‘Devastating’: Children’s Hospital of Los Angeles To End Trans Healthcare for over 3000 Adults and Minors, According to Leaked Email

CHLA plans to cut much of its healthcare to trans patients, once again obeying the Trump administration in advance to put trans lives in danger, despite their threats having no legal power.

Check out Mira’s publication Free Radical, and follow her on Bluesky here, Mady Castigan here, and David Forbes here.

Protests earlier this year successfully helped pressure CHLA to reverse a previous freeze on trans healthcare for minors. Photo by Mady Castigan.

In a leaked internal email obtained by Madycast News, the Children’s Hospital of Los Angeles (CHLA) announced – during Pride Month – that it will abruptly close the centers that provide gender affirming care plans for minors, as well as all adult surgeries, on July 22. CHLA currently provides care for over 3000 trans people up to the age of 25, according to a source with direct knowledge of the situation.

“HLA has determined that—under current conditions and despite significant efforts to avoid this outcome—there is no viable alternative to closing the Center for Transyouth Health and Development, along with the Gender-Affirming Care (GAC) surgical program,” CHLA President and CEO Paul Viviano writes in the email, which MadyCast News provides in full at the link below, with commentary from Corinne Green. Viviano makes over $2 million a year, according to tax filings reviewed by MadyCast News.

“CHLA continues to face significant operational, legal, and financial risks stemming from the shifting policy landscape at both the state and federal levels. Over the past several months, California’s deepening budget crisis, President Trump’s executive orders, proposed federal legislation and rulemaking, and growing economic uncertainty have made the situation even more dire,” Viviano writes, justifying the July 22 “sunset date” to “help give patient families adequate time to plan for moving care to providers less impacted by the legal and financial pressures our health system faces.”

Currently, there is no federal law or enforceable executive order that bans the provision of gender affirming care to trans people of any age, let alone gender affirming surgeries for adults.¹ While the Trump administration has attempted to enact many harmful executive orders that restrict gender affirming care for both minors and adults – including recent threats to Medicaid – there is no evidence that CHLA is facing any actionable legal threats from the current administration.

“The email is dissembling, inconsistent, inaccurate, and nakedly transphobic,” Corinne Greene, a trans policy expert and MadyCast News contributor, told Madycast News.“Paul Viviano makes more than $2 million a year according to CHLA’s most recent tax filing, so however dire the organization’s financials straits, it certainly has more power, resources, and attorneys (incompetence and/or cowardice aside) to leverage for resistance than the patients it’s stranding without healthcare.”

“As these large institutions choose collaboration one after the other, eventually the targets of the fascist extermination campaign are left to bear its weight alone,” she continues. “CHLA has no immediate legal obligation to kick trans people to the curb - Viviano himself admits as much. No court has ordered CHLA to do this. No federal agency has initiated an enforcement action compelling CHLA to do this. CHLA is doing this on its own, in advance. There are plenty of providers in deep red states with more mettle.”

In spite of multiple injunctions placed on each of Trump’s anti-trans provisions targeting GAC, CHLA cites unactionable threats from the federal government to investigate and challenge hospitals providing such care in court.

“Taken together, the Attorney General memo, HHS review, and the recent solicitation of tips from the FBI to report hospitals and providers of GAC strongly signal this Administration’s intent to take swift and decisive action, both criminal and civil, against any entity it views as being in violation of the executive order,” Viviano argues, in spite of courts siding against the Trump administration repeatedly.

Viviano further claims that a theoretical attack on provisions for Medicaid – through an “Immediate Jeopardy” designation – would threaten the hospital’s provision of medical care as a whole. But there is currently no ban on Medicaid coverage of gender affirming care, especially not in California. It is unclear where this worry comes from, as CHLA has not mentioned receiving any legal communications from the Trump administration that would lend any credibility to these supposed threats.

Claiming that they have “no viable path forward” to provide vital trans healthcare, Viviano attempts to assuage concerns with the hospital by referencing their prior provision of gender affirming care, and that they “will be hosting a series of team member forums over the next few days to hear your thoughts and concerns while addressing some of your questions.”

Earlier this year CHLA faced immense public outrage, including weekly protests at the hospital, after their earlier attempts to end trans healthcare. These protests were backed by legal threats from California Attorney General Rob Bonta to resume care immediately to comply with California civil rights laws. This culminated in CHLA reversing course, and showed clearly how public action works to protect the rights of trans people to life-saving healthcare.

In a statement to MadyCast News, CHLA spokesperson Lauren Song confirmed the email’s existence and July 22 as the date they will end care. She claimed this decision was “driven by the need to safeguard the hospital's ability to continue to operate amid significant external pressures beyond our control,” and paraphrased Viviano’s original email.

When asked about what alternatives CHLA will provide to families, Song said that “over the next several weeks, CHLA care teams will be actively assisting with patient navigation and seeking to identify potential alternative providers for our patients and their families.” It is unclear to the local trans community whether LA’s healthcare system can easily absorb the 3000 trans patients who will suddenly lose their providers.

“To be realistic, I'm expecting some or almost all of my hormones to get dropped by insurance… It's a step on the way toward dropping hormones out of insurance, making it even harder for trans people to get care,” a former CHLA patient – who requested anonymity for her safety – told MadyCast News.

She remembered how she and her community previously had great experiences with CHLA, particularly the medical staff.

“They were both really sympathetic and understanding of everything… It's nice to have doctors dedicated to understanding the transgender experience because that's just really helpful for trans people.”

Her positive experiences make this blow even harder. “Starting about six months ago, I very much saw this coming – this isn’t a surprise. But it's still really devastating. What a lot of the anti-trans actors don’t understand is that people are gonna be trans regardless of if there's access to care or not. It's more so a matter of if they're trans than happy or trans that's suffering. And the removal of resources like the CHLA pushes the needle into trans suffering.”

Shortly after this news was revealed to activists in LA, the Los Angeles LGBT Center announced a new rally at 6 PM on June 12 via Instagram – directly outside CHLA.

“We won't let this happen without a fight. Join us tonight at 6PM in Hollywood to demand that gender-affirming care stays accessible,” their post declared.

CHLA’s actions mirror the trend set by other nonprofits who serve LGBTQ+ people to capitulate to the Trump administration based on empty legal threats and their own cowardice.

Capitulating in advance and kicking trans people off life-saving care is one of the main ways fascism gains power. The only way to fight this cowardice is to resist, and for trans people and their allies to respond immediately, directly, and fiercely.

Cutting off this care will harm thousands of trans people in Southern California, and shows that the only way to keep this life-saving healthcare in place is to directly pressure hospitals with protests and ACT UP-style resistance sustained over the course of years, not months. We must constantly remind those in power that trans people and our allies will not tolerate institutions who obey in advance.

—Edited by David Forbes and Mady Castigan

---

1. CHLA stopped providing gender affirming surgeries for minors last November, after Trump’s election.