Planned Parenthood of Illinois has repeatedly heard the same question from transgender patients since Donald Trump won the presidential election.
Patients want to know how many refills they can get on their hormone therapy medications, which they often need to maintain their health and certain physical characteristics.
“People have definitely asked us, 'Can you send me medications for four years?'” said Mallory Cloke, director of the gender-affirming hormone therapy program at Planned Parenthood of Illinois.
Transgender patients and gender-affirming care providers in Illinois are bracing for potentially dramatic upheaval once Trump takes office. During the campaign, Trump pledged to strip federal funding from hospitals and other providers that provide gender-affirming care to minors. He said he would sign an executive order prohibiting federal agencies from promoting the concept of gender transitions. “Kamala is theirs/theirs,” Trump declared in his announcement. President Trump is for you.”
Gender confirmation care can include a range of services, such as counselling, medications to delay puberty, hormone therapy and/or surgery. Advocates of access to gender-affirming care for minors, including the American Academy of Pediatrics, say it's important health care and has mental health implications. Trump has called gender-affirming care for minors “child abuse” and “mutilation.” The Do No Harm group says gender-affirming care “can cause serious and irreparable harm to children”.
Many hospital systems and health care organizations in the Chicago area provide gender-affirming care, and a number of them offer this care to patients under 18 years of age. It is unclear how these hospitals and providers would survive, or whether they would continue to provide this care, if Trump pulled their money from Medicare or Medicaid — the main funding sources for most hospitals and health care providers.
“Hospitals and clinics are going to have to basically evaluate what they can and can't do in light of the immediate reduction in funds,” said Monie Ruiz Velasco, deputy director of Equality Illinois, which advocates for equal rights for LGBT people. “We are concerned about what this means because most hospitals and clinics cannot operate without federal funding.”
Losing federal funding would create a “huge hole in our operating budget,” said Tim Wang, director of policy and advocacy at Howard Brown Health, which specializes in caring for LGBT patients and people with HIV at centers throughout Chicago. .
“We will not be able to operate the same way we do now,” Wang said. Howard Brown treats approximately 38,000 patients annually, and about a quarter of its patients are on Medicare or Medicaid.
“Even just the threat of withdrawing federal funding would be enough to force many health care providers to end gender-affirming services, which could result in transgender people having nowhere to go to get the health services they need,” Wang said.
Klock, of Planned Parenthood of Illinois, said the organization is preparing for all eventualities. It provides gender-affirming hormone therapy to about 4,000 patients a year, Klock said.
“Transgender people, in general, and the affirming medical care that we get, is on a short list of things that people want to get rid of, and that's what makes people feel afraid,” Klock said. “But we are here, we are providing that care, and we will continue to provide that care as long as we are legally able to.”
Three Chicago-area health systems that provide gender-affirming care — Rush, Advocate Healthcare, and University of Chicago Medicine — either declined to make representatives available for interviews on the topic or did not respond to requests for comment.
Lurie Children's Hospital, which has faced criticism in the past for its gender dysphoria program, said in a statement that the hospital “is proud to provide gender-diverse youth access to comprehensive, family-centered, developmentally appropriate health care in a safe and inclusive environment.” clinical space.”
The American Academy of Pediatrics recommends that youth who identify as transgender or gender diverse have “access to comprehensive, gender-affirming, developmentally appropriate health care.” The American Medical Association has urged governors to oppose state legislation that would ban “medically necessary transition-related care” for minors. In a 2021 letter to the National Governors Association, the AMA's CEO wrote that “evidence has shown that forgoing gender-affirming care can have tragic consequences.”
Illinois has laws in place aimed at protecting gender-affirming care. In 2023, Governor J.B. Pritzker signed a bill requiring state-regulated health insurance plans to cover hormone therapy drugs to treat gender dysphoria, which is when people experience distress when their gender identity differs from their birth sex or physical characteristics. This law also protects patients and gender-affirming caregivers in Illinois from legal action from other states.
At least 26 states have laws restricting gender-affirming care for minors, according to KFF, a nonprofit health policy research, polling and news organization. The U.S. Supreme Court has agreed to hear a case next December over the constitutionality of a law banning gender-affirming care for minors in Tennessee.
As with abortion, some patients now travel to Illinois from other states to seek gender-affirming care, Klock said.
But it's unclear how Illinois' laws will hold up in the face of federal action.
“If Congress passed a ban on this care, I think our laws here would be seriously compromised,” said Ruiz Velasco of Equality Illinois, though some noted that any kind of federal ban would certainly be challenged and could be limited. In court for some time.
Advocates for gender-affirming care in Illinois aren't waiting to see exactly how far the Trump administration will go before they take action.
Wang, along with Howard Brown, said advocates are working with state lawmakers to explore whether there could be state funding streams to help provide gender-affirming care if federal funding is lost.
State Rep. Kelly Cassidy, D-Chicago, said Illinois lawmakers years ago began preparing for the possibility that the federal government would try to restrict gender-affirming care. An Illinois law protecting gender affirming care from out-of-state legal attacks came from a House working group created after the U.S. Supreme Court overturned Roe v. Wade.
Cassidy said she is already working on a bill to strengthen protections for people seeking reproductive and gender-affirming care in Illinois, by better protecting certain types of health data.
Aisha N. said: The ACLU of Illinois is also “continuously looking at ways in which we can, through litigation or legislation, combat any of these attacks on access to care,” said Davis, the group’s senior policy counsel.
“We know that the next four years are going to look a lot different than the last four years, but we also know that whatever comes, we will do everything we can to be prepared and make sure that care is not interrupted or denied,” Davis said.
