Three Massachusetts hospitals ended youth gender-affirming care
Members of Protect Trans Futures brought their hormone replacement therapies — needles, gels, pills, and sharps containers — into the lobby of Attorney General Andrea Campbell’s Boston office building on Wednesday and occupied the space, the Guardian reported. After the building closed for the day, organizers were handed a phone; an assistant attorney general offered them a meeting, a step the group had pursued for months without result. They refused. State troopers arrested nine organizers, including 21-year-old PTF member Teddy Walker. The attorney general’s office told the Guardian it was not involved in the decision to arrest the protesters.
Walker shouted “Act up! Fight back!” — a chant drawn from the Aids activist movement — as he was taken into custody.
The activists had come asking Campbell to order hospitals to reinstate gender-affirming care programs, or to investigate or litigate against the institutions for ending them. Walker said the state’s political leadership had failed to recognize what the withdrawal of services has meant for patients.
“Massachusetts politicians at the local, state and federal level are very naive in thinking and hoping that there’s not this massive loss of care, but that’s not the reality of patients and families,” Walker said. “The Trump administration’s policies are working exactly as intended.”
Some advocates who share Protect Trans Futures’ outrage at the hospitals for pre-emptively complying with Trump’s agenda have worried that the action could undermine Campbell, a sympathetic attorney general, and eventually result in a less friendly replacement, the Guardian reported. Many trans organizers see the action as holding the government to its own standards.
Hundreds of thousands of trans people and families with trans kids have relocated to Massachusetts in recent years from states with anti-trans laws, hoping to maintain access to gender-affirming care. Massachusetts is one of a handful of states with shield laws protecting LGBTQ+ residents from out-of-state lawsuits and penalties over gender-affirming care, and prominent officials — including Governor Maura Healey, the state’s first woman and lesbian governor, and Senator Edward Markey, who won his Democratic primary this week in a race largely defined by trans rights — have publicly supported trans constituents.
Those protections have not insulated hospitals from federal pressure. In the first weeks of his second term in January 2025, President Donald Trump signed an executive order threatening to cut off federal funding for hospitals that provide gender-affirming medical care to trans youth. Later that year, Health Secretary Robert F. Kennedy Jr. sought to target Medicaid funding to hospitals providing youth gender-affirming care. Many of those efforts have been tossed, and there are no reports of hospitals losing federal funding for providing this care.
Still, at least three Massachusetts hospitals or health systems have ended their programs. Fenway Health, the state’s largest LGBTQ+ healthcare provider, stopped providing youth hormone care and puberty blockers last October. Founded as a community health drop-in location in the early 1970s, Fenway centered gay clients and made the first Aids diagnosis in New England. Outer Cape Health Services, which runs three facilities on Cape Cod, and Baystate Health, which serves western Massachusetts, followed suit. A fourth Massachusetts hospital canceled all appointments for a gender-affirming surgery for adult trans women, even though adults are not the subject of Trump’s executive order.
Campbell’s office met with a group of trans youth advocates in April, after some hospitals had ended care for youth. She has repeatedly expressed support for trans youth, saying that gender-affirming healthcare “remains legal and protected” in Massachusetts and warning hospitals that ending youth gender-affirming care “may amount to discrimination” under state law. On September 2 — the same day as the protest at her office — Campbell joined 21 other state attorneys general in suing the Trump administration over its attempt to block Medicaid coverage for youth gender-affirming care.
In August, Walker publicly confronted Campbell at a Boston public library event over her inaction. She stated she will not litigate against hospitals that have ended care and has not ordered them to reinstate it, as attorneys general in New York and California, as well as Colorado’s supreme court, have done.
After Wednesday’s protest, the attorney general’s office shared with the Guardian an email it sent to Protect Trans Futures. In it, the office argued that those comparisons were imperfect and would not result in care being reinstated in Massachusetts. The office wrote, “The cessation of gender-affirming care for minors by Fenway Health, Outer Cape Health Services and Baystate Health has not resulted in a wave of hospitals or clinics ceasing to provide care in the Commonwealth.”
The email also stated: “The AGO and PTF share a common goal: maintaining access to gender-affirming care.”
Campbell’s office has said it is unaware of any youth who has lost care. Walker said the group has previously brought families to meetings with the office, but nothing came of it. In its email, the attorney general’s office asked PTF to connect with those families; Walker said the group has done so before without follow-through.
The closures have affected individual patients. Josh, who asked to use a pseudonym for privacy reasons, was born at Fenway to lesbian parents and still sees his primary care physician there. After starting hormone replacement therapy in middle school and two years on puberty blockers, he began taking testosterone. When Fenway halted care last year, he was referred to Boston Children’s Hospital, which has publicly refused to close its trans healthcare program. Restarting the intake process, however, took over a year, he told the Guardian. “It shattered his trust that his home state would be able to protect him,” the Guardian reported.
Other providers have absorbed some of the demand. Transhealth in Northampton, the country’s only independent clinic focused solely on trans and gender-nonconforming patients, has shouldered an avalanche of referrals.
Safara Malone, a Harvard University senior, moved to Massachusetts from Texas in 2024 after advocacy work in her home state. She said she intentionally chose a college where she would face fewer barriers and find more explicit support. But with graduation less than a year away, Malone said she was not sure where she would feel safe living next, amid what she called the trans “great migration.” The Guardian reported it was difficult for her to realize that had she arrived in Boston just one year later — after the changes at Fenway — she would have been refused her care. Malone is now considering leaving the country.
After Baystate cut off youth gender-affirming care, the Western Massachusetts Trans Alliance emerged to push back. The grassroots effort joined an existing network of advocacy organizations, including the Massachusetts Transgender Political Coalition and the Boston chapter of the Democratic Socialists of America, which has signed on to PTF’s efforts. The national Gender Liberation Movement also joined the protest at Campbell’s offices. PTF’s letter campaign has collected more than 3,000 signatures.
A grassroots group of parents and other adults from western Massachusetts set up a large banner depicting a blue bus labeled “Baystate Health,” with smaller signs reading “throws trans kids under the bus.” Under the banner, fabric legs with children’s sneakers poked out.
Ali Wicks-Lim, one of the western Massachusetts organizers, said the region had fewer healthcare alternatives. “Unlike Boston, western Mass does not have as many choices for healthcare,” Wicks-Lim said. “So for them to end this gender-affirming care means that people have to travel further, and search harder, to find any kind of gender affirming care for their youth.”
Wicks-Lim added: “Once we let the government start making decisions about what we do with our bodies, and what our children are able to do with our bodies, and the decisions that parents and grandparents and caregivers need to be able to make for their children, we’re in a really dangerous territory.”
Across the country, youth gender-affirming care is restricted or banned in 27 states, including Texas and Missouri; in some, doctors can be prosecuted for providing it, and parents have been investigated for seeking it out. Half of all trans youth ages 13 to 17 live in those states. Hospitals in blue states have faced pressure too: New York’s NYU Langone ended care last year and has been subpoenaed for the medical records of its former minor clients.
Fenway’s cessation of care spurred the creation of Protect Trans Futures, which has spent the summer pushing Campbell to consider its demands.