INTRO

The Shifting Ground Beneath Us

This week brought devastating confirmation that the systematic dismantling of transgender healthcare is no longer just an imminent threat but our reality. While courts delivered some crucial victories for trans rights, the healthcare landscape continues to shift beneath our feet as major medical centers abandon the patients who need them most.

From coast to coast in the US, hospitals that have provided gender-affirming care for decades are shuttering programs, citing federal pressure and "legal risks." But resistance persists. Healthcare workers are protesting in the streets, state attorneys general are filing lawsuits, and courts are rejecting frivolous challenges to protective state laws.

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NEWS

Healthcare Executives Cave Under Federal Pressure

The past week witnessed an unprecedented collapse of pediatric gender-affirming care as major healthcare systems across the US announced the closure of their transgender youth programs. Connecticut Children's Medical Center, Yale New Haven Health, Kaiser Permanente, and Children's National Hospital in Washington D.C. all ended care for patients under 18, joining Stanford Medicine and Children's Hospital Los Angeles in abandoning trans youth.

These decisions, ostensibly driven by Trump's executive order threatening federal funding cuts, represent a stunning capitulation by institutions that have provided life-saving care for decades. The healthcare exodus has sparked fierce protests, with nurses and advocates taking to the streets outside Kaiser facilities in San Francisco.

The California Nurses Association condemned the moves as a "huge betrayal" that undermines patient care and called for organized resistance. Dueling opinions have emerged in San Francisco over Kaiser's decision to pause gender-affirming surgeries, with some supporting the pause while advocates argue it denies critical healthcare. As one comprehensive analysis noted, hospitals across blue states are limiting transgender care under Trump, even where state protections remain strong.

Meanwhile, the same hospitals ending gender-affirming care continue performing controversial intersex surgeries on infants, highlighting the hypocrisy of federal pressure. As intersex advocates point out, these non-consensual procedures—which have been condemned by human rights organizations worldwide—remain untouched while evidence-based transgender care is eliminated.

Targeting Vulnerable Youth: The Homelessness-to-Foster-Care Pipeline

This week's escalation extends beyond healthcare. Trump signed an executive order making it easier to remove homeless people from streets, emphasizing involuntary civil commitment and prioritizing programs requiring sobriety over housing-first policies. The order specifically targets harm reduction programs—crucial for addiction recovery—and shifts federal funding away from compassionate, evidence-based approaches.

This development takes on sinister implications when viewed alongside a federal appeals court ruling that Oregon's adoption policy requiring prospective parents to support children's gender expression and sexual orientation violates free speech rights. The 9th Circuit decision allows a Christian woman to proceed with adoption despite refusing to affirm LGBTQ+ identities.

The connection is clear and alarming: as queer and trans youth face heightened vulnerability to homelessness—often fleeing family rejection—the administration appears to be constructing a pipeline that funnels these vulnerable young people into a foster system increasingly controlled by those hostile to their identities. With LGBTQ+ youth making up 40% of homeless youth nationally, this represents a direct threat to their safety and wellbeing, potentially subjecting them to conversion therapy and other harmful "interventions" under the guise of care.

Courts Provide Crucial Victories

Despite the healthcare exodus, federal courts delivered important wins for transgender rights this week. A federal appeals court rejected challenges to Washington State's laws protecting transgender minors' access to care and shelter services, finding that anti-trans organizations and parents lacked standing to challenge the protective statutes. The 9th Circuit dismissed claims that these laws harm parents, noting they don't force changes in parenting styles—parents who claim injury have voluntarily altered their behavior in reaction to the laws. A Reuters report confirmed the decision upholds laws allowing shelters to provide care without parental notification if there's risk of abuse.

A separate federal court granted a temporary restraining order blocking the Trump administration's restrictions on grant funding for organizations serving domestic violence survivors, LGBTQ+ youth, and unhoused populations. The decision protects essential programs that had faced extinction under the administration's anti-DEI executive orders.

Meanwhile, Ohio's Supreme Court agreed to hear an appeal regarding a law prohibiting gender-affirming medication for minors, which was previously deemed unconstitutional by a lower court. The case will determine whether the state can restrict doctors from prescribing puberty blockers and hormone therapy to transgender youth.

Legislative Battles: Massive Resistance and Hidden Threats

While 647 anti-trans bills have failed across the U.S. in 2025—compared to 120 that passed—new threats are emerging in Congress that have received little attention. Sweeping federal legislation moving through appropriations bills would ban gender-affirming care for federal employees, their families, veterans, military personnel, and ICE detainees. These measures represent some of the most comprehensive attacks on transgender healthcare access yet attempted at the federal level.

International Context: UK Healthcare Crisis Deepens

Across the Atlantic, a new UK survey reveals that trans and non-binary people face severe barriers in accessing healthcare, with only 32% rating their gender-affirming care positively. The study documented widespread misgendering, prescription disruptions, and loss of NHS records, while nearly a third of respondents who changed their gender marker lost access to previous medical records entirely.

WHY UPGRADE

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