Seattle Children's hospital is postponing some gender-affirming surgeries for people under 19, families say, following an executive order from President Donald Trump that decrees a halt to federal funding for medical care for transgender youth.
The family of one 16-year-old patient told The Stranger the hospital canceled a procedure this week, the evening before it was scheduled to occur. The family said hospital staff cited Trump's executive order.
The order, signed by Trump on Jan. 28, states, in part, that the United States "will not fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another."
Two other Puget Sound-area families told The Seattle Times they received similar calls and messages this week about canceled procedures or pauses on scheduling future appointments at Children's.
"We've been working toward this for three years," said one Whidbey Island parent, whose 17-year-old trans son's top surgery — set for next Thursday — was abruptly canceled this Wednesday. The parent requested not to be named for privacy and safety reasons.
"To me, [Children's is] showing where they stand," she said. "And they're not fighting for all children in Seattle."
Children's has not made any public announcements and has repeatedly declined to confirm to The Times whether it has stopped gender-affirming surgeries that rely on federal insurance programs, such as TRICARE and Medicaid.
A Children's spokesperson said in a statement the hospital has found itself in an "incredibly difficult situation" following the federal order, but stopped short of explaining what action it took.
"Our hearts go out to the patients and families being impacted while we review the potential implications of this executive order," the Children's statement said. "As an organization that relies on significant federal funding to provide care and conduct life-changing research, losing eligibility would jeopardize care for our patients across the region who are depending on us."
Lawsuits are beginning to be filed around the country, asserting the order violates the equal protection clause of the Constitution by discriminating based on gender.
This week in federal court in Maryland, the American Civil Liberties Union, Lambda Legal, the ACLU of Maryland, and two law firms filed a lawsuit on behalf of two transgender young adults and five transgender adolescents and their families whose health care has been disrupted by the executive order, according to the ACLU.
The executive order, titled "Protecting Children From Chemical and Surgical Mutilation," is one of several Trump signed in the last two weeks involving gender and trans issues.
In the next two months, the order says, agency leaders must report "progress in implementing this order" and a timeline for future actions. Within three months, according to the order, the secretary of health and human services — a position for which it appears Robert F. Kennedy Jr., vaccine skeptic and environmental lawyer, is poised to be confirmed — should publish a review of existing research on "best practices" on providing care for kids with gender dysphoria.
The order also uses language around trans health care that's widely disputed among professional medical and scientific groups in the U.S., including classifying guidance from the expert group World Professional Association for Transgender Health as "junk science" that "lacks scientific integrity."
Other hospitals mull order
The gender clinic at Seattle Children's has been popular in the Pacific Northwest since it opened in 2016, providing mental health and medical care for many of the region's trans and gender-diverse young people.
At other area health care facilities that provide pediatric gender-affirming care, like MultiCare Mary Bridge Children's in Tacoma, things are still up in the air.
The hospital said in a statement it was "aware of the executive order" and is "continuing to monitor the situation." Mary Bridge does not offer gender-affirming surgeries, but provides gender-related mental health and medical services.
"Executive orders are directives to federal agencies on how they will operate," the hospital said. "Much of what's been issued has not yet become rules for us to evaluate. We intend to continue with our gender health program in support of patients and families."
A spokesperson for Optum, which operates The Everett Clinic and The Polyclinic, another gender-affirming care provider for some young people, declined to comment on the short- or long-term future of their services.
In Washington, fewer than 5% of claims for gender-affirming care were made for surgeries in 2022, according to data from the state insurance office. About 93% of gender-affirming care claims were made for pharmacy or behavioral health care.
The state Attorney General's Office said in a statement Wednesday it was aware of the executive order's direct impacts on Washingtonians.
"In addition to our disgust with how this action cruelly targets marginalized communities, our office is also looking into the legality of the order," the statement said.
"A sense of crisis and panic"
Families who have received care from Children's say they are angry and feel betrayed. Frustrations with the hospital's decision and lack of communication prompted some gender clinic patients, Children's employees and other concerned community members to gather in protest outside the hospital's main Laurelhurst campus Thursday afternoon.
"A lot of it is concern about what's going to happen going forward," said one Lynnwood mom whose 17-year-old trans daughter has regular appointments to renew puberty blocker replacements and estrogen prescriptions. "What happens if she can't get the treatment she needs?"
Another Seattle parent, who spoke to The Times and was not at the protest, said their 11-year-old nonbinary child visited the hospital in the last year for a consultation on possible gender-affirming care options.
The parent, who asked not to be named to protect their family's safety, said a member of the gender clinic team "really took the time to get to know our family," offering useful information about mental health support, gender-affirming hormones and more.
"We found the clinic to be amazing, and I'm very saddened that they seem to have succumbed to the pressure of denying people services that are gender affirming," said the parent, whose child identifies as gender-fluid.
The parent said they fear the halted surgery is a sign of the hospital's wavering commitment to other services that their child may seek in the future, such as puberty blockers.
"Everybody deserves to feel at home in their body," the parent said. "Knowing the big feelings that they had over a couple small things that we were noticing in their body changing, I am devastated as a parent that my kid is going to be forced into a decision, and not actually be given an option."
Danni Askini, executive director of the Gender Justice League in Seattle, said she's heard from an "overwhelming" number of families with trans and gender-diverse youth in the last week who are "feeling a sense of crisis and panic."
"What I worry about when we see situations like Children's capitulating to an executive order that has not been implemented is, that makes it a dictate," Askini said.
The family from Whidbey Island has not heard any updates from Children's about when their teen's surgery can be rescheduled. His mom said she's hopeful the hospital will change its mind if enough people push back, including the Attorney General's Office.
"As far as I know, it's not them doing it out of hate or revenge," she said. "This is just, 'Oh crap, we don't want to lose our funding,' which I can totally understand. But I do hope that with enough of us coming forward and speaking out, they will stick to what they uphold."
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