The Blue-State Hospitals Carrying Out Trump’s Anti-Trans Agenda ...Middle East

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Some weeks later, on July 25, the White House issued a strange and stomach-churning press release, taking credit for ending what the memo called “child mutilation” in the United States. “For years, politicians have promised to end the barbaric, pseudoscientific practice,” it proclaimed, “but President Trump is the only one who has actually delivered.” Thanks to Trump, the press release said, gender-affirming surgeries for youth were no longer offered at six hospitals and health centers. Trump also took credit for ending gender-affirming care entirely at 15 hospitals and health centers.

The same is true of the other states where Trump has claimed credit for ending gender-affirming care at specialized adolescent programs: Arizona, California, Connecticut, Colorado, Illinois, New York, Virginia, Washington, and the District of Columbia. The decisions of hospitals in these states to deny care were not in response to any action by Congress, nor were they required by the recent Supreme Court decision on gender-affirming care, which will make it easier for states with bans to survive future legal challenges, while leaving the door open to further discrimination in health care.

The hospital system, for its part, insisted that its actions were warranted. A spokesperson for UPMC management told The New Republic this week, “UPMC remains steadfast in our commitment to providing exceptional care for all patients.” The Trump administration’s actions, such as “executive branch memos” and “subpoenas,” the spokesperson went on, “have made it abundantly clear that our clinicians can no longer provide certain types of gender-affirming care without risk of criminal prosecution.”

There were early indications that hospitals would cave to Trump. Once he issued his anti-trans executive orders in January, major lawsuits followed, with legal experts pointing out—as with all of Trump’s executive orders—that these decrees were not laws; some of them, such as those targeting trans people on the basis of their sex, were even violations of the law. Federal judges have asserted that Trump’s anti-trans military ban “screams animus” and that his ban on gender-affirming care “seems to deny that this population exists, or even has the right to exist.”

Finally, last week, after months of such threats, the Department of Justice subpoenaed UPMC—one of the “more than twenty” subpoenas the department said it has issued. Pennsylvania Governor Josh Shapiro joined a lawsuit challenging these subpoenas, filed August 1 in the U.S. District Court for the District of Massachusetts, alongside California, Connecticut, the District of Columbia, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York, Rhode Island, and Wisconsin. The lawsuit charges the Trump administration with targeting trans people “relentlessly” and “unlawfully,” refusing them “longstanding, medically necessary, often lifesaving care.” The administration has done this, the lawsuit continues, by intimidating providers with threats of civil and criminal prosecution. It adds, “These threats have no basis in law.” In fact, this intimidation has “coerced” hospitals and health care providers to potentially violate their state’s own antidiscrimination laws.

In aggregate, these records amount to a huge quantity of sensitive information about the health of minors. UPMC Providers for Trans Justice, the emerging group behind the open letter, along with Pittsburgh Healthcare Workers and Scientists, a local group mobilizing for equitable health access, have since pushed back on what they fear is UMPC’s willingness to hand over to the Trump administration minors’ protected health records. “Shapiro is suing Trump and the DOJ partially because of this,” said Katherine Anderson, who works with Kailey Andrew at STAR and also belongs to Providers for Trans Justice. “Why not wait?” The state’s own governor has said, in court filings, that providers have been intimidated out of providing lawful care, in part through these subpoenas; couldn’t his assertion support UPMC in fighting the subpoena? “Why not wait for that lawsuit and see how it goes?” Anderson went on. “Because our governor is actually standing up and doing something!” (The UPMC spokesperson said that the hospital system “will continue to provide essential behavioral health support and other necessary care within the bounds of the law while seeking to protect the confidentiality of the physician/patient relationship.”)

Providers for Trans Justice, Anderson and Andrew told me, plan to put pressure on UPMC higher-ups with a die-in, a direct action where protesters will symbolize with their own bodies the people who may die needlessly as the result of being denied gender-affirming care. The groups have been working with local organizations, such as ACT UP Pittsburgh and TransYOUniting, and members hope more hospitals and health care workers will join them. “This is about trans kids, and our clients, and our community, and us as providers,” Anderson said, but it’s also about “large institutions like UPMC caving in to fascism.” If major health care institutions are willing to let “baseless threats” end this care for a small population that’s been politically marginalized, Anderson continued, and then “hand over all of that vulnerable population’s medical data without a fight, then none of us are safe.” For now, that means health care workers must protect their patients and clients not only from Trump but from the leadership and the boards of the hospitals that ostensibly care for them.

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