2 central Pa. hospital systems end gender-affirming care for children, teens

• By Lucy Albright/LNP | LancasterOnline

Two large hospital systems serving central Pennsylvania have indicated they will no longer offer gender-affirming care to children and teens following President Donald Trump’s January executive order to end federal funding and support for some types of youth gender-affirming medical treatment.

Gender-affirming care includes a range of interventions, like counseling, hormones and surgery, which help align a person’s body or outward appearance with their gender identity. The executive order refers to the care as “chemical and surgical mutilation,” a term it defines as surgical and hormonal interventions, including treatments that delay puberty. The order defines a “child” as anyone under age 19.

The decisions by Penn State Health and western Pennsylvania-based UPMC come as implementation of Trump’s order has been put on hold over legal challenges. The health systems’ policy changes prompted criticism from LGBTQ+ advocates, who said they are “disheartened.”

What’s changed for Penn State Health

Previously, Penn State Health did not permit gender-affirming surgeries for people under 18, but it did provide gender-affirming medical and pharmacological services to minors through its Gender Care Clinic at Penn State Health Children’s Hospital, spokesperson Scott Gilbert said. He confirmed that the policy change is related to the January executive order.

“Our Internal Medicine team welcomes individuals aged 19 years and older who are seeking gender-affirming primary or consultative care services. In addition, Penn State Health Children’s Hospital [near Hershey in Dauphin County] operates a Gender Care Clinic, providing psychosocial care to adolescents and young adults (ages 10-24),” Gilbert said.

The clinic has never had a presence in Lancaster County, Gilbert said. Penn State Health serves patients in 15 central Pennsylvania counties at 186 outpatient practices. Its hospitals include Penn State Health Lancaster Medical Center in East Hempfield Township.

Penn State Health will continue to treat those under 19 years old who are already receiving gender-affirming pharmacologic treatment through the health system — provided that they were active patients receiving the care as of May 1 — until their care can be “transferred safely to other providers or discontinued consistent with a medically appropriate protocol,” Gilbert said.

Executive orders are signed statements about how the president wants the federal government to be managed, and they can include instructions to federal agencies or requests for reports. While executive orders aren’t law in a typical sense, in which Congress passes legislation, they are treated as law and must be implemented unless the courts rule them unlawful. The January order on gender-affirming care is being challenged in the courts, and has been temporarily blocked.

UPMC, WellSpan

“We continue to monitor and comply with directives coming from the federal government that affect the ability of our clinicians to provide specific types of care for patients under the age of 19,” UPMC spokesperson Amber Depew said in a statement in response to a question asked after abc27 reported the decision.

UPMC operates seven hospitals in central Pennsylvania — Carlisle, Harrisburg, Hanover, Lititz, York and Mechanicsburg. It also operates urgent care and outpatient centers across the region.

UPMC “empathizes” with patients and families affected by the “ongoing changes,” Depew also said in the statement. The health system offers behavioral health and other types of support “within the bounds of the law,” it said. Depew did not respond to a question about whether the system’s Lancaster County locations had previously provided gender-affirming care to people under 19, but the UPMC website lists types of care for those in the LGBTQ+ community on its website.

WellSpan, which operates WellSpan Ephrata Community Hospital in Ephrata Borough, does not have any formal programs related to gender-affirming care for minors, spokesperson Ryan Coyle said. Penn Medicine Lancaster General Health did not respond to questions about gender-affirming care for people under 19.

Concerns over the changes

Amber Roadcap, executive director of the LGBT Center of Central PA, said that the health systems’ decisions to “preemptively” stop gender-affirming care are putting lives at risk.

“As a center, we are disheartened at the decision of these two dominant health systems to stop gender affirming care to those under 19 years old,” Roadcap said. “We know that gender-affirming care is lifesaving care. Gender-affirming care encompasses so much more than medication and surgery — it is counseling, support, services, and community.”

Roadcap added that Lancaster County has seen multiple suicide deaths of queer and trans young people in the last two years, and said that Lancaster County needs more services for youth, including gender-affirming services. The LGBT Center serves people in Dauphin, Cumberland, York and Lancaster counties. It hosts weekly youth programming in Lancaster County, Roadcap said.

U.S. legislators and statehouse bills seeking to restrict transgender health care have often cited European science and policy, from countries including Finland, France, Sweden and Norway, as well as the U.K., the Associated Press reported.

In December 2024, the U.K. cemented a ban on hormone-based puberty blockers for the treatment of gender dysphoria in people under 18. This came after puberty blockers were temporarily banned, and after England’s public health system had previously limited their use.

In 2023, the American Academy of Pediatrics, which represents 67,000 pediatricians, unanimously voted to reaffirm its pro-stance on gender-affirming care for transgender children, including hormone treatments when appropriate, AP reported.

The Associated Press contributed to this report.