- Share via
Children’s Hospital Los Angeles is the preeminent center for pediatric medicine in Southern California. For three decades, it’s also been one of the world’s leading destinations for trans care for minors. Don’t take my word for it: CHLA boasts about its record of providing “high-quality, evidence-based, medically essential care for transgender and gender-diverse youth, young adults, and their families.”
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 was, until this announcement, a patient at the center.)
As Children’s Hospital Los Angeles scales back healthcare for trans youth, Stanford Medicine has stopped performing gender-affirming surgeries on patients younger than 19.
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 “a thorough legal and financial assessment of the increasingly severe impacts of recent administrative actions and proposed policies.”
In other words, the hospital caved. In advance.
CHLA made the move a week before the Supreme Court’s 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.
To defer to state legislatures on gender affirming care is to abandon a distinct group of people who are obviously discriminated against.
But the Supreme Court ruling had nothing to do with CHLA’s decision. There is no such law in California.
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.
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 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.
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 — until it didn’t. This is a debate over ideology about who is deserving of medical care.
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?
In February, when Children’s Hospital announced that it would stop taking on new patients in its Transyouth Center, California Atty. Gen. Rob Bonta sternly reminded them that they had a legal obligation to continue to provide this care. The hospital quickly reversed course.
That’s why the recent choice of the CHLA board marks a huge shift that could potentially affect care for not just trans youth patients but so many others as well.
Because what the board of CHLA did was, in fact, a choice. Moreover, CHLA’s choice went against its own medical advice about the urgent need for such care. On its website, the hospital claims it was “immensely proud of this legacy of caring for young people on the path to achieving their authentic selves.”
When confronted with threats, the board chose to sacrifice the care of one group of patients in the hope that it could continue to care for others. Perhaps the board concluded that it was following a crude, utilitarian logic: denying the medical needs of some would allow it to provide for many more.
That’s not how I see it. In caving to blackmail, they have endorsed the administration’s bigotry. They have demonstrated that trans youth are expendable. The board has made it clear that this group of patients is not as deserving of care as others. When CHLA faced actual pressure, its own record of providing “high-quality, evidence-based, medically essential care” simply became too inconvenient.
This time, it was trans youth. Who will it be next time? Disabled children? Children born outside the U.S.? CHLA agreed to play the game rather than call it out for what it is.
As a journalist, I occasionally grant anonymity to a source. It’s not an action I take lightly. The decision means that if pressured, even when threatened with contempt of court, I will not reveal their identity. Thankfully, it’s never come to that for me, although other journalists have gone to jail to protect sources. If I were to break that pledge once, I could never in good conscience grant it again.
I now wonder how doctors at CHLA can ever look their young patients in the eye again and promise that, no matter what, they will fight for their care.
Gabriel Kahn is a professor of professional practice at the USC Annenberg School for Communication and Journalism.
A cure for the common opinion
Get thought-provoking perspectives with our weekly newsletter.
You may occasionally receive promotional content from the Los Angeles Times.
More From the Los Angeles Times
Podcasts
In this episode, we discuss the history here, what lessons were learned — and not — and how that can inform what we we do this time around as we attempt to rebuild Altadena and the Pacific Palisades.
This week’s episode covers the sentencing and future legal proceedings for “The Ketamine Queen” — the doctor who pled guilty to supplying Matthew Perry with ketamine.
Sammy Roth visits Ioneer’s proposed Rhyolite Ridge mine in Nevada with managing director Bernard Rowe, who details responsible lithium/boron extraction and Tiehm’s buckwheat protection.
