Paul’s 16-year-old trans daughter had been running out of her medication last month when he saw President Trump’s executive order that labeled gender-affirming care for minors “chemical and surgical mutilation.” She has been a patient at NYU Langone’s Transgender Youth Health Program for two years, so Paul immediately contacted her doctor to get some clarity before her next appointment, scheduled for late February.
“I reached out to them through MyChart and said, ‘Hey, in light of this EO, I’m hoping we can get this prescription filled before the appointment. We’re obviously concerned,’” says Paul. The response did nothing to reassure him. “Her doctor made it clear this was coming down from above and she was not given much choice. But she said that they were waiting for better guidance from the institution.” (NYU Langone declined to comment on Paul’s and other parents’ accounts.)
Paul let the doctor know they didn’t have enough medicine to make it through to the appointment. The doctor wrote back and said they were given the go-ahead to renew prescriptions for existing patients, only to retract an hour later, saying they were getting mixed guidance and that she was very sorry. On Thursday, yet another switch: The prescription, it seemed, could be filled after all.
Over the past week, parents like Paul have been bombarding one another by text and Google Group trying to make sense of the new landscape for their children’s care. “We’re all Signal chatting, trying to figure this out,” he says. As of Tuesday, NYU Langone has canceled appointments for new patients and denied some longtime patients their preferred form of medication. Mount Sinai has also reportedly canceled young trans patients’ appointments. All this is in apparent response to Trump’s executive order, which threatens that the federal government will stop funding education or research grants for any institution that provides gender-affirming care. This care, which very rarely includes surgery, is supported by all major medical associations in the United States.
For Paul’s daughter, being denied her meds after a year on estrogen would be “catastrophic. She has pretty extreme gender dysphoria,” Paul says. If she started to experience the effects of testosterone-driven puberty, “that would put us in a position where I would greatly fear for her health and safety.” This isn’t an abstract fear: Paul’s daughter knows trans people who have been driven to suicide and struggle with suicidality daily. “These are kids with supportive families who go to an incredibly supportive high school,” he says.
He has seen a complete turnaround in his daughter’s happiness since she started receiving hormones. “Before she came out as trans, we were having incredible behavioral issues, and she was just not herself and depressed,” Paul says. “Coming out really started her journey to flourishing as a person. We’ve seen her flower and mature and be happy. Getting into NYU was a really important step in that process, and seeing that she had people who cared and were willing to help.”
The meaning of Trump’s order is unclear and its implications are anxiety inducing both for children and their families and for the doctors who work with them. “We don’t know what to tell patients,” says one doctor, who works in a non-NYU clinic that treats trans youth and asked to remain anonymous. “Patients are fearful of what’s going to happen. There’s a mutual sense of stress because everyone understands the intent of these executive orders is to be confusing.”
That stress has affected one mother in the Bronx whose son transitioned at the age of 3. He will soon be 12, and his doctor at NYU Langone informed her that he will not be able to get a puberty-blocker device implanted in his arm this spring as planned. She was told the hospital is interpreting the order’s ban on “surgery” to include this quick outpatient procedure. While the medication-delivery device lasts a year, the alternative is quarterly injections, which would mean a two-hour commute by train every three months. Plus, her son is afraid of needles. “I haven’t even told him yet because things feel so in flux, and we’re hoping they can be ashamed or shocked or forced by law into giving the care they need to give,” she says. “This is a civil rights issue.”
“Gender-affirming care for pediatric and adolescent populations — it’s best-practice medical care. Full stop,” says the doctor. “The disinformation that we’re dealing with is that pediatric and young adult trans-affirming health care is a threat to transgender patients and not something that is oftentimes lifesaving and improves their quality of life and decreases adverse outcomes.”
Since the election, he’s been contacted by patients worried about their medical records, asking to change diagnostic codes or move certain medications off their charts. He also has concerns that some patients will go DIY with unapproved, unsafe, or ineffective medication.
“It’s concerning that patients will seek hormones from non-licensed or non-FDA-approved sources,” he says. “People get hormones off the street. You can go online, buy things from other countries without lot numbers, without expiration dates.” He compared the shifting landscape around gender-affirming care to the legal patchwork governing abortion post-Roe: “There’s a fear among providers and patients that we’ll regress to a situation where the best-practice medical care is not something we can legally provide.”
J.D., who is the trans dad of a 15-year-old trans daughter, tells me he stockpiled a year’s worth of meds for her after the election and has shared information with other families on how to do the same. “It’s a life-and-death issue,” he says. “There’s nothing more important in her life than having this care. We’ve known she was trans since she was 2 and a half.” The mood in their home has been brutal since the election. “We are an all-queer family. I’m a trans person myself,” he adds. “I’m very angry and I have a lot of despair.”
On Monday night, J.D. and his daughter, the mother from the Bronx, and Paul and his daughter joined other families, doctors, clergy members, and assorted Democratic socialists at a rally a few blocks away from NYU Langone. “Shame!” they shouted, their voices echoing in unison off the towers surrounding St. Vartan Park on Manhattan’s East Side. The mood was defiant and uplifting. Heart-shaped balloons in the colors of the trans flag bobbed among the crowd, who cheered celebrity guest speakers including the costume designer Qween Jean and the actress Cynthia Nixon, who mentioned that her son had his top surgery at NYU. Nixon said that in the “barrage” of bad news since the election, “nothing has made me feel so good as coming around the corner today and seeing you all, standing here, fighting for transgender rights.”
New York attorney general Letitia James had issued a letter earlier that day warning doctors to keep providing gender-affirming care to stay in compliance with New York State law. But most of the city’s clinics haven’t clarified whether this care will continue. Callen-Lorde, the LGBTQ+ focused community-health center in Greenwich Village, has confirmed to teenage patients that it is still providing care. “Access to medically necessary transgender health care is explicitly protected in New York State,” its website states. “You are protected here in New York, and so is your care.”
I asked four other pediatric- and adolescent-gender clinics in the city how they plan to respond to the executive order. Three were noncommittal — Mount Sinai said “We will keep you posted”; New York-Presbyterian said, “We are working through this developing situation to comply with applicable state and federal laws and regulations”; and Northwell Health had no comment. Only the municipal system responded affirmatively: “NYC Health + Hospitals continues to offer gender-affirming care, including for minors.”
Before Trump took office, 23 states had already banned this kind of health care for minors. The speakers at Monday’s rally voiced a sense of betrayal at what felt like the loss of a safe haven, at this one hospital in particular — NYU Langone has, as it still trumpets on its website, long been designated an LGBTQ+ Healthcare Equality Leader by the Human Rights Campaign Foundation and in New York City in general. “It’s shocking,” says the doctor. “That’s the scary part. It shouldn’t be happening here.”
This is a developing story and has been updated.