking for medical records Transgender minors.
After Bugs’ false start at Baystate, he was able to start taking testosterone at the new clinic in the spring.
His mother, Jay, says the treatment is going smoothly and Bugs has learned how to inject himself. But Jay is nervous that the federal government will find another way to cut off his treatment again. He sometimes second-guessed the family’s move from Texas to Massachusetts, wondering if they should have moved to Canada instead.
This article is from a partnership that includes New England Public Media, NPRand KFF Health News.
KFF Health News A national newsroom that produces in-depth journalism on health issues and is one of KFF’s core operating programs—an independent source of health policy research, polling and journalism. Learn more about KFF.
this Article appeared first KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-No Derivatives 4.0 International License.
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Previously published at kffhealthnews.org
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Photo credit: splash
