Next month, Children’s Hospital LA (CHLA) is ending its health care program for trans youth — one of the oldest and largest of its kind in the country. CHLA is also one of the few hospitals providing gender-affirming care to patients on public assistance. Thousands of families will be immediately affected.
CHLA says it had no choice after President Trump threatened to pull all federal funding and prosecute doctors. However, state law prohibits discrimination based on sex and gender identity. And California Attorney General Rob Bonta is preparing to sue CHLA and the Trump administration.
Jordan Held, a therapist who sits on the board of directors of the Los Angeles LGBT Center, says many myths exist in the U.S. about what gender-affirming care looks like; and the reality is that clients and their families are consulting with case managers and doctors “who are culturally humble to meet them where they're at,” discussing gender diversity and the possible trajectory of their child’s future.
“Clients have had the real ability to start social transition when they were younger, and then upon puberty, if deemed appropriate, access medicalization,” he notes. “And there really aren't that many other places that do this work from a high caliber lens, using the best practices that have been recommended and set forth by all of the major medical and mental health organizations around the world.”
Many families are concerned that not enough competent medical providers exist to care for patients, especially those under age 18, he says. He gives the example of young people who are on puberty blockers or have a surgery coming up — now they don’t know where to go.
This widens the divide between the haves and have nots. CHLA’s Center for Transyouth Health and Development was a beacon for families who are of color, low-income, rural, and can’t afford private or out-of-state care, Held says. “The closure of the clinic really creates a two-tiered system here, one where only those with privilege can have access to gender-affirming care.”
As for Rob Bonta’s prospective lawsuit, Held says he hopes he can make it clear that California supports the LGBTQ+ community. Now is a time when CA’s legislation and major nonprofits “are pointing to the fact that California needs to be the leader in this space,” he adds.
Now, providers are finding contingency plans for clients, which includes referrals to other programs, he says.
“Lots of folks across Southern California are scrambling to make sure that families can get their needs met, so that there isn't a big time lapse in care. But there's also going to need to be a high level of waiting and seeing how this does shake out … because this is still really live right now.”