Doctors under pressure as U-M ends gender-affirming care for minors

The University of Michigan will no longer extend certain gender-affirming care to patients under age 19
U-M’s decision comes as the Trump administration pressures doctors to end what it calls ‘gender ideology extremism’
For now, transgender care for minors remains legal in Michigan

The University of Michigan doctors will end gender-affirming care for minors under “escalating external threats and risks” of civil and criminal prosecution.

“The University of Michigan, including Michigan Medicine, is one of multiple institutions across the country that has received a federal subpoena as part of a criminal and civil investigation into gender-affirming care for minors,” read a statement released Monday evening.

“In light of that investigation, and given escalating external threats and risks, we will no longer provide gender affirming hormonal therapies and puberty blocker medications for minors,” it continued.

The Ann Arbor-based school also posted a version of the statement on its patient webpage, directing the message to “gender diverse patients under the age of 19.” It notes “unprecedented legal and regulatory threats to our clinicians and our institution.”

The statement ran under the same photo that months ago topped a page stating that U-M’s transgender care “is informed by evidence based professional guidelines for the care of gender diverse youth, including mental health and medical services to meet a person’s gender goals.”

A screenshot of gender services at the University of Michigan. — Last year, the University of Michigan marketed to “transgender, non-binary, and gender diverse children and adolescents” but now is ending certain gender-affirming care. (Screenshot)

At the time, the page read, the Gender Services team that serves “transgender, non-binary, and gender diverse children and adolescents” would see “patients and families at any point in their process.”

A University of Michigan spokesperson did not answer Bridge questions about the number of minor patients in its care nor about the nature of the “escalating external threats and risks,” or who received them.

Spokesperson Mary Masson said, however, that the university will make referrals to other doctors for “gender diverse” patients and continue to provide other services, such as behavioral health and social work.

“We recognize the gravity and impact of this decision for our patients and our community. We are working closely with all those impacted, and we will continuously support the well-being of our patients, their families, and our teams,” the statement read.

The move is not altogether surprising.

Universities have faced increased pressure from the Trump administration to end what Trump calls “gender ideology extremism.” Within eight days of taking office, he signed an executive order and has threatened to prosecute health care providers who provide transgender care — what the executive order calls “chemical and surgical mutilation” — to minors.

Such care is legal in Michigan, but not everywhere in the US. Michigan Attorney General Dana Nessel and others have argued that the Trump administration is overstepping its authority. She and a coalition of more than a dozen other attorneys general filed a multistate lawsuit against the Trump administration, arguing against its efforts to restrict access to transgender care to minors.

On Tuesday, she called U-M’s announcement “shameful, dangerous, and potentially illegal.”

Earlier this year, U-M and other universities backed off diversity, equity and inclusion efforts, too, under federal pressure. And universities have continued to face funding cuts in crucial research areas.

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A few universities have stood ground against the federal pressure to change policies, but federal pressure — and threats — continue to mount. Spokespeople for both Wayne State and Michigan State universities said their doctors do not provide hormone therapy and puberty blockers for transgender care.

Equality Michigan, which advocates for LGBTQ+ people, said members were “deeply disappointed and concerned” by U-M’s most recent decision. It called it “yet another alarming move by a major healthcare institution to walk away from its responsibility to serve all patients — including some of our most vulnerable young people.”

“Even in making this harmful decision, the University of Michigan appears to acknowledge the legitimacy and value of gender-affirming care. Yet, it has chosen to retreat. This sends a chilling and damaging message to the very young people who most need affirmation, stability, and support,” said Erin Knott, executive director of Equality Michigan, according to the statement.

The change may put pressure on other doctors, who also are watching developments in Washington.

Dr. Latonya Riddle-Jones used to see patients as young as 15 at Detroit-based Corktown Health, a clinic providing care to LGBTQ+ people.

Gender-affirming care is more than prescriptions for hormones, said Dr. Latonya Riddle-Jones, who practices at Corktown Health in Detroit and teaches at the Wayne State University School of Medicine. (Courtesy photo)

She stepped away for some time to teach, and when she returned earlier this year, Corktown had decided against seeing pediatric patients, in part, because of federal pressure, she said. Corktown relies on federal funding, as do many other providers — whether through research dollars, grant funding, or Medicaid or a combination of them.

“The threats from the (Trump) administration are working,” she said.

Still, she and others say they can still provide other services — social work, counseling and treatment for anxiety and gender dysphoria.

“There is more to gender affirming care than hormone blockers and cross-sex hormones,” she said.

Dr. Paul Benson has been providing care to LGBTQ+ patients since the 1980s. That includes thousands of adult patients of the Be Well Medical Center in Berkley who now receive transgender care, along with “a few” teenagers and adolescents.

The lobby of Be Well Medical Center in Berkley, Mich., where Dr. Paul Benson has provided care to LGBTQ patients for decades. — Health care providers who rely on direct federal funding face the most pressure to abandon hormone therapy and puberty blockers for certain care for transgender youth, said Dr. Paul Benson at the Be Well Medical Center in Berkley. (Brayan Gutierrez for Bridge Michigan)

For now, the care will continue, he said. Like Riddle-Jones, he said hormone therapy is one component of a larger treatment plan that includes counseling. And for the most part, he advises against puberty blockers for minors, he said.

“I explain to people that transgender first starts from your heart,” he said. “You can be a true transgender person in transition without hormone therapies when you’re young.”

Especially for prepubescent patients, they can dress as they wish or use the pronouns they wish, without medication. His private practice has “never endorsed” surgical care until adulthood, he said.

By Tuesday morning, Benson had already heard from a parent of a U-M patient, seeking a continuation of care as the U-M treatment ends. Other doctors continue to provide care, but for how long depends on how much they rely on the federal government for funding — whether through grants or Medicaid.

And there’s something else, he said.

“I would — without a heartbeat — continue to provide all this care, except for one thing,” he said. “I’m 72 years old. I don’t want to live my life in jail — I’m not going to … jail over this.