U.Va. Health announced Jan. 31 that it will no longer provide gender affirming care for patients aged 18 and below in order to maintain federal medical funding and in accordance with an executive order from President Donald Trump. The announcement of this suspension sparked community outrage as dozens gathered in protest outside the main entrance of the U.Va. Medical Center. This comes as students continue to grapple with the new directives of the Trump administration.
Trump signed an executive order Jan. 28 stating that the federal government will no longer fund or support institutions which provide gender affirming care to patients below the age of 19. In this order, Trump referred to sex-change procedures of minors as a “horrifying tragedy” involving the “maiming and sterilizing” of children and demanded that all federally funded institutions halt these operations as well as eliminate all gender affirming care including hormone therapy, puberty blockers and counseling for patients below the age of 19.
As an institution that receives federal funding for research from the National Institute of Health, U.Va. Health and the Medical Center are subject to this order. In a memo sent Jan. 30, Virginia Attorney General Jason Miyares personally reached out to both the University and Virginia Commonwealth University to enforce Trump’s order. He threatened financial liability and termination from Medicare and Medicaid programs if these universities do not comply.
“Hospitals and institutions that continue to mutilate children place themselves at significant legal risk and face substantial financial exposure,” Miyares said. “Given these risks, my office will be closely monitoring this issue and the actions of the Commonwealth’s agencies.”
This new policy immediately drew pushback. Elizabeth McKenney, member of the University’s chapter of United Campus Workers and PhD candidate in religious studies, attended the protest against U.Va. Health’s decision to suspend gender affirming care at the Medical Center Jan. 31. This protest was organized by UCW-VA and the Charlottesville Gender Expansive Network, and consisted of approximately 150 students and community members.
McKenney noted the wide-range of medical options associated with gender affirming care, stating that there has been considerable fear and misinformation surrounding this care as people are falsely generalizing all forms of gender-based treatment as surgical operations.
“Gender affirming care is a range of care options that are used on [cisgender] people as well as trans patients,” McKenney said. “Trans kids are some of the most vulnerable members of our community, [and] gender affirming care helps keep them safe, it empowers them.”
McKenney said she was very proud of the turnout of this protest as it was organized within a few hours as an immediate response to the suspension. According to McKenney, the University immediately complied with the demands of Trump and Miyares, and she urged University administrators to have more courage in challenging unjust policy moving forward.
“U.Va. Health is what we would call complying in advance. They are giving into a threat from Jason Miyares,” McKenney said. “This is not a law that has been carefully vetted, that we definitely know has legal force. This is a response to a letter that was sent from the attorney general that's very clearly just meant to threaten and frighten U.Va. Health.”
According to a statement on the U.Va. Children’s Hospital website, all gender-affirming care for patients 18 and under has been suspended. Appointments for transgender and gender-diverse patients will remain scheduled to discuss care options in compliance with executive orders and guidance from the Virginia Commonwealth Office of the Attorney General.
“Like many health systems across the country … [U.Va.] Health [is] working to analyze and interpret the federal order and related state guidance, as well as monitoring other potential policy changes and impacts to ensure we are always delivering care in accordance with the law,” the statement said. “[U.Va.] Health remains committed to being a community of healing, compassion and respect for all.”
Prior to the suspension, U.Va. Children’s Hospital provided gender affirming care for patients aged 11 to 25 with services including sex and contraceptive education, therapy referrals for mental health issues as well as voice therapy, cross-sex hormones puberty including testosterone and estrogen, puberty blockers — which delay sex-related physical changes — and referrals for gender-affirming surgeries.
Medicine student Sage Royston stated that she understood the difficult position the University was placed in by Trump and Miyares in terms of funding but was disappointed by the decision to immediately comply without court involvement or taking further legal action. According to Royston, suspending gender-affirming care directly contradicts the objectives of medical providers to care for patients to the best of their abilities.
"One thing that we're taught in medical school are the core tenets of our ethics as physicians, and one of the biggest [tenets] is beneficence. We're supposed to not harm our patients and do what's best for them,” Royston said. “Having this degree of political [interference in] the care that a doctor can provide sets a very dangerous precedent, so right now they're just using it for children/young adults 19 and under. But where does that go from there?"
Royston cited a 2023 article from the American Academy of Pediatrics — the largest professional association of pediatricians in the United States — as evidence of the importance of gender-affirming care as a facet of healthcare. According to this article, the AAP supports the use of gender-affirming care to help transgender youth and opposes any laws that discriminate against gender-diverse patients or that interfere in the doctor-patient relationship.
Representatives from the University and the University Medical Center did not respond to repeated requests for comment at the time of the publication of this article, but President Jim Ryan sent a video to the University community Friday addressing concerns about a series of federal directives from the Trump administration, saying his office has received "a number of questions" about Trump's executive orders.
"We will continue to produce life-changing research and to provide world-class health care, and we will work to protect as best we can the ability of our researchers to explore important questions and the ability of our doctors to make their best judgments about patient care,” Ryan said.
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