After North Carolina’s two largest medical providers halted gender-affirming care for patients below the age of 19, trans youth in the state are left with few options for treatment.
Ahead of a looming Trump administration crackdown on treatments like hormone replacement therapy — which substitutes sex-related hormones like estrogen or testosterone to physically transition patients’ bodies to align with their gender identity — for patients 18 and younger, Advocate Health and UNC Health have ended such gender-affirming care for anyone under 19.
“It’s very disappointing that they would do this,” said Ivy Johnson, an attorney with the ACLU of North Carolina. “It’s completely ignoring the fact that 18-year-olds are adults in this country, and I think it’s irresponsible to discontinue care for people who’ve already been under a certain course of treatment.”
The restrictions adopted by UNC Health and Advocate Health exceed a North Carolina law passed in 2023 over then-Gov. Roy Cooper’s veto that barred minors from receiving gender-affirming care, but exempted patients already undergoing treatment due to health risks associated with halting care.
Secretary of Health and Human Services Robert F. Kennedy Jr. testifies before a Senate Appropriations subcommittee on Tuesday, May 20, 2025. (Screenshot from committee webcast)Just eight days into his second term, President Donald Trump issued an executive order directing the Health and Human Services Department to crack down on medical interventions such as puberty blockers, hormone replacement therapy, and other treatments aimed at facilitating gender transition for patients under 19.
That manifested in December as a set of HHS regulations that would condition Medicare, Medicaid, and Children’s Health Insurance Program for hospitals on compliance with federal restrictions on gender-affirming care, among other measures intended to pressure health care providers.
Now, trans youth in North Carolina who are not yet 19 will be forced to halt their care, find alternate providers in a state with dwindling options, or leave the state for treatment.
Heron Greenesmith, deputy director of the Transgender Law Center, stressed that the proposed HHS restrictions are not set to take effect for months, and that hospitals choosing to end care early are doing so voluntarily. “Right now, there is no ban.”
“Pre-compliance has been a problem for trans-supporting, trans-inclusive organizations and agencies across the country, not just for trans-affirming care,” Greenesmith said. “It could be fear for funding or for retribution from the federal government.”
While federal opposition to gender-affirming care focuses on health risks of procedures — with Trump’s executive order warning that some recipients “will never be able to conceive children of their own or nurture their children through breastfeeding” — Johnson and Greenesmith both warned of complications from suddenly stopping gender-affirming care.
“You’ll have physical changes that can be rapid,” Greenesmith said. “The return of dysphoria is going to be a big impact and that obviously has mental health impacts, including an increased risk of suicidality and suicidal ideation, and then the other kind of emotional and mental health crises, anxiety, depression, PTSD.”
Advocate Health, which oversees state provider Atrium Health, implemented the restrictions in August. UNC Health began notifying patients in September that care would be discontinued, though no public announcement accompanied the policy shift. Both hospital systems have been connecting affected patients with support resources, including a newly established 24/7 hotline at Advocate aimed at providing counseling.
UNC Health spokesman Alan Wolf said in a statement that concerns over the federal regulatory environment prompted the decision to restrict care.
“UNC Health follows state and federal law related to medical services around gender transition. While state law limits these services to patients 18 and older, given the unsettled state of federal guidelines, last year we began limiting these services to individuals age 19 or older,” Wolf said. “UNC Health remains committed to caring and treating all patients.”
In comments to NC Health News last year, Advocate Health raised similar concerns: “This new policy allows our hospitals, clinics and pharmacies to continue caring for all patients’ health needs in the changing federal environment.”
Duke Health, whose policy on gender-affirming care for minors remains unchanged according to their website, now has a several-months wait for those wishing to switch to their services.
“Due to increasing demand, we are currently booking new patient appointments several months out,” the page for the Duke Child and Adolescent Gender Care Clinic reads. “We are working on strategies to accommodate this increased demand. Thank you for your patience.”
Duke Health did not respond to multiple requests for comment on their gender-affirming care policies or whether patients who have lost access to care from other providers may receive expedited appointments.
Washington Attorney General Nick Brown speaks outside the federal courthouse in Seattle where a judge sided with his office, temporarily blocking President Donald Trump’s order to stop federal funding for facilities that provide gender-affirming care to young people. (Photo by Jake Goldstein-Street/Washington State Standard)The HHS restrictions are the subject of a federal lawsuit led by Oregon and joined by 18 other states, including the District of Columbia. At the state level, hospitals themselves are facing litigation. In Colorado, several families sued Children’s Hospital Colorado in state court over its suspension of gender-affirming care for minors, which has halted treatment for around 800 patients.
But North Carolina officials have declined to take action. Attorney General Jeff Jackson did not join the challenge to the administration’s policies, despite participating in a series of high-profile lawsuits against Trump executive actions last year, meaning state providers will not benefit from any injunction against the HHS restrictions.
North Carolina Department of Health and Human Services spokeswoman Summer Tonizzo said in a statement that “gender dysphoria care is not covered by any NC Medicaid plans,” citing the 2023 state law, when asked about the department’s response to hospital restrictions.
Johnson, the ACLU NC attorney, said she believes hospitals may be illegally discriminating against patients on the basis of sex by suspending gender-affirming care.
“This seems unconstitutional and dangerous on the part of these hospitals, whose functions are otherwise supposed to be to provide medically necessary care to their patients,” Johnson said. “I would encourage people to reach out to us.”
GET THE MORNING HEADLINES.
SUBSCRIBEHence then, the article about trans youth under 19 left with few options for gender affirming care in nc was published today ( ) and is available on NC news line ( Middle East ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
Read More Details
Finally We wish PressBee provided you with enough information of ( Trans youth under 19 left with few options for gender-affirming care in NC )
Also on site :