In January, President Donald Trump ordered a ban on federal funding for many types of gender-affirming health care for people under 19 years old. The executive order also restricts hospitals that receive federal funding from offering this care at all.
At least two federal judges have already blocked the order, pausing its required action while litigation plays out.
Trump’s administration also switched positions from the Biden administration’s push against Tennessee’s ban on gender-affirming care for transgender youth, withdrawing from the case entirely. The Justice Department stated that the new administration would not have opposed this state’s ban in the first place.
Institutions across the country, including those in Evanston, have had to respond to these measures.
Evanston’s two school districts have remained committed to their stated DEI values including gender inclusivity.
Northwestern University has taken a harder look at their compliance to the administration’s measures, including evaluating the schools’ Gender and Sexuality Resource Center, as reported by The Daily Northwestern.
The hospital systems in Evanston have been quieter on these measures, with no public stance on the federal actions.
What is gender-affirming care?
This umbrella term refers to care that helps patients achieve characteristics more aligned with their gender identity and support them physically, mentally and socially throughout this process.
The RoundTable spoke with Dr. Michelle DallaPiazza, the director of trans and nonbinary care at Howard Brown Health, to further understand the kinds of care impacted by Trump’s ban.
Trans and nonbinary youth and their parents exploring medical options might first opt for puberty blockers. These delay puberty for a child, which gives them and their family time to delay development while a child explores their gender identity.
“Research has shown us that if the child remains very steadfast in their gender identity throughout puberty, they’re unlikely to reverse later on in life,” DallaPiazza said. “They will most likely continue on that journey with their gender affirmation.”
When a patient does not continue on this journey, DallaPiazza said that puberty begins again shortly after a patient stops taking the blockers.
If a young person already started puberty, they might consider hormone therapy to help produce physical traits more affirming to their identity.
For either of these options, patients and families go through extensive detailed mental health assessments, social work assessments and medical assessments before any treatment begins. All treatments for juvenile patients require legal guardian approval.
DallaPiazza said long-term studies show that there are meaningful benefits to this care, and that completely withholding could cause significant harm to youth who are gender diverse.
“It really is a life-or-death situation for many youth,” DallaPiazza said. “Youth could potentially experience significant distress over the course of puberty if they do not have access to care.”
When youth have access to social support, medical care and familial assistance, DallaPiazza said, research has shown vastly lower suicide risk than those who are not supported.
“These bans are not only about withholding medical care, they’re based in ideas about how people shouldn’t be allowed to reach their full potential or live authentically, and medical care is a part of helping people lead fulfilling and productive lives.” DallaPiazza said.
Hospitals react
Chicago Lurie Children’s Hospital has already halted gender affirming surgeries for those under 19, prompting protests in the city. The hospital continues to offer puberty blockers and hormone therapy, though.
DallaPiazza said the chances of someone in this age range requiring surgery were already quite slim.
“In the majority of cases, surgery would not be offered to anyone under the age of 18,” DallaPiazza said. “There are a few exceptions, which are usually related to chest masculinization surgery for those who identify as trans masculine or nonbinary —patients who have a lot of dysphoria around their chest to the point where it’s causing them significant psychological distress.”
Howard Brown Health does not offer these kinds of surgeries for youth, or puberty blockers or hormone therapy on a programmatic level. Media contact Wren O’Kelly told the RoundTable that when it comes to youth gender affirming care, Lurie Children’s is the most robust program in the area.
Here in Evanston, it’s unlikely that Ascension St. Francis Hospital ever offered this kind of care. The hospital is Catholic, and mentions no kind of LGBTQ+ care even for adults on their website.
The RoundTable reached out to Ascension to learn more, but received no reply.
Endeavor does have puberty blockers listed on their Health Encyclopedia, and offers a list of LGBTQ+ affirming providers across a number of medical services, including pediatrics.
The RoundTable contacted Endeavor and several pediatricians, but was not able to confirm if Endeavor has ever offered this kind of care in the Evanston area.
School districts committed to LBGTQ+ rights
Evanston Township High School took a strong stance in support of their LGBTQ+ students this year when threats to their status and care began to roll in.
“Federal stances and policies may continue to evolve, but ETHS remains firmly grounded in our core values as both an institution and a community,” Superintendent Marcus Campbell wrote in an email to the school community in late January.
Campbell also reaffirmed this commitment at the Feb. 24 joint board meeting between District 202 and District 65.
“These orders, particularly the orders targeting gender initiatives, gender inclusion initiative, diversity and equity are a front to our values,” Campbell said at the meeting.
ETHS resources for trans or nonbinary students looking to adjust their gender identity at school remain online in the wake of these federal changes.
The RoundTable contacted ETHS to speak to their health clinic on how these youth are supported and directed, but the school declined a request for an interview.
District 65 also upheld their commitment to a safe learning environment for all students regardless of identity.
“Our efforts will remain unwavering in fostering an inclusive and uplifting learning environment for our students and our staff of every race, ethnicity, religion, ability level, culture, citizenship status, sexual orientation and gender identity,” District 65 Superintendent Angel Turner said.
Parents doing their best
Even before the executive orders rolled out, Evanston’s chapter of Parents, Families, and Friends of Lesbians and Gays (PFLAG) saw an uptick in worried parents as the climate on transgender and nonbinary individuals began to change.
“I found in the last year and a half or so, the number of unsolicited emails that we receive in our inbox from parents, mostly of trans children, trying to do their best for their kids,” has gone up, said Evanston’s PFLAG President, who goes by Lex.
Lex has seen the need for support for parents in this experience as part of this chapter the last five years.
“I think the need is the same,” Lex said. “It has intensified, because loving queer people and queer people loving themselves is very hard when authority figures tell you either you don’t exist or … there’s something wrong with you.”
Illinois attempts to be a safe haven
On a state level, Illinois has remained a force of opposition against the Trump administration’s hostility to this healthcare for young people.
The attorney general of Illinois promised the state would protect access to gender affirming care for youth in the wake of the ban.
“The Trump administration’s recent executive order is wrong on the science and the law. Despite what the Trump administration has suggested, there is no connection between female genital mutilation and gender-affirming care, and no federal law makes gender-affirming care unlawful,” the statement reads. “President Trump cannot change that by Executive Order.”
Governor JB Pritzker also shared on social media that he’s made it his “mission to make our state the best to call home including for our LGBTQ+ community. No matter who you are or who you love, everyone deserves dignity and equality.”
On top of these government commitments, the Aids Foundation of Chicago has been one of multiple nonprofits suing the Trump administration over the executive order.
“We have done everything we can to protect transgender youth in particular, but for all transgender folks,” said state Rep. Robyn Gabel, who represents Evanston and much of the North Shore.
With the state’s commitments and potential future actions committing to gender affirming care for youth, families from out of the state could travel here to receive this care. Illinois has seen this behavior at large with reproductive healthcare, with thousands traveling to the state for abortion care every year.
“When it comes to reproductive rights, Illinois is the number one recipient of people who come to get the care that they need,” said Evanston resident and U.S. Rep. Jan Schakowsky. “We may see people coming with their children from other states in order for them to be healthy and live their best life and be entitled to that care.”
• Editor’s note: This story is part of an ongoing topic of threats to gender affirming care to youth. If you or anyone you know has attempted to access this care in the Evanston area, or has further information or perspective on the subject, the RoundTable would love to hear from you.
How Evanston community is reacting to federal ban on gender-affirming care for youth is from Evanston RoundTable, Evanston's most trusted source for unbiased, in-depth journalism.