Another Monday, another chance to change the world.

There's a particular kind of exhaustion that comes from watching institutions abandon their stated missions when political pressure arrives. Not the exhaustion of a busy clinical day, but the bone-deep weariness of realizing that the systems we've built together to protect vulnerable patients will fold when tested.

This week brought sharp reminders that institutional courage is rare, and that the infrastructure supporting trans healthcare is more fragile than many of us wanted to believe. But it also brought evidence of what sustained organizing can accomplish when people refuse to accept betrayal as inevitable.

The terrain keeps shifting. The work continues. Let's get into it.

NEWS: the headlines you need to stay informed.

Fenway Health, Boston's historic LGBTQ+ healthcare institution, announced it will stop providing gender-affirming care to patients under 19, citing fears of losing federal funding under Trump administration pressure. The decision has sparked continuous protests from activists demanding the clinic return to its founding mission of serving the most marginalized members of the community—not abandoning them when political winds shift.

The federal assault on gender-affirming care continues to intensify. The Children's Hospital of Philadelphia is fighting a DOJ subpoena demanding sensitive patient information as part of what CHOP's lawyers describe as baseless accusations of billing fraud—accusations the hospital characterizes as part of a coordinated anti-trans political agenda.

In Texas, Dallas pediatrician Dr. May Lau surrendered her medical license amid Attorney General Ken Paxton's lawsuit over prescribing testosterone to minors. Harvard Medical School postponed its continuing education course "Advancing Excellence in Transgender Health" after conservative media questioned whether fee waivers for transgender physicians violated discrimination law.

Providers in Vermont are preparing for potential insurance coverage changes as federal pressure mounts, while North Carolina's 4th Circuit Court reinstated a state health plan exclusion for gender transition treatments dating back to the 1990s—though coverage for complications and mental health services related to gender dysphoria remains intact.

Internationally, Queensland's puberty blocker ban is being challenged in court, where judges heard evidence of "political interference" and lack of proper consultation with health executives. Norway's Oslo University Hospital was censured for conducting unauthorized research on transgender minors without proper ethical approval or consent—a breach that undermines trust in medical institutions serving vulnerable populations.

The Supreme Court is hearing arguments in Chiles v. Salazar, a case that could threaten state bans on conversion therapy for minors by framing harmful practices as protected speech. A new international report documents rising danger for LGBTQ+ people globally, with increased hate crimes, discriminatory legislation, and social media platforms failing to prevent the spread of anti-LGBTQ+ rhetoric.

On Intersex Awareness Day, advocates highlighted ongoing fights for bodily autonomy and the ways current anti-trans policies harm intersex individuals—a reminder that these struggles for recognition, rights, and healthcare access are deeply interconnected.

Public health officials are monitoring the first confirmed cases of local transmission of the more dangerous mpox Clade 1 strain in California, with particular concern for higher-risk populations including gay and bisexual men. Vaccination remains the most effective protection.

Rx RESIST: how you can make a difference

RX RESIST: how you can make a difference

When students at McMaster University discovered their institution had partnered with the Society for Evidence-based Gender Medicine (SEGM)—an anti-trans advocacy group masquerading as scientific authority—to produce flawed systematic reviews weaponized against gender-affirming care, they organized until the university committed to refuse future SEGM funding. This is what institutional accountability looks like: students and faculty identifying harm, demanding transparency, and refusing to stop until leadership acted.

Healthcare and academic institutions in your community are making similar decisions right now about which funders to accept, which research to promote, and whether to abandon patients under political pressure. If you're looking for concrete actions this week:

Investigate your institution's funding sources and partnerships. Request transparency about grants, research collaborations, and continuing education sponsors. If you find concerning partnerships, organize colleagues to demand accountability.

Support providers and institutions resisting federal pressure. CHOP is fighting the DOJ subpoena. Fenway protesters are showing up repeatedly. Find the resistance efforts in your area and add your voice—whether that's signing open letters, attending actions, or providing material support to affected patients.

Document everything. When patients lose access to care, when providers surrender licenses under threat, when institutions cave to political intimidation—these stories matter for future litigation, policy fights, and historical record. Share what you're witnessing with journalists, advocacy organizations, and legal groups tracking these attacks.

Build alternative care networks now. As institutional providers retreat, community-based care becomes critical infrastructure. Connect with mutual aid networks, underground referral systems, and providers committed to continuing care regardless of federal threats.

Institutional courage is built from individual practitioners refusing to comply with unjust demands. The students at McMaster proved that sustained organizing works. Show up and make your institution prove its stated values.

MIXED MEDIA: good reads, podcasts, documentaries, and more

This week's reading spans the authoritarian playbook targeting LGBTQ+ communities, radical reimagining of healthcare access models, and critical analysis of how polling shapes—and misshapes—public discourse on trans rights.

• In authoritarianism, dictators come for LGBTQ+ people first. Here's why. - Analysis of why authoritarian regimes consistently target queer communities as early signals of democratic backsliding, examining the connection between anti-LGBTQ+ policies, HIV funding cuts, and broader threats to civil society. The piece situates the No King's March within historical patterns of resistance against creeping authoritarianism.

• Informed Consent Doesn't Go Far Enough: The Case for Hormones Over-the-Counter - A compelling argument for eliminating medical gatekeeping entirely by making hormonal treatments available over-the-counter, challenging providers to consider whether our current "progressive" informed consent model still functions as an unnecessary barrier to bodily autonomy and self-directed transition care.

• Polls on Trans Issues Ignite a Debate That Ignores Their Many Limitations - Critical examination of how public polling on transgender issues often obscures more than it reveals, with analysis of low baseline knowledge, elite narrative influence, and the danger of letting survey data define advocacy strategy rather than illuminate the contested terrain of public discourse.

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Original Reporting

When parents resist their child's gender identity, providers face a clinical challenge that requires balancing evidence-based affirming care with the reality that family acceptance is profoundly protective—and family rejection doubles suicide risk.

This week's article offers practical strategies for navigating these dynamics, plus Professional and Lifetime members can download a comprehensive 40-page evidence guide and 10-page quick-reference factsheet with the statistics and citations needed for difficult conversations with anxious parents.

New Downloadable Resource!

Check out the new resources in the library!