Advocates and families blast Children’s Hospital of OC’s decision to close trans health care clinic

Children’s Hospital of Orange County is now the latest Southern California medical provider to stop offering gender-affirming care, blaming investigations and escalating actions from the federal government.

The hospital, as well as other hospitals in San Diego and Riverside counties under the Rady Children’s umbrella organization, has said that it will stop offering gender-affirming care to patients under 19 effective Feb. 6.

The decision has forced patients to scramble to find healthcare in a span of two weeks or risk complications from a forced withdrawal from hormone therapy.

The backlash from community members has been swift after dozens of protesters recently hit the streets outside CHOC’s hospital in Orange to rally against the decision.

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CHOC said it’s making the decision under duress to preserve funding for all its patients amid proposed federal rules that would pull all Medicare and Medicaid reimbursements for hospitals that offer gender-affirming care to people under 19.

“This was a very difficult decision, made to ensure we can continue serving all children and families across the communities we serve,” a CHOC spokesperson said in a statement to LAist.

But parents of CHOC patients who attended a rally Saturday opposing the move said that they were not consulted by hospital leadership for the decision. Some said they would have advocated for CHOC to preserve its gender-affirming care clinic if they were.

Security guards stood watch over the rally from the roof of an adjacent CHOC-owned building.

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Haley Horton, a mother who carpools with trans youth CHOC patients, said the clinic’s planned closure was a “business decision.”

“ I know my son's nurse who's at this hospital doesn't want that happening,” Horton said. “I know the doctors at this hospital don't want this to happen.”

The background behind the decision

An ongoing concern for hospitals is the potential that their Medicaid and Medicare funding will be revoked if they offer gender-affirming care to minors.

The Centers for Medicare and Medicaid Services are currently in the middle of a public comment period for two proposed rule changes that would defund gender-affirming care for youth, and restrict all Medicare and Medicaid funding for hospitals that provide the care.

Those rules have not taken effect and are expected to be challenged by LGBTQ+ legal rights organizations.

A CHOC spokesperson also confirmed to LAist that the U.S. Department of Health and Human Services’ inspector general’s office had launched an investigation into the hospital. Legal experts interviewed by LAist have referred to subpoenas and investigations launched by the federal government as “scare tactics,” and say that it’s possible they won’t hold up in court.

According to TransFamily Support Services, a San Diego-based organization that also protested the closure of Rady Children’s Hospital’s clinic in San Diego, the hospital system will continue to offer services like hormone replacement therapy to people 19 and older even though the clinics are closing.

The hospital did not respond to a direct question from LAist asking the hospital what provisions were being made for families who now have two weeks to find another health care provider in an extremely precarious market. When Children’s Hospital Los Angeles closed its gender-affirming care clinic last July, administrators gave families a six-week off-ramp to find another provider, and many doctors wrote out prescriptions to tide people over for months.

What families are saying

Horton has been in touch with the families she knows with trans teenagers who are patients at CHOC. She told LAist that those families did not attend the weekend rally in order to protect their mental health as they “scramble” to find alternate care.

The rally also drew turnout from elected officials and public figures, like Tustin School Board Trustee Allyson Muñiz Damikolas.

Muñiz Damikolas said she came out on behalf of her kids, who are also patients at CHOC due to a complex medical condition, and to support trans youth nationwide.

Chris Kluwe, a former NFL player turned political advocate who’s running to represent Huntington Beach in the state assembly, said CHOC’s leaders were “cowardly bureaucrats who aren't willing to stand up and do the right thing” in the face of a “tyrannical federal government."

Chris Kluwe, who's running to represent Huntington Beach in the state assembly, showed up to rally against the CHOC clinic's closure.

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OC LGBTQ+  groups denounce the move

“ I'm a transgender woman and I'm here to tell you that denying people this gender affirming care doesn't make gender dysphoria go away,” said Stephanie Wade, chair of Lavender Dems of Orange County. “All it does is make it metastasize into suicidal depression. And I've been there. I dealt with this as a child. We can't take this away from kids.”

Wade pointed to studies that show that trans youth who are denied access to gender-affirming care are more likely to attempt suicide.

Stephanie Wade of Lavender Democrats was one of many local LGBTQ political leaders attending Saturday's rally.

Felicity Figueroa, the chair of the Orange County Equality Coalition, called on hospital leadership to consult with the families and doctors, especially given that the proposed federal rules have not yet taken effect.

 “They're saying it's gonna affect the other kids who aren't LGBTQ,” Figueroa said. “But are they asking the parents of the other kids if they're willing to throw their neighbor's kids under the bus just because of a [possibility]? That's the thing. They aren't listening.”

Lasting concerns 

Brit Cervantes of OCGAPNet, an advocacy organization for gender-affirming providers in Orange County, said the closure of CHOC’s clinic would likely have ripple effects that could reverberate for years.

“ There's going to be a time where we exist beyond this administration, and we will have to work to rebuild this trust with our patients after we abandon them.  That is a very long lasting impact,” Cervantes said.

Cervantes, a medical professional, said that discontinuing hormone therapy can lead to major complications akin to what menopausal women experience.

In addition to the effects on local adolescents, the rally’s organizers also pointed to what they saw as a wider-scale erosion of rights and norms under the second Trump administration. It took place on the same day that ICU nurse Alex Pretti was shot and killed by immigration agents on the streets of Minneapolis.

Speakers at the rally outside CHOC blasted the hospital leadership for capitulating to the Trump administration.

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Kanan Durham, executive director of the Huntington Beach-based nonprofit Pride at the Pier, linked the closure to “blackmail, intimidation and state violence” happening at other levels of the federal government, including the actions of immigration enforcement officers in Minneapolis.

“ Suggesting that evidenced-based health care that is supported by every major institution in the Western world is medical fraud is to set a foundation where the government can decide who is allowed to have health care and who is not,” Durham said. “They are making decisions based on their own moral judgements. And if that's where they're coming from, then any American, anybody living in this country has their health care under risk.”

The backstory

Children’s Hospital Los Angeles, which was the largest provider of pediatric gender-affirming care in the country, closed its Center for Transyouth Health and Development last July, affecting even patients over 19.

That was followed by other providers who said they’d stop or pause certain types of health care for trans youth, including Kaiser Permanente’s ongoing pause of gender-affirming surgeries and certain implants for people under 19.

Advocates say these closures are making it harder and harder for trans youth in Southern California to find the care that they need.

Pride at the Pier, OCGAPNet and TransFamily Support Services are also soliciting signatures for an open letter to CHOC and Rady’s leadership asking them to reverse their decision.

To weigh in on the CMS rule changes, visit this website.