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After the Trump administration on Thursday escalated its crusade to end gender-related health care for minors nationwide, Oregon Health & Science University said its prominent transgender medical care program marches on, signalling a brewing showdown for an institution that reports receiving about half its revenue from the federal government.
“OHSU continues to offer gender-affirming care for pediatric, adolescent and adult patients, in compliance with all state and federal laws,” OHSU spokesperson Sara Hottman said in a written statement. “Our health care team follows established, evidence-based medical standards and employs a thoughtful, multidisciplinary process that involves both patients and their support systems.”
She added, “The deeply personal decisions around gender-affirming care are a critical factor in health and well-being. OHSU steadfastly supports the dedicated clinicians, researchers and learners who work tirelessly every day to advance access to care for all people.”
OHSU’s press team did not answer questions about the number of patients the Transgender Health Program program has seen lately, but the medical center has in recent years become a major provider of such care, which can span from mental health therapy to puberty blockers to hormone treatments to surgery.
In a 2023 report, OHSU described its Transgender Health Program as one of the “largest and most comprehensive” in the United States, noting that it provided nearly 11,000 visits and exams with adult and youth transgender patients that fiscal year. It also touted its transgender virtual health clinic, which it said, following a referral by a local primary care provider, connects patients with an OHSU provider for a consultation about hormone therapy and other gender care.
As an increasing portion of Americans, and particularly youth, identified as transgender—and many sought medical treatment to better match their bodies to their sense of self—pitched debates have emerged over when certain body-altering medical interventions are appropriate, especially for minors.
Major medical associations endorse gender-affirming care performed on carefully evaluated patients, including youth. And aiming to support the LGBTQ+ cause, Oregon leaders have moved to protect gender affirming care—and enshrine it in law.
A 2023 state law prohibits health insurers from denying claims for “medically necessary gender-affirming treatment,” and after the measure went into effect last year, the Oregon Health Authority said it would start ensuring Medicaid insurers in the state had providers who could provide such care in their networks.
At the same time, activists around the U.S. have pushed their governments in the opposite direction. Animated by a range of actors, from skeptics in the medical community who cast gender-affirming care as dangerous “junk science,” to conservative religious movements that see sex as immutable, more than two dozen states have already passed restrictions on gender-affirming medical care for minors, with many banning it outright, backed by a U.S. Supreme Court sympathetic to their cause.
They’ve also found a powerful ally in President Donald Trump. From the outset, his administration has targeted nascent academic research on transgender health care, and threatened institutions and medical providers who seek to provide it.
As WW has noted, in this context Oregon institutions like OHSU could find themselves in the midst of a legal crossfire, as they seek to comply with conflicting state and federal laws.
Perhaps Trump’s greatest salvo yet came Thursday, as his administration proposed rules that would block federal funds from flowing to institutions that provide gender affirming care to minors.
Legal challenges are almost inevitable. But if implemented, the nationwide policy would create unworkable situation for numerous major health care institutions, which, like OHSU, tend to run in large part on federal money.
It’s not just OHSU where transgender medical programs are at risk. Another major institution that offers gender affirming health care is Legacy Health. Legacy did not answer questions Thursday about the status or size of its gender care program; in a statement, a spokesperson simply said that “Legacy is committed to keeping our patients informed and supported regarding any updates to their care plan,” and that the health system would contact impacted patients if any changes occur.
Still, OHSU’s program stands out. On its website, OHSU’s Doernbecher Children’s Hospital describes offering ”a full range of services for transgender and gender-nonconforming children and teens,“ provided by specialists in puberty, primary care, hormone therapy and mental health.
In an interview Thursday morning, OHSU president Dr. Shereef Elnahal told WW that he seeks to be “maximally supportive” of the LGBTQ+ community. He noted that the science of what the standard of care should be when helping someone transition genders—especially minors—remains a new area of scientific discovery.
“For that reason,” he said, “I defer strongly to the leaders, and the clinicians in particular, within the transgender health program on what we should do. What they tell me is that this is, in effect, restricting needed care for these patients.”
He noted that the Trump administration rules are merely proposals, that a 60-day comment period looms.
“We will be taking advantage of that,” he said, “and we will be gathering feedback directly from the transgender health program. We are ready to make the case that this is needed care.”
