Access to gender affirming healthcare for minors faces increasing obstacles

Access to gender affirming healthcare for minors faces increasing obstacles

In Missoula, a transgender 18-year-old named Liz is preparing to drive seven hours to Seattle Children's Hospital for her gender-affirming care. However, she is concerned about the hospital's ability to accommodate the increasing number of patients, as well as the financial implications of the journey.

The legal landscape around gender-affirming care for minors is fraught with complexity. As of late July and early August 2025, Montana's law banning gender-affirming care for transgender minors, the "Montana Youth Protection Act," remains blocked by court injunctions upheld by the Montana Supreme Court. This means that transgender minors in Montana can still legally access gender-affirming medical care despite the state's legislative attempts to ban it. However, the Governor and some state legislators strongly oppose the court's decision and intend to continue fighting the injunction.

Beyond Montana, the availability of gender-affirming healthcare for minors is becoming increasingly difficult to obtain nationwide, even in states where it remains legal. This is due in part to threats from the federal government to cut funding to hospitals that provide this care. The White House has reportedly threatened to withhold federal funding from hospitals offering gender-affirming treatment to minors, impacting access across states.

The situation is further complicated by the numerous anti-LGBTQ laws passed this year by various states, including Montana, which target transgender rights. These laws include bans or restrictions on gender-affirming care, changes in Medicaid coverage, and limits on trans people using facilities aligned with their gender identity.

The discontinuation of gender-affirming care for minors at Community Medical Center in Missoula, Montana, has left Liz and her parent, E, without a local option. E's daughter, who is about a year away from puberty, was planning to receive gender-affirming care, including puberty blockers and hormone replacement therapy, at Community Medical Center. The hospital declined an interview request regarding the closure of their gender clinic.

E's daughter was initially unaware that her gender-affirming care might not be available. Lindsey Dawson from KFF states that hospitals across the country are discontinuing gender care for minors due to the federal funding threat. Major medical associations deem gender-affirming care for gender dysphoria as appropriate care.

The unavailability of gender-affirming care is a concern for many families, who feel betrayed by hospital administrators who end this care, despite it still being legal. This practice is observed in both red and blue states, as well as purple states, with reports in California, Colorado, Pennsylvania, and Montana.

Transgender youth are four times more likely to attempt suicide than their peers, making the discontinuation of gender-affirming care even more concerning. Liz fears for her safety and only uses her first name in interviews. She fears that Seattle Children's Hospital could be the next to stop offering this care, leaving her once again without treatment.

The Montana Supreme Court has permanently protected gender care for minors, but the federal funding threat remains a significant obstacle. The Trump administration considers gender-affirming care harmful and is threatening to pull funding from hospitals that do not comply. The nearest option for Liz and her family for gender-affirming care is Seattle Children's Hospital, a seven-hour drive away.

A quote from an unidentified person reads, "It's concerning that Community Medical Center did not stand up for gender-affirming care. It saves lives." The future of gender-affirming care for transgender youth in Montana and across the nation remains uncertain, as legal battles continue and federal funding policies impact access to this vital medical care.

1. In light of the legal battles over gender-affirming care for minors, Liz, an 18-year-old transgender individual from Missoula, is worried about her seven-hour drive to Seattle Children's Hospital, concerned about the hospital's capacity and her financial burden.
2. The Montana Youth Protection Act, which aims to ban gender-affirming care for transgender minors, remains blocked by court injunctions, allowing transgender minors in Montana to still legally access such care despite the state's efforts.
3. The White House has reportedly threatened to withhold federal funding from hospitals offering gender-affirming treatment to minors, a move that affects access to this care across states.
4. The unavailability of gender-affirming care for minors at Community Medical Center in Missoula has left Liz without a local option, as her daughter, who is close to puberty, had been planning to receive such care there.
5. The discontinuation of gender-affirming care for minors, even in places where it remains legal, raises concerns for families, many feeling betrayed by hospital administrators, with reports of such incidents in red, blue, and purple states.

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