Mary Bridge Children’s Hospital in Tacoma plans to shut down its gender clinic this week under mounting federal pressure to ban all gender-affirming health care for trans youth.
Hospital leaders announced the decision in a Monday memo to employees, writing that “recent developments at the federal level” threaten to halt Medicaid and Medicare payments to the entire MultiCare Health System, which owns Mary Bridge, if it continues to offer gender-affirming health services to minors.
“This was an incredibly painful decision, and one that I wish we did not have to make,” MultiCare CEO Bill Robertson wrote in the memo, which the hospital shared with The Seattle Times. “We recognize how important this care is to our gender health clinic patients and have a sense of the impact this will have on these patients and their families.”
But without federal Medicaid and Medicare payments, Robertson continued, “our organization would cease to exist.” According to the hospital, more than 60% of all Mary Bridge patients rely on Medicaid, known as Apple Health in Washington.
Mary Bridge cut its gender clinic waitlist of about 150 families in September, confirming then that the clinic would continue to serve those who were already receiving gender-affirming medication, like hormone therapy and puberty blockers, but would not start any new medical treatment.
This week’s news means cutting off care to the clinic’s remaining patients — roughly 320 young people, including 180 under 18, who will now have to get their prescriptions renewed or find gender-affirming mental health care elsewhere.
“We only made this decision after extremely careful consideration of all our options,” Robertson wrote. “We’ve had conversations with local leaders, including members of the LGBTQ+ community, on our implementation plan and how we, as a community, can support these patients and families.”
While gender-affirming care for trans and gender-diverse minors remains legal in many states, including Washington, President Donald Trump and the U.S. Department of Health and Human Services have continued to target gender care providers and patients in many ways over the last year.
In 2025, the White House issued an executive order to halt federal funds linked to gender-affirming care for people under 19; launched efforts to collect evidence that providers are promoting “false or unsupported claims” around gender care; and threatened providers with felony charges for offering certain types of care.
The Justice Department has also subpoenaed more than 20 doctors and gender clinics to hand over patient information. And in December, HHS Secretary Robert F. Kennedy Jr. introduced a series of regulatory actions that essentially attempt to ban access to all gender-affirming care for youth, even in states where it’s still legal.
Washington state Attorney General Nick Brown’s office filed a lawsuit against the Trump administration over the executive order that sought to halt federal funding for pediatric gender-affirming care. A federal judge in Seattle has since found the executive order to be discriminatory and issued a preliminary injunction that blocks the order while the case proceeds.
Brown is coleading a separate lawsuit against the federal government over the December proposed rules, alleging that HHS’s declaration seeks to coerce providers to stop offering gender-affirming care for youth and circumvent legal requirements for policy changes.
Those proposals are not final or legally binding, but LGBTQ+ families and advocacy organizations have feared the news would further discourage health providers from offering the care to minors.
The Mary Bridge news prompted significant frustration and disappointment this week for Matthew Wilson, executive director of Oasis Youth Center, a Tacoma nonprofit that supports LGBTQ+ kids, teens and young adults, and Joanne Levy, executive director of the Rainbow Center, which also serves LGBTQ+ communities in the Pierce County area.
“We find it unacceptable to leave our trans community members without care with such short notice,” Wilson said Tuesday in a message on behalf of himself and Levy. “We’ve already had some youth reach out to us, distressed about what to do next.”
The organizations are working together to share more information on how to assist patient families in the coming days, Wilson said.
Mike Faulk, a spokesperson for Brown’s office, wrote in an email Tuesday that the attorney general will continue working to protect everyone’s access to health care from the Trump administration’s “unlawful attacks.”
“Gender-affirming care for adolescents and adults remains legal and protected in Washington state,” Faulk said. “While the Trump administration has continued to pressure hospitals to cease the provision of this lifesaving care, no law or rule currently in effect bans gender-affirming care for anyone.”
In the U.S., medical providers who are experts in delivering gender-affirming care say treatments can significantly reduce depression and suicide risk among trans youth. Most major U.S. medical associations, including the American Academy of Pediatrics and the American Medical Association, continue to support gender-affirming care options for gender-diverse minors.
In response to Kennedy’s announcement in December, the American Academy of Pediatrics called on HHS to reverse course, saying “children and families will bear the consequences.”
There are private providers who continue to offer this care to trans youth, but a number of children’s hospitals, including in Democratic-controlled states, have already chosen to narrow their gender care services or shutter gender clinics altogether. They mostly cited increasing federal pressure.
Kaiser Permanente, which has clinics and health centers in Washington, announced plans last July to limit gender-affirming surgeries to patients 19 and over. Kaiser still offers gender-affirming medication and mental health care to patients under 19.
Mary Bridge, whose gender clinic opened in 2015 as one of two hospital-based pediatric gender clinics in the state, notified clinic patients of the closure on Monday via MyChart and through mailed letters, per Robertson’s memo.
The hospital will continue to offer behavioral health and other supportive care to gender-diverse minors. Mary Bridge does not provide gender-affirming surgeries, which are rare among youth under 18.
No staffers who work at the gender clinic will be laid off, since they’re part of the hospital’s larger pediatric endocrinology team, Robertson wrote.
Seattle Children’s, which runs Washington’s other hospital-based pediatric gender clinic, continues to offer gender-affirming medical and behavioral health care for trans patients under 18. Children’s has declined to say if it continues to offer surgeries, but the hospital no longer lists surgeries on its gender clinic website, which used to include details about a variety of services offered.
