Rady Children's Hospital, under federal investigation, ends gender-affirming care
Rady Children’s Hospital has confirmed it is halting gender-affirming medical care, and revealed the hospital was under federal investigation by the Health and Human Services’ Inspector General.
The hospital declined to provide details about the investigation, but a statement released Wednesday said “escalating federal actions” surrounding the topic of gender-affirming care, as well as a tip to the Inspector General’s office, led to their decision to end services. A spokesperson for the Inspector General’s office said the agency doesn’t confirm investigations as a matter of policy.
“These developments affect our role and responsibilities as a provider participating in federal programs such as Medicaid and Medicare, which are essential to caring for all children and families in our communities. For these reasons, we will no longer be providing gender-affirming medical interventions, procedures and prescriptions,” the hospital said, in part, in a written statement. The hospital said it would continue to provide counseling, mental health resources, and care coordination.
Wednesday’s announcement from Rady validates a report from a San Diego family who said their teenager’s upcoming mastectomy surgery was canceled by the hospital because of, they were told, the Trump administration’s proposal to cut federal funding to hospitals that provide gender-affirming care to minors.
“I was sure that I wasn’t going to make it to the weekend knowing that,” said 15-year-old Enfys Zerlaut, who is non-binary.
The mastectomy was the latest step in Zerlaut’s care that began at Rady Children’s Hospital about 10 months ago, which included therapy, endocrinologist appointments and surgical consultations.
Those seeking gender-affirming care are typically evaluated for gender dysphoria, or the distress caused when gender identity doesn’t match a person’s assigned sex. If children meet guidelines and are showing signs of puberty, they can begin taking puberty blockers and, if further criteria is met, teens can begin hormone treatments. Leading medical authorities say surgery is rare for minors, with exceptions for older teens who meet certain criteria.
The Voice of San Diego reported in September that Rady Children’s Hospital was making moves toward the eventuality that was Wednesday’s announcement by deactivating its gender-affirming care webpage, obscuring a once-celebrated program, as hospitals faced mounting pressure from the federal government to end those medical services.
In the Trump administration’s latest move, the U.S. Department of Health and Human Services proposed regulatory actions to restrict the use of puberty blockers, hormone therapy and surgical interventions for transgender minors. The proposals, which are under comment period until mid-February, have been challenged legally by a coalition of democratic states, including California, for overstepping the state’s ability to regulate Medicaid programs, the group said.
“If the Administration attempts to finalize these proposals, the Attorney General’s Office is prepared to take further legal action to prevent them from going into effect,” California AG Rob Bonta said.
To hospitals that appear to be appeasing the federal government, Bonta has said California hospitals may be in violation of state law that prevents descrimination on the basis of sex.
“I understand that the President’s executive order on gender affirming care has created some confusion. Let me be clear: California law has not changed, and hospitals and clinics have a legal obligation to provide equal access to healthcare services,” Bonta said last February.
It is unclear how that dichotomy will play out for Rady Children’s Hospital but, for now, the pause on gender-affirming services has left the Zerlaut family in limbo and searching for what’s next in Enfys’ care. Regardless, the family is determined to keep fighting.
“I’ll probably never be 100% happy with how I identify and how I present my gender, but I can try the best to be who I want,” Enfys said.
Read Rady Children’s full statement:
The environment around gender-affirming care has changed dramatically, with escalating federal actions. As part of this escalation, we were recently referred to the U.S. Department of Health and Human Services Office of Inspector General for investigation. Taken together, these developments affect our role and responsibilities as a provider participating in federal programs such as Medicaid and Medicare, which are essential to caring for all children and families in our communities. For these reasons, we will no longer be providing gender-affirming medical interventions, procedures and prescriptions. This was a very difficult decision, made to ensure we can continue serving all children and families across the communities we serve. Our care teams are communicating with affected patients and families to discuss next steps. We continue to provide supportive care including counseling, mental health resources, and care coordination. We will also help connect families to ongoing resources. We respect the dignity of all patients, including LGBTQ+ patients and transgender youth, and remain committed to providing compassionate, respectful care.
Jackie Crea contributed to this report.
