As rain sprinkled over East Hollywood last Thursday, Juan Carlos Perez took the microphone amid a crowd of hundreds of people who had gathered outside of Children’s Hospital Los Angeles to protest the hospital’s recent restrictions on gender-affirming care for young people. He said that “rage and determination” had brought him there.
Perez told HuffPost that he was close to reaching his breaking point. In January, the Eaton Fire ripped through Altadena and burned down the house that Perez shared with his wife and three children. The family lost everything except for the few items they were able to fit in the car the night of the fire. Perez’s middle child, who is trans, had managed to pack their hormone treatments.
An immigrant from Peru and the father of queer and trans children, Perez said the last month of President Donald Trump’s executive orders and decisions has made his family feel like a target.
“I’ve never found my breaking point,” Perez said. “But I worry about getting there — from losing everything literally overnight to finding yourself really vulnerable in a country where your family isn’t supported … the very things that make our family and make us strong make us vulnerable right now and susceptible to attacks.”
In early February, the Children’s Hospital announced it was pausing hormone therapy for new patients under the age of 19, as hospital officials reviewed Trump’s sweeping executive order targeting providers of gender-affirming care for youth. The hospital had already stopped providing gender-affirming surgeries for youth last year.
In the U.S., 24 states have already placed restrictions on access to gender-affirming care for trans youth. And now the future of access to this care hangs in the balance as the Supreme Court is expected to deliver a decision this summer on whether these bans on care violate the Constitution.
On the night of the protest, Perez told the crowd that his child was embraced with love and acceptance when they came out as transgender.
“I have a child who lost everything they have and who comes out of that feeling attacked and told they don’t exist,” Perez said to HuffPost. “All of that is infuriating and offensive. When I find myself attacked, I tend not to retreat. I lean in and fight back.”
Perez said he felt “betrayed” when he heard the news about the Children’s Hospital’s restrictions, which came days after Trump signed an executive order directing agencies to ensure that hospitals and medical schools receiving federal research and education grants “end the chemical and surgical mutilation of children.” The order also declared that the United States will not “fund, sponsor, promote, assist, or support” the transition of a child under 19 years of age.
Perez’s 18-year-old is already a patient with the hospital and has not lost access to their estrogen hormone therapy. They have been receiving gender-affirming care from the hospital’s Center for Transyouth Health and Development — one of the largest providers of medical and mental health support for trans youth in the country — for the past 3 1/2 years. Under the hospital’s care, Perez said that his child’s “severe dysphoria” dissolved as they were supported by the center’s team at every step of the way.
But other families have already had disruptions to their care at the Children’s Hospital. The Los Angeles Times spoke with one family who had an appointment canceled while another family had an appointment to replace a puberty blocker briefly canceled before it was reinstated.
In a statement responding to questions about the future of gender-affirming care, the Children’s Hospital said it will “continue to carefully evaluate the Executive Order to fully understand its implications … and continue to support our patients and their families with access to mental health and social support services.”
This week, members of the Committee of Interns and Residents, a union of physician residents that also organized the protest Perez attended, circulated a petition for Los Angeles doctors to demand that the Children’s Hospital reinstate and continue providing gender-affirming care for young people.
“We are really disappointed that CHLA has decided to comply with an executive order that violates California state law and will negatively impact the health and safety of trans youth in Los Angeles,” said Shea Nagle, a resident physician and member of CIR. “We’re all blindsided, and we are hopeful that in the coming days they will reverse this decision.”
California Attorney General Rob Bonta said on Feb. 5 that he was putting the hospital on notice that withholding access to care for trans youth could violate state law. In a letter sent to the hospital, Bonta wrote that Trump’s order “does not provide federal agencies with any basis to threaten or revoke your federal funding” and gave the hospital 10 days to inform him of any cancellations and justifications for doing so. In its statement, the Children’s Hospital said it is “currently reviewing” the letter.
Bonta is one of 14 Democratic state attorneys general that issued a joint statement of support for protecting access to gender-affirming health care for trans youth. The statement was signed by the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, New Jersey, New York, Nevada, Rhode Island, Vermont and Wisconsin.
The White House rescinded a memo about the freeze, which was initially detailed by the Office of Management and Budget, though Trump has still continued to block some funds.
But the attorneys general said that the federal courts’ decisions meant that federal funding for hospitals that provide gender-affirming care “continues to be available, irrespective of the recent executive order” — and that these highest state law officers will take legal action if need be.
“State attorneys general will continue to enforce state laws that provide access to gender-affirming care, in states where such enforcement authority exists, and we will challenge any unlawful effort by the Trump Administration to restrict access to it in our jurisdictions,” the attorneys general wrote.
The attorneys general’s support comes after other children’s hospitals and clinics from around the country have canceled appointments or announced restrictions to care for trans youth.
In New York, NYU Langone Healthcanceled appointments for new patients, including one for a 12-year-old boy to get a puberty-blocker device implanted in his arm, a quick outpatient procedure that will pause the onset of puberty. In response, thousands of people took to the streets in Manhattan to protest against the medical center.
Hospitals in Virginia, Colorado and Arizona have also stopped providing various forms of gender-affirming care for people under 19. On Wednesday, a Michigan hospital lifted its pause on new hormone therapy appointments for pediatric patients after taking time to assess the order.
A very small percentage of youth have access to gender-affirming care in the U.S. A recent study published in JAMA Pediatrics found that fewer than 1 in 1,000 U.S. adolescents with private insurance receive puberty blockers or hormone therapy — and surgical procedures are incredibly rare.
Still, Trump applauded these hospitals’ decisions as evidence of his commitment to “protect American children.” His executive order on gender-affirming care is one of a flurry of other orders Trump has signed during his first month in office to reverse Biden-era civil rights policies meant to protect transgender people and their equal access to health care, education and legal recognition.
Trump has signed orders aimed at barring trans women from participating in women’s sports, barring trans people from serving in the military, and redefining the government’s definition of sex as “only two sexes, male and female.”
In a lawsuit filed on behalf of the families of transgender youth, the American Civil Liberties Union, Lambda Legal and several other LGBTQ+ advocacy organizations argued that Trump’s orders fly in the face of laws passed by Congress that bar hospitals that receive federal funding from discrimination on the basis of sex or transgender status.
Many of Trump’s other executive orders targeting trans people have faced legal challenges for violations of the Fifth Amendment’s equal protection clause and claims of the president “usurping legislative function.”
And while the courts deliberate whether Trump has the power to make these sweeping changes, his orders have already had widespread consequences across American life. The few trans women who were correctly housed in women’s prison facilities have been placed into solitary confinement or moved to men’s facilities. The State Departmentand Social Security Administration have stopped issuing changes to sex markers on federal documents and in internal computer systems. And the Department of Education announced it is investigating colleges with trans athletes and trans-inclusive sports policies.
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Some organizations and individuals have decided to stand up in the face of these threats. Dr. Jeffrey Birnbaum, a pediatrician and adolescent medicine specialist, told NBC News that he will continue to provide gender-affirming care to young patients “until somebody calls me away.”