'Like a punch in the gut': Trump threats halt Tucson provider's teen gender-affirming care
Tucson transgender teens and their parents were left in a lurch after they were notified their health care provider would no longer offer pediatric gender-affirming care following threats from the Trump administration.
Parents and advocates said providers from El Rio Health, one of the region's most sought-after provider of pediatric gender-affirming care, called them to inform them of the halt in services.
'This was like a punch in the gut,' Derrick Fiedler said after he found out his 13-year-old son would no longer be able to receive care at El Rio. 'It wasn't entirely unexpected, but at the same time, you still hope that the people running these organizations ... you still have the hope that they're going to take a stand and do the right thing."
The decision to stop offering gender-affirming care to patients under 18 years of age came after the U.S. Attorney General's Office issued a memorandum on April 22 enforcing an executive order President Donald Trump issued in January on transgender Americans and their families, said El Rio spokesperson Nathan Holaway.
Holoway told The Arizona Republic in an email the memorandum seeks "to criminalize gender-affirming care for minors and committing the DOJ to prosecute offenders to 'the fullest extent possible' while encouraging 'whistleblowers' to report offenders directly to the Department of Justice.'
The medical center confirmed it is not prescribing or dispensing pubertal suppressants or gender-affirming hormones for patients under 18 years of age.
Gender-affirming care is 'life-saving health care for transgender people of all ages,' according to the Tucson Medical Center. This includes a range of care, from social transitioning, being referred to by the pronouns and by the name the person wants to be referred to, to medical interventions such as puberty blockers and gender-affirming hormone interventions or surgical intervention.
It's already against the law for any child younger than 18 to get gender-affirming surgery in Arizona, and even in states where it is legal, such surgeries are rare, several studies have shown.
A study by researchers at Johns Hopkins University, published Sept. 25, 2023, in the Cureus Journal of Medical Science, identified 108 such surgeries over three years in U.S. kids ages 17 and younger. The study looked at gender-affirming surgeries between 2018 and 2021 through the American College of Surgeons National Surgical Quality Improvement Program Pediatric database and found more than 90% were chest masculanization surgeries.
For Fiedler, gender-affirming care helps provide his son with a thriving life.
'We all just want to do what's best for the kids and give them a full, flourishing life. And that's what gender-affirming care does,' he said.
The Tucson-area provider is just one of a slew of providers who have halted services across the state following Trump's Jan. 28 executive order.
Trump's executive order says that the United States will not fund, sponsor, promote, assist or support the "so-called transition of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures."
The April memo from the U.S. attorney general refers to Trump's executive order and puts medical providers on "notice." It calls expanding access and rights of the transgender population a 'radical gender ideology' and criticizes the Biden administration for choosing an openly transgender pediatrician to serve as the U.S. assistant secretary of health, and for inviting trans influencers to the White House.
The memo details how some trans children regret their decision to transition when they become adults.
Russell Toomey, a professor of human development and family scienceat the University of Arizona, called out the memo for using 'derogatory' language, and said the research on regret shows the regret rate for adults who transitioned in childhood or adolescence is less than 1%, which he noted is "less than knee surgery regret or hip surgery regret."
According to the Centers for Disease Control and Prevention, 3.3% of high schoolers identified as trans in 2023.
Fiedler's son came out as transgender four years ago, when he was 9 years old.
Before he socially transitioned, using a boy's name and physically presenting as a boy, his son would often feel 'down' and would cry, asking why he 'can't be normal like other kids?'
After socially transitioning, 'it was like night and day,' Fiedler said, noting how much happier his son was. 'It was like a weight had been lifted off his shoulders.'
About a year ago, Fiedler's son started showing the beginning signs of female puberty. So, they put him on a puberty blocker implant.
Fiedler said his family is lucky that his son's implant is good for at least another year, and noted the immediate impact is not as great as those who need hormone replacement therapies.
Other Tucson teens need care sooner.
Veronica Camacho's 16-year-old daughter needs hormone-blocking injections in a couple of months. Camacho said El Rio was the best place in Tucson for gender-affirming care. Now, she is considering traveling as far as Mexico to access care for her daughter.
'She's terrified,' Camacho said about her daughter. 'We're hopeful that we can go get treatment somewhere else. But if she doesn't, then she would have to be put back into a body that she doesn't want to be in, that she's not comfortable or happy in. And it would just undo all the work that she has done to get where she is now.'
Before transitioning, her daughter was suicidal, depressed, and struggling in school. After going on hormone blockers, her daughter's outlook on life improved dramatically.
'She went into her next school year confident and happy, and it was literally life-changing,' Camacho said.
Camacho said that while the decision to stop offering gender-affirming care was not unexpected given the political climate, the lack of warning or communication from El Rio made the decision feel 'out of the blue.'
Toomey studies LGBTQ+ youth populations with a specific focus on gender-diverse and trans youth populations. He said access to gender-affirming care is critical to those who need it.
'We have decades of research that have documented the mental health benefits, the physical health benefits of having access to this care,' Toomey said.
Because the ban on accessing gender-affirming care is relatively new, Toomey said less is known about what an abrupt change, or halt in care, will do to someone's physical or mental health.
But 'given what we know about mental health and the benefits of this medical intervention, an abrupt removal without any kind of transition period is likely to have devastating consequences for mental health, as well as physical health.'
Some of those include new puberty symptoms or menopause-like symptoms, Toomey said.
'Unsafe, unwelcome': How transgender students at Mesa Public Schools feel about pronoun proposal
Republic reporter Stephanie Innes contributed to this article.
Reach the reporter at sarah.lapidus@gannett.com.
The Republic's coverage of southern Arizona is funded, in part, with a grant from Report for America. Support Arizona news coverage with a tax-deductible donation at supportjournalism.azcentral.com.
This article originally appeared on Arizona Republic: Trump threats halt Tucson provider's teen gender-affirming care
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