The U.Va. Health and Virginia Commonwealth University hospitals suspended gender-affirming care for people under 19 years old Jan. 31. This move was made following President Donald Trump’s executive order Jan. 28, which asserted that the federal government will not fund gender-affirming care. Virginia Attorney General Jason Miyares consequently directed hospitals to preemptively slash care and cancel appointments, and U.Va. Health followed this direction even as the order has been constitutionally challenged in the courts. These court cases, brought by states, doctors and affected families, argue that the order violates congressional anti-discrimination laws in addition to constitutional commitments to equal protection and state sovereignty. Despite this obvious legal ambiguity of and patient harm caused by the order, U.Va. Health capitulated, choosing to enforce a legally questionable policy and compromising its commitment to anti-discriminatory medical practices.
Gender-affirming care was a service to which U.Va. Health previously devoted numerous specialists, even receiving commendation from the Human Rights Campaign Foundation. Ranging from peer-to-peer therapy to surgery and treating people who identified as cisgender and transgender, these services enabled U.Va. Health to support a variety of populations with high quality care. In this way, gender affirming services fit well into U.Va. Health’s mission of transforming the quality of care that patients received. But now, these patients are left with no care and few answers.
The lack of clarity surrounding the future has unsurprisingly damaged the broader University’s relationship with the community. As a part of the University, U.Va. Health’s decisions are implicitly reflective of the University writ large. And to this date, U.Va. Health has yet to publicly acknowledge the reasons behind such compliance, failing to transparently address the severe impact they have on patients. While this lack of transparency is harmful, it is not new. In fact, the process of this decision reflects the same lack of transparency that led 128 employees to demand the resignation of U.Va. Health’s leaders last October — silence over security for those the system impacts.
This failure to protect gender-affirming care will not just affect Charlottesville. The effects of U.Va. Health’s restrictions on gender-affirming care in particular will echo throughout the entirety of the region. Offering multiple specialists devoted to gender health services, U.Va. Health previously offered a sanctuary of sorts for gender-affirming care which may have not been sufficiently available in other regions. Many patients travel hundreds of miles regularly to book these limited appointments and receive these services. In this way, the decision to suspend gender-affirming care for minors paints a grim picture for regional gender affirming care beyond simply Charlottesville.
Compromising this care points to a U.Va. Health administration that thoroughly lacks the creativity — or bravery — to act in opposition to this executive order. Consider the example of New York’s response. One of the largest hospital systems in New York City, NYU Langone Health, cancelled gender-affirming care appointments in anticipation of the effects of this executive order. However, New York Attorney General Letitia James disputed this decision by arguing that these hospitals are directly violating anti-discrimination laws. Instead of allowing potentially unconstitutional orders to uproot their oath to do no harm, New York prioritized patients over sweeping legal changes. Even in the absence of a supportive Attorney General like James, U.Va. Health should have taken a stance against Miyares’ order and worked to find an innovative workaround.
The suddenness of Trump’s executive order has left many hospitals around the nation uncertain of how to proceed — do they compromise patient care supported by all major medical associations in the United States or do they risk losing federal funding by resisting the order? This is undoubtedly a tricky situation to be in. But to immediately and fully submit to this legally questionable order sets a dangerous precedent in relation to future executive orders. In effect, the University has admitted that orders from the Trump administration, irrespective of their legality, will be upheld on Grounds. If the University allows a pernicious harm to be pushed on those seeking gender-affirming care, what is to prevent the Trump administration from constricting reproductive freedom or HIV prevention at U.Va. Health? From the evidence which currently exists, the Trump administration is correct to assume that the University will be their partner in preemptively enforcing executive orders which dangerously politicize health care.
Trump’s abrupt change to gender affirming care is perhaps the first truly public challenge for the University under the new presidential administration. But it will not be the last — Trump has also threatened higher education institutions with the removal of student and research grants in addition to the suspension of the Department of Education. The University cannot claim to appropriately engage with affected communities — or uphold the University’s status as a world-renowned public university — if it utterly fails to act uprightly in the face of illegal opposition. It is high time to resist these authoritative and dangerous actions before there are no federal avenues left for resistance.
The Cavalier Daily Editorial Board is composed of the Executive Editor, the Editor-in-Chief, the two Opinion Editors, the two Senior Associates and an Opinion Columnist. The board can be reached at eb@cavalierdaily.com.
Read More
CARTER: U.Va. Health owes clarity to transplant patients
By Nathaniel Carter | 3 days agoUnfortunately, this negative press is fully the fault of U.Va. Health — it failed to address significant stakeholder concerns when crafting its justification.
EDITORIAL: Upholding medical amnesty is a collective effort
By Editorial Board | 4 days agoUniversity leadership, Greek life organizations and students themselves must recommit to the safety provided by an effective and knowledgeable use of medical amnesty.
KURTZWEIL: Dockworkers’ unions cannot avoid the threat of automation
By Paul Kurtzweil | 5 days agoInstead of continuing to demand decreased automation, the union should work with the legislature in the hopes of driving investment into the reorganization of the current workforce.
