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The Trump administration says it wants to withhold funds from hospitals that provide gender-affirming care to minors. It says the treatment is damaging physically and psychologically, even though major medical groups say the opposite. Some states like Massachusetts are trying to reassure families that the care will be protected, but it won't be easy. Karen Brown with New England Public Media reports.
KAREN BROWN, BYLINE: A teenager nicknamed Bug has just come home from his middle school in the Berkshires. He grabs the new iPad he got for his 14th birthday.
BUG: This is supposed to have a newer processing chip, so it'll, like, go faster for stuff.
BROWN: Soon he turns to doodling, creating a fantasy world based on the book series "Warrior Cats."
BUG: This is my character, Calix. This is the first sheet I made for him, and then I started drawing him in color.
BROWN: Bug keeps his hair spiky and half shaven. After school, to get comfortable, Bug takes off his binder, a piece of clothing he wears to keep his chest flat. Last summer, Bug, who was assigned female at birth, told his parents he was a boy.
BUG: I started feeling weird being referred to as she/her and my old name.
BROWN: Bug's mother asked NPR to identify Bug by his nickname and identify her by her first initial J because the family fears harassment. J asked Bug how he wanted to proceed.
J: Like, what do you need to be supported? And he asked to get healthcare, and so I asked around.
BROWN: The family had only lived here a year after moving from Texas. J assumed Massachusetts would have better services for her kids and would be more inclusive than the South.
J: And I had a fear of being, like, the frog in the boiling water and not realizing what was happening until it was too late.
BROWN: After Bug came out, the family got an appointment at Baystate Health, the largest hospital system in western Massachusetts. Baystate had doctors who could prescribe hormone therapy. Bug was excited about starting soon on testosterone, often called T.
BUG: I really wanted to get on T. Like, my voice is changing. Oh, my God. Like, just in general, it'd be - like, every part of it sounds fun. Except for I recently learned that they give it to you via shots, so that was scary, a little bit.
BROWN: But in February, right before Bug was going to start, Baystate announced it was stopping that care for children, offering only counseling. J was shocked.
J: Maybe this is naive. I didn't think that would happen in Massachusetts and certainly not preemptively.
BROWN: She knew the Trump administration was trying to strip Medicaid and Medicare funding from any hospital that offered gender-affirming care to minors. But several states, including Massachusetts, were fighting back in the courts. And Massachusetts had passed a shield law to protect doctors and nurses who provide gender-affirming care. J felt Baystate should've hung in there until all the court battles were over.
J: So I really had no idea that we were that close to just giving in.
BROWN: In March, a federal judge ruled against Trump's policy, though the administration could appeal. The hospital declined an interview with NPR to explain why it stopped offering the treatment. In a statement, Baystate cited the threat of losing hundreds of millions in federal dollars. Hospitals in other blue states, including California, Illinois and New York, have done the same. Bug himself took the decision hard.
BUG: I bet there's tons and tons of kids who were like, OK, I'm going for trans-affirming healthcare, yay. And they were like, no, never mind. And like, tons and tons of kids were disappointed and sad and frustrated.
BROWN: Another mother of a 14-year-old says her daughter was severely depressed before she got gender-affirming care at Baystate. The mother requested NPR not identify her because she fears harassment.
UNIDENTIFIED MOTHER: I was hopeful that once we kind of found the right path for her, that things might start to turn around, and that's exactly what happened.
BROWN: She was furious when Baystate ended treatment and scared for her daughter.
UNIDENTIFIED MOTHER: There's a sense of, how could you? And there's also the awareness of the impact that, you know, just pulling care could have from a physical health perspective but also from a mental health perspective.
BROWN: Trans patients in this area do have other options for now. Bug switched to a private clinic that does not rely on federal funding. But J worries the government will find other ways to stop treatment. She sometimes second guesses their move from Texas to Massachusetts, wondering if they should've moved to Canada instead.
For NPR News, I'm Karen Brown in Springfield, Massachusetts.
RASCOE: This story comes from NPR's partnership with New England Public Media and KFF Health News. Transcript provided by NPR, Copyright NPR.
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