At the Pediatric Academic Societies' 2026 annual meeting in Boston, trans youth from Protect Trans Futures and allied clinicians disrupted and protested a panel stacked entirely with SEGM-affiliated speakers — the only panel dedicated to gender care at the conference, and the only one offering CME credits. Despite a 90,000-email campaign, PAS proceeded; the Pediatric Endocrine Society later issued a statement that the panel "was made up entirely of individuals who have espoused views that run counter to the bulk of the primary literature," and doctors attending the conference said they hadn't known about the panel's composition until activists told them. For a full account of how SEGM launders pseudoscience into clinical and legislative spaces, last month's Rx Resist column has the map.

The attacks on adult coverage escalated on multiple fronts this week. The 4th U.S. Circuit Court of Appeals upheld West Virginia's Medicaid ban on gender-affirming surgery for adults in Anderson v. Crouch — the first federal appellate court to apply Skrmetti beyond minors — with legal experts warning it could embolden at least seven other states facing similar lawsuits. Ohio Rep. Josh Williams, now with six anti-LGBTQ+ bills this session, introduced HB 838 to strip gender-affirming surgery from municipal employee insurance coverage.

At the federal level, House Republicans attached five anti-LGBTQ+ riders to the State Department's FY2027 funding bill, including a provision that would defund any organization that provides or promotes healthcare for trans people or "promotes transgenderism" — effectively any organization that acknowledges trans people exist — despite gender-affirming care being endorsed by nearly every major medical association.

Activists rallied at Springfield City Hall after Baystate Health ended gender-affirming care for patients under 18 in February — preemptively, without legal compulsion, and in apparent violation of a 2022 Massachusetts state law — even as a federal court had already ruled those Medicaid threats illegal; the hospital has not reversed course, and state AG Andrea Joy Campbell has yet to compel it. The pattern is doing exactly what it's designed to do: New Mexico's Planned Parenthood clinics have seen a 50% increase in hormonal treatment patients over six months, with half traveling from out of state, as the state becomes a de facto refuge for people abandoned by providers elsewhere.

The federal intimidation campaign against gender-affirming care providers took two significant steps this week. After losing subpoena fights in Massachusetts, Pennsylvania, Washington, and Colorado, the Trump administration filed a new petition in the Northern District of Texas — 1,800 miles from Rhode Island Hospital — exploiting a HIPAA venue provision to land the case before a favorable judge, and a Bush-appointed judge there ordered Brown University Health to hand over patient records within 14 days.

Trump also nominated Fox News contributor Dr. Nicole Saphier as Surgeon General, his third attempt to fill the role; if confirmed, Saphier — who has called trans youth a mental health "national emergency" and falsely equated gender-affirming care with "promoting body dysmorphic disorder" — would have a bully pulpit courts and insurers routinely cite. Tennessee's newly passed HB 754, meanwhile, is being called a registry in everything but name, requiring clinicians and insurers to report patient data on gender-affirming care to the state under the guise of research — and de-identified data in small communities can and does get re-identified.

After the Supreme Court's 8-1 ruling in Chiles v. Salazar effectively legalized conversion therapy nationwide last month, Colorado passed HB26-1322, a new ban using a private right of action — the same legal mechanism behind Texas's abortion bounty hunter law — allowing survivors to sue practitioners directly; the bill now heads to Governor Polis, who has given only lukewarm signals about signing it.

Internationally, the European Parliament voted to back an EU-wide ban on conversion therapy, a non-binding resolution signaling legislative intent across member states at a moment when the U.S. Supreme Court has moved in the opposite direction.

Contribute to Uncloseted Media's investigation into the LGBTQ+ mental health crisis: Over the next two weeks they're publishing on how the American healthcare system is failing trans kids and where Canada is falling short too — work that requires reader support to stay free and ad-free. The numbers they're working from: 39% of LGBTQ+ youth seriously considered suicide last year, over a third of LGBTQ+ people across 31 countries live with depression or anxiety disorders.

Build your answer to "What rights have trans people actually lost?": TransVitae's plain-language guide covers four domains — safety, healthcare access, public participation, and equal legal protection — with model language for the version of that question that comes from a genuinely curious patient, family member, or colleague rather than a bad-faith one.