How Health Care Workers Are Defending Their Transgender Patients from Trump’s Attacks

In the five years Quinn has worked as a licensed counselor, they have seen the astonishing positive impact that gender-affirming care can have on young patients’ lives.

But because Quinn’s clinic relies on federal funding, it’s in the crosshairs of the Trump administration. In the wake of Trump’s efforts to outlaw gender-affirming care for people under 19, the clinic did make some changes to its public-facing communications, said Quinn. But “the actual care has continued, because it’s ethical medical care.” (Quinn, who is going by a pseudonym, also requested that I not identify their clinic out of fear of retribution.)

Quinn is one of countless health care workers across the U.S. mobilizing to support young transgender patients, as the Trump administration unleashes a flurry of executive orders and attacks aimed at limiting this population’s ability to exist openly in the world.

Before Trump’s second term began, 24 states already had laws that banned gender-affirming health care for minors, like puberty blockers, hormone therapies, or surgery. Now, a fleet of executive orders are taking aim at federal funding for the health care options that do exist for this population. An executive order dated January 28 says the U.S. will not “fund, sponsor, promote, assist, or support” gender-affirming care for people under 19.

A federal district court temporarily blocked that order on February 13, and Quinn hopes this will preserve funding for their clinic’s existing services. But the order has already had a material impact: hospitals from Colorado to Virginia to Massachusetts to Washington state have paused or disrupted some gender-affirming care, prompting criticisms and protests for “complying in advance.”

Other executive orders aim to cut off federal funding for research and medical care related to gender transition and prevent transgender people from obtaining or renewing passports that match their genders.

PUBLIC PROTESTS

Within this climate, many workers, like Quinn, are mobilizing in private. Others are taking action in the open as union members, with protests and creative actions to support their patients. While no one is free from fear of repercussions, those organizing as union members seemed more comfortable going on the record.

Andrea Soto López, a pediatrician for a Los Angeles-area hospital, told me that her union, the Committee of Interns and Residents, is “currently organizing, figuring out next steps, making sure we move forward in a strong manner” to support “our trans and gender-diverse youth.” She is a regional vice president of CIR, an SEIU local that represents more than 37,000 resident physicians and fellows across the U.S.

Recently the union worked with Democratic Socialists of America–Los Angeles to organize a February 6 protest against Children’s Hospital Los Angeles (CHLA) for pausing vital forms of gender-affirming care. Similar protests have taken place at hospitals from New York to Washington, D.C., to Chicago. Sophia Nova, a former member of DSA’s national leadership, told me that workers and unions from a variety of sectors have turned out.

CHLA also received pushback from California Attorney General Rob Bonta, who wrote a letter warning the institution that withholding services from transgender individuals is discriminatory and violates California law. Physicians mounted weekly protests and a petition drive.

These demands appear to have had an impact: the Los Angeles Times reported that CHLA is “lifting its pause on the initiation of new hormonal therapies for patients seeking gender-affirming care, effective immediately.” (The hospital isn’t resuming surgeries.)

In Illinois, some—though certainly not all—medical institutions are pausing or restricting key forms of gender-affirming care, despite the Illinois attorney general’s warning that the state’s Human Rights Act prohibits unlawful discrimination on the basis of sex, which includes gender identity.

‘SANCTUARY HOSPITAL’

No matter what protections exist on the books or what legal challenges are levied, when hospitals maximally comply with Trump’s edicts or flip-flop on them, appointments are getting canceled and health care is being denied to people who need it.

Some health care workers want to make sure their institutions don’t get a chance to comply. Sydney Simpson is a registered nurse in interventional radiology at Kaiser Permanente San Francisco Medical Center, and a member of the California Nurses Association. On February 13, Simpson and about 20 other nurses gathered in the hospital, home to the Gender Pathways Clinic, holding signs that read, “Transgender rights are human rights,” “Nurses care for all patients,” and “This is a sanctuary hospital.”

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The demonstration followed a similar action outside Kaiser’s South San Francisco Medical Center the day before. At both, nurses also passed out information about immigrant rights. “The idea was that we would designate both of these facilities publicly as sanctuary hospitals,” Simpson explained.

The nurses want Kaiser to publicly lay out its plan for protecting patients from Immigration and Customs Enforcement and preserving gender-affirming care, and also to pledge to protect nurses who stand up for their patients. They are part of National Nurses United, the nation’s largest nurses union, which has condemned the Trump administration’s “attacks on trans people and patients.”

“Gender-affirming care is life-saving care for any patient,” Nancy Hagans, a registered nurse, the president of the New York State Nurses Association, and one of the co-presidents for NNU, told me over the phone. “Everyone deserves to be taken care of properly, the way they need. If you have a heart condition, you go to a cardiologist and take care of your heart. When someone decides to go to gender-affirming care, it’s not only helping them physically, it’s helping them mentally.”

COPING WITH BANS

Ken Haller, a retired pediatrician and an emeritus professor of pediatrics at the Saint Louis University School of Medicine, lives in Missouri, where state law prohibits gender-affirming surgeries for people under 18 and bars hormones and puberty blockers for young people who didn’t start treatment before August 2023. Doctors who provide such can face penalties, including losing their licenses.

What that means, he said, is that patients who need gender-affirming care “either had to find care out-of-state or move out of state... It’s really difficult.”

Haller testified against a bill on February 3 that would make Missouri’s restrictions on transgender health care permanent.

Rebecca, a primary care physician who serves transgender adults and physicians in a state where gender-affirming health care for minors is banned, is working with groups of physicians from other states that have banned this care. They get patients the resources they need to cross state lines, strategize about how to best protect patients’ personal medical information, and connect patients and workers to resources such as the Beyond Do No Harm Network, for health care workers who want to uphold their commitments to trans and migrant patients.

Meanwhile, more unions are coming forward to condemn Trump’s actions. The executive council of 1199SEIU, the U.S.’s largest health care union, released a statement on February 24 saying it “unequivocally stands against” Trump’s executive orders targeting transgender people. The union promised to “fight to protect funding for federally qualified health centers” that serve “transgender individuals and other marginalized populations.”

Sarah Lazare is the editor of Workday Magazine. This article is a shortened version of a story published jointly by The Nation and Workday Magazine, a nonprofit newsroom devoted to holding the powerful accountable through the perspective of workers.