Seattle Children's halts gender-affirming surgeries after executive order threatens loss of federal funds

Seattle Children’s suddenly canceled a 16-year-old’s gender affirmation surgery, planned for Tuesday, Feb. 4, his family says, citing President Trump’s executive order that bars federal funds to clinics that provide such care to trans youth.

After three years on the waiting list, his mother, who requested anonymity to protect her son’s privacy, says Children’s called it off at 5 p.m. the day before.

“The person at Seattle Children's who deals with insurance approvals called my son while he was on the bus on the way home from school and told him that, because of the executive order, all gender-affirming surgeries were being postponed,” she said.

In an emailed statement, Jen Morgan, Children’s spokesperson, said, “Like pediatric hospitals across the country, we find ourselves in an incredibly difficult situation and our hearts go out to the patients and families being impacted while we review the potential implications of this executive order.”

Given Children’s dependence on federal funding for research and patient care, Morgan said, “losing eligibility would jeopardize care for our patients across the region who are depending on us.”

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The 16-year-old said that, although he understands the hospital’s priorities, “Having read the executive order, my surgery would not have inhibited their ability to receive federal funding. They have 60 days from when that executive order was published to stop, and both my surgery and the follow-up appointment to make sure everything is healing well were within the 60 days of the executive order.”

The teen and his mother said Children’s did not give any indication as to when — or whether — his surgery might take place. There were no other changes made to his gender care, he said, such as his hormone replacement therapy.

Gender-affirming care for children has been supported by all major medical organizations, including the American Academy of Pediatrics. While young people have a wide range of needs, wishes, and readiness for interventions including puberty blockers and surgery, gender care is considered a critical component to the mental health of transgender youth.

K.J. Glaves, who works with trans kids and teens in her role as clinical director of child and family therapy at Protea Wellness, said she is worried about the impact of Children’s limiting gender care on young people’s mental health — “and in particular, suicidality.”

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Studies show that trans youths are many times more likely to have considered or attempted suicide than cisgender peers, and that gender-affirming care mitigates the unusually high rates of depression, eating disorders, and self-harm among gender-divergent young people.

In a letter to Seattle Children’s leadership, Glaves questioned why the hospital was so quick to comply with the executive order, which has not yet taken effect, rather than wait for potential legal challenges.

“Why not resist as long as you can?” she asked.

At Kaiser Permanente, which also serves children and teens in its Gender Health clinics, spokesperson Linnae Riesen said in a statement that the organization “continues to deliver safe, high-quality care to our members, including gender-affirming care, subject to all state and federal laws and regulations.”

Unlike most providers, including Children’s, most patients at Kaiser are insured through its health coverage plans.

“Health plans are required by Washington state law to provide members with access to medically necessary gender-affirming care,” Riesen said, adding that Kaiser is closely monitoring the Trump administration’s policy announcements and executive orders to evaluate their implications to members.

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Aidan Key, founder of the organization Gender Diversity and an advocate for trans and gender-diverse youth, urged organizations like Children’s to avoid reactivity to such executive orders and policy decisions.

“I would like a beat or two to happen while they think through practically about what their options are, rather than just as some across the U.S. are doing, which is just sort of a panicked reaction,” Key said.