{"id":166267,"date":"2025-08-22T10:37:16","date_gmt":"2025-08-22T10:37:16","guid":{"rendered":"https:\/\/www.europesays.com\/us\/166267\/"},"modified":"2025-08-22T10:37:16","modified_gmt":"2025-08-22T10:37:16","slug":"atrium-health-halts-gender-affirming-care-for-patients-under-age-19","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/166267\/","title":{"rendered":"Atrium Health halts gender-affirming care for patients under age 19"},"content":{"rendered":"

By Rachel Crumpler<\/strong><\/p>\n

Since 2020, Josh Dumas\u2019 14-year-old transgender son has received gender-affirming care \u2014 including puberty blockers and testosterone \u2014 from an Atrium Health doctor in Charlotte.\u00a0<\/p>\n

Dumas said the gender-affirming health care has made all the difference for his youngest child\u2019s gender dysphoria<\/a>, a condition in which there is a conflict between the sex assigned at birth and the gender someone identifies with.<\/p>\n

His son started puberty blockers around age 10 \u2014 shortly after he came downstairs one night sobbing, distraught after noticing the first signs of breast development. It was a distressing discovery for the child who had identified as a boy since he was five years old and lived as one.<\/p>\n

\u201cMy heart just broke for him,\u201d Dumas said. \u201cI mean, he\u2019s a boy. He looks like a boy. Everyone sees him as a boy.\u201d<\/p>\n

The puberty blockers have acted as a pause on puberty, stopping him from developing breasts or menstruating. Several years later, at age 13, his doctor prescribed testosterone.\u00a0<\/p>\n

\u201cWhen he started testosterone, the changes were pretty quick in his shoulders and his arms. He started growing hair on his face and armpits,\u201d Dumas said. \u201cHe just loves it. Body image for him is a big deal.\u201d<\/p>\n

Dumas said his son hasn\u2019t wavered from his identity. He also said that the gender-affirming care provided at Atrium has been life-saving, allowing his son to blossom.\u00a0<\/p>\n

But now Dumas\u2019 son won\u2019t be able to receive the care at Atrium.\u00a0<\/p>\n

That\u2019s because Atrium Health, part of the multi-state Advocate Health<\/a> system, changed its policy this month to stop providing gender-affirming medications and surgeries to all patients under age 19 \u2014 a restriction exceeding North Carolina\u2019s 2023 state law<\/a>, which allows children who were already receiving such care to continue and anyone above age 18 to start it.\u00a0<\/p>\n

The news came as a \u201cgut punch\u201d to families who are left to scramble to find new providers \u2014 in some cases, leaving behind patient-doctor relationships they have had for years.<\/p>\n

The number of patients in North Carolina affected by the decision to further limit gender-affirming care is not clear. Atrium Health did not respond to NC Health News\u2019 question about how many patients would lose access to care. However, an advocate with knowledge of the impact, who requested anonymity, said about 120 patients being seen at the Atrium Health Levine Children\u2019s Center for Gender Health<\/a> in Charlotte were affected by the policy change and required transfers to other clinicians to continue care. The center provides gender-affirming care to transgender and gender-expansive children, adolescents and young adults up to age 25.<\/p>\n

Other Atrium providers not affiliated with the center also had patients younger than age 19 who were affected by the move.<\/p>\n

In an emailed statement<\/a> sent to NC Health News, Advocate Health cited \u201cthe evolving regulatory environment\u201d in its decision to end gender-affirming care for patients under 19, as access to such care has increasingly come under scrutiny from the administration of President Donald Trump.<\/p>\n

\u201cWe recognize that this is a deeply complex issue, and this decision was made after a multi-disciplinary team spent numerous hours carefully considering the options and outcomes,\u201d a spokesperson for Advocate Health said in the statement. \u201cThis new policy allows our hospitals, clinics and pharmacies to continue caring for all patients\u2019 health needs in the changing federal environment.\u201d<\/p>\n

Advocates for transgender youth denounced the decision as preemptive compliance with an unjust policy and argued that Atrium Health is \u201cturning their back\u201d on vulnerable patients.<\/p>\n

\u201cIt signals to trans kids that your health care doesn\u2019t matter, your identity is not valid,\u201d said Mollie Burkholder, interim executive director at PFLAG Charlotte<\/a>, a nonprofit support organization that serves the LGBTQ+ community.\u00a0<\/p>\n

\u2018A campaign issue\u2019\u00a0\u00a0<\/strong><\/p>\n

This move by North Carolina\u2019s largest health system is just the latest restriction on access to gender-affirming care in the state<\/a> \u2014 medical care that has grown increasingly divisive<\/a> in recent years. Since 2023, such care for transgender youth has been significantly limited after state lawmakers passed legislation banning gender-affirming care<\/a> \u2014 including puberty blockers, hormones and surgeries \u2014 for people under the age of 18. The law was enacted over then-Gov. Roy Cooper\u2019s veto and included a provision allowing minors who began treatment before Aug. 1, 2023, to continue receiving their care.<\/p>\n

North Carolina\u2019s law is part of a broader wave of legislation across the United States; 27 states<\/a> have enacted bans on gender-affirming care for minors. The restrictions have come even though gender-affirming care for transgender adults and minors is considered medically necessary and often lifesaving by major medical organizations<\/a> like the American Academy of Pediatrics<\/a>, the Endocrine Society<\/a> and the American Medical Association<\/a>.<\/p>\n

\"AMore than half of states in the United States have enacted laws limiting youth access to gender-affirming care. The first state to pass such a law was Arkansas in 2021. Credit: KFF<\/a><\/p>\n

In addition to state-level restrictions, the Trump administration is focused on ways the federal government can discourage and prevent gender-affirming care for minors.<\/p>\n

\u201cThis was a campaign issue the Trump administration ran on,\u201d said Lindsey Dawson, director of the LGBTQ Health Policy program<\/a> at KFF<\/a>, a nonpartisan health policy and research organization. \u201cIt really made this an outsized issue.<\/p>\n

\u201cThe share of people who identify as transgender or nonbinary is very small<\/a>, and then not all of those people seek gender-affirming medical care, and so we\u2019re actually talking about a very small share of the population who\u2019s seeking these services, and when the service is provided, it\u2019s not happening overnight. It\u2019s a long, careful, thoughtful decision.\u201d<\/p>\n

In North Carolina, an estimated 21,800 people ages 13-17 identify as transgender, according to a 2025 report<\/a> by UCLA\u2019s Williams Institute<\/a>, which researches sexual orientation and gender identity law and public policy.<\/p>\n

Federal pressure<\/strong><\/p>\n

A week after Trump took office, he issued an executive order titled \u201cProtecting Children From Chemical and Surgical Mutilation<\/a>\u201d that makes it U.S. policy to \u201cnot fund, sponsor, promote, assist, or support the so-called \u2018transition\u2019 of a child from one sex to another.\u201d The order threatens to withhold federal funding from medical institutions that provide gender-affirming care to people under age 19. It has been met with lawsuits<\/a>, and there is currently an injunction<\/a> prohibiting the enforcement of the executive order.\u00a0<\/p>\n

In the months since, the federal government has taken additional measures<\/a> to review and limit gender-affirming care practices.\u00a0<\/p>\n

Among the actions, the U.S. Department of Health and Human Services published a report<\/a> in May questioning the benefits of such care. In July, the U.S. Department of Justice announced that it had subpoenaed<\/a> more than 20 clinics and doctors \u201cinvolved in performing transgender medical procedures on children\u201d and is encouraging whistleblowers to come forward. That same month, the Federal Trade Commission held an all-day workshop<\/a> examining whether unfair or deceptive trade practices are being used in the provision of gender-affirming care. And the Centers for Medicare and Medicaid Services has begun the rulemaking process focused on reimbursement policies<\/a> related to gender-affirming care.<\/p>\n

\u201cThe environment is one of hostility to providers offering this care, and one that understandably is creating an atmosphere of fear and uncertainty,\u201d Dawson said.<\/p>\n

As a result, a growing number of hospitals across the country \u2014 including in blue states where bans aren\u2019t in effect \u2014 have restricted or even shut down gender-affirming care clinics. For example, in July, Children\u2019s Hospital Los Angeles<\/a>, one of the largest providers of gender-affirming care for minors in the country, closed its he<\/a>a<\/a>lth clinic for transgender youth<\/a>, citing pressure from the Trump administration. Hospitals in other states, such as Connecticut<\/a>, Pennsylvania<\/a>, Virginia<\/a> and Montana<\/a>, have also stopped offering gender-affirming care to people younger than 19.\u00a0<\/p>\n

Dawson said these hospitals are preemptively pulling back care before there\u2019s formal law or regulations requiring them to do so. This leaves gaps for minors who need gender-affirming care.\u00a0<\/p>\n

Increased restrictions\u00a0<\/strong><\/p>\n

Atrium Health is the first hospital system in North Carolina known to have changed its gender-affirming care policies to align with the shifting regulatory stance of the Trump administration.<\/p>\n

During a 15-minute closed Microsoft Teams meeting on July 31 that NC Health News obtained an audio recording of, Advocate Health leaders announced to a group of physicians providing gender-affirming care that the hospital system would no longer prescribe gender-affirming medications or perform gender transition-related surgeries for patients under age 19. The move included minors who were grandfathered in under the 2023 North Carolina law. The policy applies across all hospitals operated by Advocate Health in six states, not just those based in North Carolina.<\/p>\n

\u201cWe understand the complexity of this, we understand the emotion, the real concern around it.\u00a0We share it, which is why there has been so much time and so many people weighing in on this,\u201d Scott Rissmiller, chief clinical officer at Advocate Health, said during the meeting. \u201cAt the end of the day, ultimately, it is to protect our clinicians and our patients, and our organization as we move forward.\u201d<\/p>\n

On the call, Advocate Health leaders said the policy change would take effect just days later on Aug. 4, citing the \u201cculmination\u201d of federal activity and its potential impacts as the reason. Doctors were told to notify all their affected patients no later than Aug. 15. To ease the transition, clinicians have been permitted to prescribe a one-time, final 90-day supply of medications to their patients and provide tapering recommendations. Tapering effectively ends hormonal support and, if patients do not find care elsewhere, they may begin developing unwanted physical traits associated with the puberty of their sex assigned at birth.<\/p>\n

An Atrium provider, who spoke with NC Health News and requested anonymity because they were not authorized to speak to the media, said the news was \u201creally upsetting.\u201d Informing affected patients the week after the decision marked one of the most difficult weeks of their medical career, the provider said. Many patients felt blindsided and broke down in tears as they learned how the policy change would affect their care.<\/p>\n

\u201cThe moral injury inflicted by this policy is incredible to the providers who are delivering the care,\u201d the Atrium provider told NC Health News. The provider said they continue to believe in the benefits of gender-affirming care for some youth with gender dysphoria. They noted they have seen patients emerge from depression after beginning treatment.\u00a0<\/p>\n

Seeing that care get restricted beyond North Carolina\u2019s legal limits, they said, is deeply concerning.<\/p>\n

Advocate Health acknowledged in a statement that the policy change is \u201cdifficult news\u201d for affected patients and said it has established a 24\/7 hotline to assist them, with a focus on providing counseling support that may be needed.<\/p>\n

Turning its back on patients<\/strong><\/p>\n

Holly Savoy, executive director at Charlotte Trans Health<\/a> and a psychologist serving transgender youth, expressed disappointment over Atrium\u2019s decision, arguing that the hospital system is operating out of fear, rather than standing by the evidence of gender-affirming care.\u00a0<\/p>\n

\u201cThe standards of care and the science have not changed,\u201d Savoy said. \u201cAtrium is succumbing to federal pressure and out of fear. We just need to get back to care being between a patient and the family and their provider, and get the politics out of there.\u201d<\/p>\n

Savoy worries about the consequences of making gender-affirming care less accessible, as she\u2019s seen how transformative it can be. For many transgender youth, Savoy said access to affirming care reduces rates of depression, anxiety and suicidality among a population who face disproportionate mental health challenges<\/a>.\u00a0<\/p>\n

\u201cI\u2019ve seen so many youth really be at that brink of suicide and by being affirmed and being accepted by their families and by friends and loved ones and getting access to affirming care and providers, really turn their lives around and have successful lives,\u201d Savoy said.<\/p>\n

Reducing the number of providers offering gender-affirming care to minors doesn\u2019t change the number of people in need of care, Savoy said. She fears that Atrium\u2019s move could set a precedent for other hospitals in North Carolina.<\/p>\n

That concern is shared by parents of transgender youth who aren\u2019t Atrium patients. Dana, a parent from Charlotte who requested NC Health News not use her last name for privacy and safety concerns, said her 14-year-old transgender child is on puberty blockers and that continued access to gender-affirming care is vital.<\/p>\n

\u201cThey were, and still are, deathly afraid of male puberty,\u201d Dana said about her child. \u201cThey do not want anything that\u2019s going to happen to them physically, that\u2019s going to have them basically present male in any way. That makes them very uncomfortable, makes them very distressed.<\/p>\n

\u201cIf one organization and one health system can say, \u2018We\u2019re not treating this group of people because of this thing,\u2019 then so could Novant, so could independent providers, and then our child\u2019s left out in the cold,\u201d Dana said.<\/p>\n

So far, advocates say they haven\u2019t learned of policy changes at other North Carolina hospitals.\u00a0<\/p>\n

Duke Health and Novant Health did not respond to questions from NC Health News about the status of care. A UNC Health spokesperson responded with a brief statement, saying the system follows North Carolina law about gender transition procedures and is \u201caware of the executive order which is directed at federal agencies and are continuing to monitor communications from those agencies.\u201d<\/p>\n

Scrambling to find new providers<\/strong><\/p>\n

Charlotte family physician Rhett Brown, who is not affiliated with a hospital system, is one doctor who has taken on several patients who lost access to gender-affirming care at Atrium. Brown, who has been providing gender-affirming care since 2010, said he plans to continue offering that care within the bounds of North Carolina law.<\/p>\n

\u201cWe should be here to provide support, guidance and acceptance and care for people in a way that is evidence-based medicine, and that is also legal,\u201d Brown said. \u201cSo in North Carolina, taking care of patients who are gender nonconforming or transgender between the ages of 18 and 19 is still legal in North Carolina and ethical, and is best practice to care for those patients.\u00a0<\/p>\n

I\u2019m not sure why physicians would step back from taking care of such a vulnerable population.\u201d<\/p>\n

Nonprofit organizations like PFLAG Charlotte<\/a> and Charlotte Trans Health<\/a> said they received an influx of messages from families urgently seeking new providers in the wake of Atrium\u2019s decision. They have been working to help point people to providers still offering care. However, some providers already have full caseloads.<\/p>\n

Brown warned that disruptions in care can have serious mental health consequences.<\/p>\n

\u201cThere\u2019s a good chance that if they have gender dysphoria-related depression, the depression is going to come back very strongly,\u201d Brown said. \u201cThe big thing is not feeling authentic anymore, feeling like you\u2019re being victimized for something that you have no control over, and feeling that you\u2019re being targeted for reasons that have nothing to do with optimizing your health care.\u201d<\/p>\n

Breaking point<\/strong><\/p>\n

Challenges to gender-affirming care come alongside broader rollbacks of transgender rights at the state and federal levels. Just last month, North Carolina state lawmakers overrode Gov.\u00a0 Josh Stein\u2019s veto to pass House Bill 805<\/a> \u2014 legislation that recognizes only two sexes in state government rules and public policies<\/a>, mandates retaining original birth certificates if a person changes their gender and extends the time doctors can be sued for malpractice for treating minors for gender transition.<\/p>\n

For Dumas, the parent of a transgender teen, the past few years \u2014 and especially the last eight months of the Trump administration \u2014 have felt like a \u201crelentless onslaught\u201d against his son\u2019s identity.\u00a0<\/p>\n

\u201cYou\u2019re on pins and needles waiting for the next terrible thing to happen and trying to figure out how that affects your family and how it affects your situation,\u201d Dumas said.<\/p>\n

\"AThe Dumas family at the White House in 2024. Since taking office, President Trump and his administration have focused on ways the federal government can discourage and prevent gender-affirming care for minors. Credit: Courtesy of Josh Dumas<\/p>\n

For years, Dumas and his wife have discussed backup plans they hoped they\u2019d never need. But after years of advocacy work and speaking with lawmakers, Dumas said the family has reached a breaking point.\u00a0<\/p>\n

Dumas said they can\u2019t live feeling like every day they are \u201cfighting for their family\u2019s existence.\u201d<\/p>\n

North Carolina and the United States no longer feel like a safe place for their transgender son, he said. Atrium\u2019s decision to pull back on gender-affirming care was among the final straws for him and his family.\u00a0<\/p>\n

Dumas\u2019 wife and transgender son plan to move to Canada in October, while he and their older son remain in North Carolina for his senior year of high school.\u00a0<\/p>\n

\u201cIt\u2019s just time to go,\u201d he said.<\/p>\n

Republish This Story<\/p>\n

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Republish our articles for free, online or in print, under a Creative Commons license.<\/p>\n","protected":false},"excerpt":{"rendered":"By Rachel Crumpler Since 2020, Josh Dumas\u2019 14-year-old transgender son has received gender-affirming care \u2014 including puberty blockers…\n","protected":false},"author":3,"featured_media":166268,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[95609,77982,86610,95610,95611,19149,92353,14544,95612,210,1141,1142,95613,3173,95614,5005,95615,19746,95616,4352,67,132,68],"class_list":{"0":"post-166267","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-advocate-health","9":"tag-anti-trans-legislation","10":"tag-atrium-health","11":"tag-charlotte-trans-health","12":"tag-gender-affirmation","13":"tag-gender-affirming-care","14":"tag-gender-dysphoria","15":"tag-gender-identity","16":"tag-gender-affirming-surgery","17":"tag-health","18":"tag-health-care","19":"tag-healthcare","20":"tag-hormone-therapy","21":"tag-kff","22":"tag-pflag","23":"tag-president-donald-trump","24":"tag-puberty-blockers","25":"tag-transgender","26":"tag-transgender-care","27":"tag-trump-administration","28":"tag-united-states","29":"tag-unitedstates","30":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115071984855808622","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/166267","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=166267"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/166267\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/166268"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=166267"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=166267"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=166267"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}