Outside Children's Hospital Los Angeles this month, protesters rallied against the closure of the gender-affirming care center.
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Kevin Tidmarsh
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LAist
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Topline:
Children’s Hospital Los Angeles is officially closing its gender-affirming care center today, ending a chapter for one of the oldest and largest clinics of its kind in the U.S. The hospital’s thousands of trans patients under 21 are now left to find a new provider to access therapy, hormones and surgeries.
What led to the closure? CHLA told patients and staff that while it stood by its care as “evidence-based,” the hospital had faced mounting pressure from the Trump administration.
CHLA’s financial reality: The hospital receives about two-thirds of its funding through federal sources, including direct grants and Medicaid payments. According to a letter to patients announcing the closing provided to LAist, the hospital said it could sustain operations for only about 50 days if all federal funding were withheld.
Response from advocates: “Instead of protecting that care, CHLA caved,” said Sydney Rogers, a program manager at the L.A. LGBT Center and vice chair of the L.A. County LGBTQ+ Commission. “Instead of defending the youth they once promised to serve, they closed the doors and turned off the lights. Now families across L.A. are scrambling for crumbs in a healthcare system built on fear.”
Read on … for what patients had to say about the closure’s timeline.
Children’s Hospital Los Angeles is officially closing its gender-affirming care center today, ending a chapter for one of the oldest and largest clinics of its kind in the U.S. The hospital’s thousands of trans patients under 21 are now left to find a new provider to access therapy, hormones and surgeries.
The closure marks a turning point in the nationwide battle for transgender rights, as the Trump administration has sought to restrict access to gender-affirming care by withholding federal funding, even in deep-blue states with “shield laws” protecting such medical services.
Advocates organized by the Los Angeles LGBT Center had protested the shuttering of CHLA’s Center for Transyouth Health and Development at rallies outside the hospital.
"Gender-affirming care is protected by law,” said Maria Do, community mobilization manager at the L.A. LGBT Center, at a rally July 17. “CHLA’s compliance with political pressure and anti-trans fearmongering must be investigated and prevented from ever happening again.”
What were the federal forces behind the closure?
In January, President Donald Trump issued an executive order seeking to restrict access to gender-affirming hormones and surgeries. The administration called the treatments “chemical and surgical” hormones.
CHLA cited this executive order when announcing its Feb. 4 decision to pause gender-affirming surgeries, hormones and puberty blockers for new patients under 19. Following public outcry, CHLA then resumed the intake of new patients under 19 for these services about two weeks later.
Over the next months, CHLA said its leadership watched guidance from various federal departments, including the Federal Bureau of Investigation, the Department of Justice, Health and Human Services and the Centers for Medicare and Medicaid Services.
Protesters have gathered weekly outside Children's Hospital L.A. since the closure of its gender-affirming care clinic was announced last month.
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Kevin Tidmarsh
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LAist
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These directives were cited by hospital administrators on June 12, when they announced the closure.
The hospital said it gave families six weeks’ notice before closing its gender-affirming care center. Many current and former patients who spoke at rallies said they thought this wasn’t enough time for youth — particularly for longtime patients who had built relationships with medical staff — to find new providers.
CHLA’s financial reality
About 65% of the hospital’s funding comes indirectly or directly through federal sources, and the hospital is more dependent on these funds than the state average, according to the hospital. The latest publicly available data shows an even higher percentage: just over 70%.
That federal funding largely comes from Medicaid, according to state data — which was cut by about $1 trillion under Trump’s signature budget package. According to a letter to patients announcing the closing provided to LAist, the hospital said it could only sustain operations for about 50 days if all federal funding were withheld.
The hospital said it was left with no choice but to shutter the center despite its decades of “evidence-based” care — especially as the prospect of securing funding from California grew more and more uncertain amid a statewide budget crisis.
A large crowd of people listens to a speech at a rally outside Children's Hospital L.A.
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Kevin Tidmarsh
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LAist
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What are patients and advocates saying?
Weekly protests have been held outside the hospital in support of gender-affirming care for trans youth.
A protest on July 17 saw around 100 protesters packed onto a cramped sidewalk on Sunset Boulevard across from the hospital. Protesters’ signs, chants and speeches called out a variety of actors, primarily the Trump administration and CHLA administrators.
Protesters held signs shaped like CHLA's butterfly logo with messages supporting transgender, gender diverse and intersex youth written on them.
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Kevin Tidmarsh
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LAist
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People at the rally, including a few wearing medical scrubs, held signs in the shape of CHLA’s butterfly logo with messages of support for trans, gender non-conforming and intersex people. Vehicles driving past — including some utility trucks and ambulances — honked in support of the rally, sharply punctuating speeches from local LGBTQ+ advocates and former patients in support of keeping access to gender-affirming care.
“Instead of protecting that care, CHLA caved,” said Sydney Rogers, a program manager at the L.A. LGBT Center and vice chair of the L.A. County LGBTQ+ Commission. “Instead of defending the youth they once promised to serve, they closed the doors and turned off the lights. Now families across L.A. are scrambling for crumbs in a healthcare system built on fear.”
What now for gender-affirming care providers?
For CHLA’s thousands of patients and their families, finding new doctors could prove difficult. Other providers in the state are restricting their services in an effort to shield themselves from federal attention.
For instance, Stanford Medicine paused gender-related surgeries on patients under 19 last month.
Protesters led chants at a recent rally, including some that directly targeted CHLA's policies.
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Kevin Tidmarsh
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LAist
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Attorney General Rob Bonta also advised the hospital earlier this year it may be violating state law by not offering gender-affirming care.
“Let me be clear: California law has not changed, and hospitals and clinics have a legal obligation to provide equal access to healthcare services,” Bonta said in a letter to CHLA.
However, in a statement provided to LAist on Monday, Bonta’s office said it would focus on “the source of this problem — and that’s the Trump administration's unlawful and harmful threats to providers.”
Trump’s One Big Beautiful Bill Act contains a provision that would remove gender-affirming care as an essential health benefit under the Affordable Care Act. Bonta filed a lawsuit Friday challenging that clause.
