'No alternatives left': VCU Health halts all gender-affirming care for minors

VCU Health to Cease Gender-Affirming Care for Patients Under 19

Virginia Commonwealth University (VCU) Health has announced that it will no longer provide gender-affirming care to individuals under the age of 19. This decision comes after a thorough review, which concluded that there are currently no viable alternatives to ensure compliance with federal and state regulations. The change was made public through an update on the hospital’s website, specifically the page detailing transgender care offered at the Children’s Hospital of Richmond at VCU.

The updated information states that the facility will “cease providing gender-affirming care” for “youth under age 19.” According to VCU Health, this decision aligns with similar actions taken by other children’s hospitals and academic medical centers across the country. The statement emphasizes that the choice was made following a comprehensive evaluation that found no other options available at this time.

What is Gender-Affirming Care?

Gender-affirming care refers to a range of medical and psychological services designed to support individuals whose gender identity does not match their sex assigned at birth. These services may include:

• Medical evaluations to assess the patient's needs
• Hormone management to align physical characteristics with gender identity
• Prescription medications, such as puberty blockers or hormones
• Mental health care to address emotional and psychological well-being
• Voice therapy to help individuals achieve a voice that aligns with their gender identity
• Letters of medical necessity to facilitate hormone treatment, school accommodations, or surgical procedures
• Referrals to specialists for further care
• Peer and family support groups
• Educational materials to inform patients and families about gender-affirming care

This type of care is often essential for transgender and nonbinary youth, helping them navigate the challenges of transitioning in a supportive environment.

Historical Context and Policy Changes

The decision by VCU Health is influenced by broader policy changes at the federal level. During President Donald Trump’s second term, an executive order was issued that restricted federal funding for institutions offering gender-affirming care. The order, titled “Protecting Children from Chemical and Surgical Mutilation,” defined a “child” as someone 18 years old or younger. It described gender-affirming care as involving “chemical and surgical mutilation,” including the use of puberty blockers, hormone treatments, and surgical procedures.

Although the specific language of the order is no longer available on the White House website, the impact of such policies has been felt across the healthcare sector. Many institutions have had to reassess their offerings in response to these directives.

Previous Changes at VCU Health

This is not the first time that VCU Health has altered its approach to gender-affirming care. In January, the hospital initially suspended both gender-affirming surgery and medications for patients under 19. However, in late February, it resumed offering medications to current patients while maintaining the suspension of surgeries.

The latest decision, effective July 29, marks a more comprehensive change, as it now includes all forms of gender-affirming care for those under 19. This means that even services that do not involve medication or surgery will no longer be provided.

Transition and Support for Patients

VCU Health officials have stated that they will not stop offering these services immediately. Instead, they plan to “wind down” the care over a 90-day period. During this time, the hospital will work with existing patients to ensure a safe transition to other providers. Care teams will provide support and assistance, taking into account each individual’s unique needs.

In addition, VCU Health has increased access to mental health services for patients affected by this change. For those not in crisis, the Virginia Treatment Center for Children can be contacted at 804-828-3137. Those in immediate need should call 911, visit the nearest emergency room, or reach out to local community services boards.

The hospital reaffirmed that it remains open to all patients for other health care needs. Officials emphasized that their commitment to patient care remains unchanged, even as they navigate this difficult transition.

For more details, VCU Health has published a full statement and an accompanying FAQ on its website.