Children’s Hospital Los Angeles stands as the premier institution for pediatric medicine in Southern California. For thirty years, it has also been recognized globally as a top destination for transgender care for minors. Don’t just take my word for it: CHLA proudly highlights its commitment to “high-quality, evidence-based, medically essential care for transgender and gender-diverse youth, young adults, and their families.”
However, earlier this month, the hospital unexpectedly announced the closing of the Center for Transyouth Health and Development during a staff meeting. (My daughter was a patient at the center until this news broke.)
Was there a groundbreaking medical discovery or unexpected study that led to the abrupt discontinuation of care for approximately 2,500 patients? No. The hospital clarified that the decision followed “a thorough legal and financial assessment of the increasingly severe impacts of recent administrative actions and proposed policies.”
In essence, the hospital avoided confrontation.
CHLA made this decision just a week before the Supreme Court’s 6-3 ruling in the United States vs. Skrmetti, which upheld a Tennessee law banning most gender-affirming care for minors. Over 20 states have enacted similar laws that restrict access to various forms of medical care for trans minors. This ruling effectively protects those laws from potential legal challenges.
Yet, the Supreme Court ruling had no relevance to CHLA’s decision. California does not have such a law.
So, why did the center close suddenly, without any legal directive or statute, leaving numerous young patients without access to medical care? The likely explanation is apparent.
Pressure from the Trump administration threatened the hospital with serious consequences if it continued to serve these patients. One source of this pressure was a letter from May 28 issued by the Centers for Medicare and Medicaid Services, led by former TV host Dr. Mehmet Oz. The letter indicated that his agency would be seeking financial records regarding various gender-affirming care procedures from numerous hospitals.
Faced with the dilemma of ceasing care for an entire demographic of patients or confronting the administration over access to financial documentation, no doctor wants to be put in that position. This isn’t a dispute over medical science or appropriate care for trans youth. CHLA adhered to the science — until it didn’t. This issue revolves around ideology and the question of who merits medical care.
In recent months, we’ve witnessed powerful law firms, major corporations, and universities grappling with difficult choices. Should they acquiesce to an administration that has targeted them or pursue legal action?
When Children’s Hospital announced its decision to halt accepting new patients in its Transyouth Center in February, California Atty. Gen. Rob Bonta firmly reminded the hospital of its legal duty to continue providing this vital care. The hospital quickly reversed its decision.
This recent decision by the CHLA board represents a significant shift that could impact not just trans youth patients but many others as well.
What the CHLA board chose was, in fact, a decision. Furthermore, this choice contradicted its own medical recommendations regarding the urgent need for such care. On its website, the hospital claims to be “immensely proud of this legacy of caring for young people on the path to achieving their authentic selves.”
When faced with threats, the board opted to sacrifice the care of one demographic of patients in hopes of maintaining services for others. Perhaps the board adopted a stark, utilitarian rationale: neglecting the medical needs of a few would enable them to provide for many more.
That’s not how I interpret it. By succumbing to coercion, they have validated the administration’s prejudice. They have indicated that trans youth are replaceable. The board has made it clear that this group of patients is not deemed as worthy of care as others. When confronted with genuine pressure, their previously upheld record of delivering “high-quality, evidence-based, medically essential care” conveniently became a burden.
This time, it was trans youth. Who will be next? Disabled children? Kids born outside the U.S.? CHLA chose to play along rather than confront the reality of the situation.
As a journalist, I occasionally allow anonymity for sources, a decision I do not take lightly. This means that if pressured, even in the face of contempt of court, I will not disclose their identity. Fortunately, I have never encountered that situation, though other journalists have faced jail to protect sources. If I were to break that pledge even once, it would become impossible for me to grant it again in good faith.
Now, I question how CHLA doctors can look their young patients in the eyes and assure them that they will fight for their care, no matter the circumstances.
Gabriel Kahn is a professor of professional practice at the USC Annenberg School for Communication and Journalism.
