Children\u2019s Hospital Los Angeles is the preeminent center for pediatric medicine in Southern California. For three decades, it\u2019s also been one of the world\u2019s leading destinations for trans care for minors. Don\u2019t take my word for it: CHLA boasts about its record of providing \u201chigh-quality, evidence-based, medically essential care for transgender and gender-diverse youth, young adults, and their families.\u201d<\/p>\n
Earlier this month, it abruptly ended all that, telling its staff in a meeting that the Center for Transyouth Health and Development would be shutting down. (My daughter<\/a> was, until this announcement, a patient at the center.)<\/p>\n Did some new medical breakthrough, some unexpected research drive the decision to cut off care for roughly 2,500 patients with no warning? No. It came, the hospital said, after \u201ca thorough legal and financial assessment of the increasingly severe impacts of recent administrative actions and proposed policies.\u201d<\/p>\n In other words, the hospital caved. In advance.<\/p>\n CHLA made the move a week before the Supreme Court\u2019s 6-3 decision in the United States vs. Skrmetti, which upheld a Tennessee law that bans most gender-affirming care for minors. More than 20 states have passed similar laws that prevent trans minors from accessing many different forms of medical care. The decision essentially shields those laws from future legal challenges.<\/p>\n But the Supreme Court ruling had nothing to do with CHLA\u2019s decision. There is no such law in California.<\/p>\n Why, then, without any court order or law, did the center suddenly close, leaving so many young patients in need of doctors, medications and procedures? You can probably guess the answer.<\/p>\n Pressure from the Trump administration threatened the hospital with severe repercussions if it continued to serve these patients. One form of pressure arrived in a May 28 letter<\/a> from the Centers for Medicare and Medicaid Services, signed by its administrator, the former TV host Dr. Mehmet Oz. He announced that his agency would seek financial records on a range of gender-affirming care procedures from several dozen hospitals.<\/p>\n Being faced with the choice of discontinuing care for an entire class of patients or battling the administration over access to financial records is not a dilemma any doctor wants to face. To be clear, this is not a debate over medical science or proper care for trans youth. CHLA followed the science \u2014 until it didn\u2019t. This is a debate over ideology about who is deserving of medical care.<\/p>\n In the past few months, we have seen powerful law firms, large corporations and universities forced to contend with difficult bargains. Settle with an administration that has singled you out? Or take the battle to court?<\/p>\n