Children’s Hospital L.A. keeps limits on transgender care amid challenges to Trump order

Children’s Hospital Los Angeles is keeping its recent restrictions on gender-affirming care in place as hospital officials review decisions by federal judges to pause parts of President Trump’s executive order targeting the use of puberty blockers, hormones and other procedures for transgender youths.

In separate rulings, U.S. District Court judges in Baltimore and Seattle issued temporary restraining orders to put parts of Trump’s executive order on hold, including a section that directs federal agencies to ensure that hospitals receiving federal research or education grants “end the chemical and surgical mutilation of children.”

In an email to staff last week, hospital chief executive Paul Viviano and Chief Operating Officer Lara Khouri said they welcomed the temporary restraining orders issued by the federal judges, but were still reviewing them to understand their implications.

One of them “disappointingly appears to apply only to the three states that filed the lawsuit,” and the other blocked only the section of the executive order “pertaining to certain federal agencies withholding or conditioning funds” based on whether gender-affirming care is provided for youths, the hospital leaders said.

Children’s Hospital said this month that it had paused the initiation of hormonal therapy for “gender affirming care patients” under the age of 19 as it assessed Trump’s executive order. In addition, the L.A. hospital also said it had already halted gender-affirming surgeries for minors.

Restricting hormonal therapy “was a difficult decision and one that was taken quickly,” Viviano and Khouri said in their email to hospital staff. The decision “was communicated poorly and for this, we apologize.”

A hospital spokesperson said Wednesday that there were no updates to its policy on gender-affirming care.

LGBTQ+ advocates and L.A. City Councilmembers Ysabel Jurado and Hugo Soto-Martinez joined hundreds of people who protested outside the hospital this month, saying that the move jeopardized the health of transgender youths and defied the guidance of major medical organizations such as the American Academy of Pediatrics, which recommends transgender youths have access to gender-affirming care.

The move by Children’s Hospital to restrict such care was celebrated by groups such as the California Family Council, which has decried medical care involved in gender transition as harmful for youths and urged other hospitals to follow suit as facilities in New York, Virginia and elsewhere paused services.

In a letter sent two weeks ago, California Atty. Gen. Rob Bonta’s office cautioned the L.A. hospital that withholding gender-affirming care from transgender youths could run afoul of state law. LGBTQ+ advocates have also stressed that many of the changes outlined in the executive order hinge on federal rulemaking that has yet to be carried out.

In their message to staff, Viviano and Khouri stressed that the hospital relies heavily on funding from the federal government. “In all our combined decades in hospital administration, we can’t think of a time when there was more at risk for CHLA,” they wrote. “We want to be clear that every decision we make is with all our patients and team members top of mind.”

Jesse Thorn, whose children receive care at Children’s Hospital Los Angeles, said he sympathizes with its fears, but “I also would ask them to search their hearts and say, ‘What other groups of people would we stop providing care for?’ Where do they draw the line here?”

Families of transgender youths and others have sued to try to stop Trump’s executive order, saying it violates the rights of transgender youths. In Baltimore, U.S. District Court Judge Brendan Hurson granted their request for a temporary restraining order last week, saying that the executive order “seems to deny that this population even exists, or deserves to exist,” and that disrupting their care could cause “irreparable harm.”

The restraining order in that case lasts 14 days but could be extended. A federal judge in Seattle also granted a temporary restraining order pausing the executive order on Friday, in response to a lawsuit by Democratic attorneys general from Washington state, Oregon and Minnesota. The order issued Friday says it applies “within the Plaintiff states,” which don’t include California.

Dannie Ceseña, director of the California LGBTQ Health and Human Services Network, said that as of last week, he didn’t know of any California healthcare providers besides Children’s Hospital L.A. that had continued to suspend care for transgender youths after Bonta had spoken out about the issue.

The Associated Press contributed to this report.