The Brief

Children’s Hospital Los Angeles — one of the country’s oldest and largest providers of gender-affirming care for children and young adults — has announced that it will close its Center for Transyouth Health and Development on July 22.

In a letter sent to hospital staff today, the hospital cited “external pressure” — specifically attempts from the Trump administration to block gender-affirming care for youth — in its decision.

Trump began issuing executive orders that aimed to curtail this health care soon after taking office in January.

Why is CHLA making this move?

In its letter to staff, Children’s Hospital Los Angeles acknowledged that it was making this move before many of its peers, which are continuing to offer gender-affirming care.

Hospital leadership called the decision a “painful and difficult decision” and said they had no choice but to comply with the federal government, which has sought to target providers of gender-affirming care.

“Over the past several months, California’s deepening budget crisis, President Trump’s executive orders, proposed federal legislation and rulemaking, and growing economic uncertainty have made the situation even more dire,” the letter reads.

They also said lower Medi-Cal reimbursement rates factored into the hospital’s decision.

The hospital also called its fiscal position “fragile” and said it could only sustain operations for approximately 50 days without federal funding. The hospital said it needed to remain open to serve the “hundreds of thousands of Southern California children, adolescents, and young adults, who are disproportionately low-income and underserved.”

About two-thirds of the hospital’s total inpatient and outpatient revenue came from Medicare and Medi-Cal, totaling $723 million as of 2022.

The hospital said that the Departments of Justice and Health and Human Services, the Centers for Medicare and Medicaid Services, the FBI, and the Federal Trade Commission had all taken positions against health care for trans youth. The positions taken by these agencies go against guidance from many professional medical and pediatric organizations.

Response from local LGBT leaders

After the decision became public, the L.A. LGBT Center issued a statement condemning the move and quickly organized a protest outside the hospital.

“Despite this harrowing news, we are not giving up,” L.A. LGBT Center CEO Joe Hollendoner said in a statement. “We must take action now to demand CHLA keep its gender clinic open to new and current patients in need of gender-affirming care.”

What can current patients do?

In a letter to staff, the hospital said it will help current patients "with patient navigation and seeking to identify potential alternative providers," though it did not specify exactly how. It also said it would explore reassigning employees at its transgender health center to other roles at the hospital "based on needs and available funding."

The hospital also said it chose to shutter the center on July 22 to “give patient families adequate time to plan for moving care to providers less impacted by the legal and financial pressures our health system faces.”

The backstory

In February, amid pressure from the Trump administration regarding gender-affirming care for minors, Children’s Hospital Los Angeles paused the intake of new patients under 19 for gender-affirming surgeries.

At the time, Attorney General Rob Bonta assured Children’s Hospital Los Angeles that it would protect the hospital and other providers of health care for trans youth.

"While the Trump administration attempts to bully and intimidate through its threats to withhold critical federal funding, California remains firm in its commitment to uphold the dignity and rights of all," Bonta said in a statement at the time.

After severe blowback from local health care providers, including weekly protests outside the hospital, the hospital reversed course and once again began offering its full suite of services to all patients.

Guidance from the medical community 

The American Academy of Pediatrics has supported gender-affirming care for minors since 2018 and opposes “any laws or regulations that discriminate against transgender and gender-diverse individuals, or that interfere in the doctor-patient relationship.”

The American Medical Association, the Endocrine Society and the American College of Obstetricians and Gynecologists, among others, have also taken similar positions supporting gender-affirming care for adolescents.

The Walt Disney Company has invested $1 billion in OpenAI’s Sora video-generation tool, making it the first major media company to license its intellectual property to an AI system.

Household names like Mickey Mouse, Darth Vader, Iron Man and Cinderella are just some of the several hundred characters that are included as part of this three-year licensing deal that allows fans to generate and share videos with these characters, using Sora.

“This is very much a situation of if you can't beat them, join them,” said Erik Barmack, AI columnist for The Ankler. He added that the media conglomerate’s characters were being generated in videos by Sora users already, and the company wants to engage those users while also having its own guardrails in place.

Currently, vague limitations have been outlined by Disney CEO Robert Iger in the deal, including a ban on the use of character voices and on how long a video’s duration can be. Barmack said there will be blocking that Disney will likely define what is or isn’t appropriate for a Disney character.

“They are not going to put Lilo and Stitch into adult situations. But those guardrails have not been published as part of this deal yet," he said.

Disney also will become a “major customer” of OpenAI and use its technology to build new products, tools and services. It also will roll out ChatGPT for employee use. Both companies said they are committed to responsible use of AI that protects the safety of users and the rights of creators. As part of the deal, some user-generated Sora videos will be made available on the Disney+ streaming service.

Learn more

Listen to our interview with Erik Barmack, AI columnist for The Ankler on AirTalk with Larry Mantle.

Irvine city leaders approved a land swap with property developer FivePoint in a 4-3 vote Tuesday, greenlighting the development of 1,300 market-rate units that won’t have to comply with affordable housing requirements.

As part of the deal, the city will give FivePoint 26.4 acres of land within Great Park in exchange for 35 acres bordering the Irvine Spectrum, dubbed the Crescent site.

 The development of 1,300 market-rate housing units, said Stephanie Frady, director of community development at the city, will generate more than $200 million in special taxes Great Park residents pay to fund school expansions and public infrastructure development.

The Crescent site “ creates an exciting opportunity for transit-oriented development and an important linkage between the Great Park and the greater Spectrum area,” said Pete Carmichael, assistant city manager.

The Irvine Spectrum attracts 17 million visitors each year, while Great Park sees around six million, with many more expected as the park builds out.

Because of the unequal acreage in the land swap, city officials also voted to waive state affordable housing requirements for the developer. The staff report for Tuesday’s meeting did not include a financial analysis of the land swap or the effects of waiving affordable housing requirements for FivePoint. LAist has requested those documents. But during the meeting, Carmichael said the 8.6 incremental acres are valued at around $66 million and that the deal benefits the city  by about $37 million.

Elizabeth Hansburg, co-founder of People for Housing OC, called the land swap an opportunity for the city to have greater say in the kind of development bordering a transit center.

 ”When the city becomes the owner of the land adjacent to the transit center, then the city will be held to a higher percentage of affordable [housing] than a private entity would be,” she said.

Housing close to a transit center, Hansburg said, opens up “the region of where you can go for jobs.”

“For households that are low income and maybe aren't a two-car family, or maybe there isn't a car for every driver, having proximity to transit does increase your mobility in terms of areas where you're able to go to work,” she said.

$15 million toward a public library

In the land swap, FivePoint also will give the city $15 million. During Tuesday’s meeting, Mayor Larry Agran pushed for the city to consider using that money toward a final resting place for veterans.

But residents spoke out overwhelmingly against the idea during the public comment portion of the meeting, calling for the money instead to go toward a library.

In the end, Councilmember Melinda Liu introduced a motion to approve the land swap and to  prohibit expenditure of any portion of the $15 million on the design or development of a columbarium for cremated remains. That motion passed 4-3.

Federal health officials on Wednesday expanded an outbreak of infant botulism tied to recalled ByHeart baby formula to include all illnesses reported since the company began production in March 2022.

The U.S. Food and Drug Administration said investigators "cannot rule out the possibility that contamination might have affected all ByHeart formula products" ever made.

The outbreak now includes at least 51 infants in 19 states. The new case definition includes "any infant with botulism who was exposed to ByHeart formula at any time since the product's release," according to the U.S. Centers for Disease Control and Prevention. The most recent illness was reported on Dec. 1.

No deaths have been reported in the outbreak, which was announced Nov. 8.

Previously, health officials had said the outbreak included 39 suspected or confirmed cases of infant botulism reported in 18 states since August. That's when officials at California's Infant Botulism Treatment and Prevention Program reported a rise in treatment of infants who had consumed ByHeart formula. Another 12 cases were identified with the expanded definition, including two that occurred in the original timeline and 10 that occurred from December 2023 through July 2025.

ByHeart, a New York-based manufacturer of organic infant formula founded in 2016, recalled all its products sold in the U.S. on Nov. 11. The company, which accounts for about 1% of the U.S. infant formula market, had been selling about 200,000 cans of the product each month.

News that ByHeart products could have been contaminated for years was distressing to Andi Galindo, whose 5-week-old daughter, Rowan, was hospitalized in December 2023 with infant botulism after drinking the formula. Galindo, 36, of Redondo Beach, California, said she insisted on using ByHeart formula to supplement a low supply of breast milk because it was recommended by a lactation consultant as "very natural, very gentle, very good for the babies."

"That's a hard one," Galindo said. "If there is proof that there were issues with their manufacturing and their plant all the way back from the beginning, that is a problem and they really need to be held accountable."

Amy Mazziotti, 43, of Burbank, California, said her then-5-month-old son, Hank, fell ill and was treated for botulism in March, weeks after he began drinking ByHeart. Being included in the investigation of the outbreak "feels like a win for all of us," she said Wednesday.

"I've known in my gut from the beginning that ByHeart was the reason Hank got sick, and to see that these cases are now part of the investigation brings me to tears — a mix of relief, gratitude and hope that the truth is finally being recognized," she said.

In a statement late Wednesday, ByHeart officials said the company is cooperating with federal officials "to understand the full scope of related cases."

"The new cases reported by CDC and FDA will help inform ByHeart's investigation as we continue to seek the root cause of the contamination," the statement said.

Lab tests detected contamination

The FDA sent inspectors last month to ByHeart plants in Allerton, Iowa, and Portland, Oregon, where the formula is produced and packaged. The agency has released no results from those inspections.

The company previously reported that tests by an independent laboratory showed that 36 samples from three different lots contained the type of bacteria that can cause infant botulism.

"We cannot rule out the risk that all ByHeart formula across all product lots may have been contaminated," the company wrote on its website last month.

Those results and discussions with the FDA led CDC officials to expand the outbreak, according to Dr. Jennifer Cope, a CDC scientist leading the investigation.

"It looks like the contamination appeared to persist across all production runs, different lots, different raw material lots," Cope said. "They couldn't isolate it to specific lots from a certain time period."

Inspection documents showed that ByHeart had a history of problems with contamination.

In 2022, the year ByHeart started making formula, the company recalled five batches of infant formula after a sample at a packaging plant tested positive for a different germ, cronobacter sakazakii. In 2023, the FDA sent a warning letter to the company detailing "areas that still require corrective actions."

A ByHeart plant in Reading, Pennsylvania, was shut down in 2023 just before FDA inspectors found problems with mold, water leaks and insects, documents show.

Infant botulism is rare

Infant botulism is a rare disease that affects fewer than 200 babies in the U.S. each year. It's caused when infants ingest botulism bacteria that produce spores that germinate in the intestines, creating a toxin that affects the nervous system. Babies are vulnerable until about age 1 because their gut microbiomes are not mature enough to fight the toxin.

Baby formula has previously been linked to sporadic cases of illness, but no known outbreaks of infant botulism tied to powdered formula have previously been confirmed, according to research studies.

Symptoms can take up to 30 days to develop and can include constipation, poor feeding, loss of head control, drooping eyelids and a flat facial expression. Babies may feel "floppy" and can have problems swallowing or breathing.

The sole treatment for infant botulism is known as BabyBIG, an IV medication made from the pooled blood plasma of adults immunized against botulism. California's infant botulism program developed the product and is the sole source worldwide.

The antibodies provided by BabyBIG are likely most effective for about a month, although they may continue circulating in the child's system for several months, said Dr. Sharon Nachman, an expert in pediatric infectious disease at Stony Brook Children's Hospital.

"The risk to the infant is ongoing and the family should not be using this formula after it was recalled," Nachman said in an email.

Families of several babies treated for botulism after drinking ByHeart formula have sued the company. Lawsuits filed in federal courts allege that the formula they fed their children was defective and ByHeart was negligent in selling it. They seek financial payment for medical bills, emotional distress and other harm.
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