{"id":929,"date":"2026-05-27T23:05:34","date_gmt":"2026-05-27T23:05:34","guid":{"rendered":"https:\/\/jacksonvillemovingnews.com\/?p=929"},"modified":"2026-05-27T23:05:34","modified_gmt":"2026-05-27T23:05:34","slug":"its-not-just-kids-trumps-crackdown-on-trans-healthcare-extends-into-adulthood","status":"publish","type":"post","link":"https:\/\/jacksonvillemovingnews.com\/?p=929","title":{"rendered":"It’s not just kids: Trump’s crackdown on trans healthcare extends into adulthood"},"content":{"rendered":"
\n

An 18-year-old transgender college student tried to refill her estrogen prescription at Northwestern Medicine in Chicago. She was told she needed to wait until her 19th birthday.<\/p>\n

Read more Miami Dolphins<\/a><\/p>\n

In Texas, a 37-year-old U.S. Army veteran regularly went to a Department of Veterans Affairs hospital for gender-affirming care, including therapy, wigs and prosthetics. Staff suddenly cut the services.<\/p>\n

And in Colorado, a 37-year-old scientist for the federal government planned to undergo transition surgery. She discovered her insurance would no longer cover it.<\/p>\n

A decade ago, these denials wouldn\u2019t have been allowed. The federal government widely supported access to transition care.<\/p>\n

That changed last year when the Trump administration began issuing sweeping directives across the government banning or limiting treatments for people with gender dysphoria, which is the distress felt from a mismatch between birth sex and gender identity.<\/p>\n

Those who back restrictions on transition care \u2014 including conservatives such as President Donald Trump \u2014 say they are focused on protecting trans youth who can\u2019t consent to or understand the long-term effects of treatments like puberty blockers, hormone therapy and surgeries.<\/p>\n

But the administration\u2019s actions and the resulting impacts have been far broader, blocking thousands of adults \u2014 including veterans, longtime government employees and older teens \u2014 from getting healthcare they need.<\/p>\n

Since Trump re-entered office, he has signed an executive order prohibiting hospitals that receive federal funding from providing transition services to \u201cchildren,\u201d but the directive includes a broad definition of child: anyone under 19. The Department of Veterans Affairs has ended transgender care at the agency\u2019s hospitals for anyone who wasn\u2019t already receiving hormone therapy. The Department of Health and Human Services has enacted a rule that prohibits gender-affirming care from being covered as an essential health benefit under the Affordable Care Act \u2014 reversing an Obama administration expansion of trans care access. Federal officials have scrapped for federal and Postal Service employees unless they are \u201cmid-treatment.\u201d Next year, the administration will .<\/p>\n

What trans people are asking for isn\u2019t extraordinary, advocates say. Nearly everyone, at some point in their lives, receives medical care related to their gender expression: taking estrogen or testosterone during menopause or treating erectile dysfunction. Many private insurance plans also cover gender-affirming care.<\/p>\n

Tell us about your access to transition care as a transgender adult \u2014 Fill out form<\/strong><\/em><\/p>\n

To understand the effects of the Trump administration policies, NBC News conducted more than 30 interviews with trans adults, treatment providers across the country, conservative activists and lawmakers as well as advocates and lawyers from the nation\u2019s largest trans rights groups.<\/p>\n

Trans adults from Florida to Washington state said they\u2019ve lost access to treatment or had procedures canceled because hospitals and clinics opted to roll back transition care amid the crackdowns. They\u2019ve started saving money and setting up online fundraisers to pay out of pocket for gender-affirming surgeries. And they\u2019ve faced long wait times and lengthy drives to see doctors who still offer care.<\/p>\n

Academic research has shown that access to such treatment improves the mental health of trans patients, including reducing suicidal thoughts.<\/p>\n

Those who have already faced barriers to care said they\u2019ve experienced depression and anxiety affecting their ability to feel comfortable in public or perform well at work. Half said they have been stockpiling hormones in fear of further restrictions.<\/p>\n

Come June, Kacey Garner, a 25-year-old Postal Service clerk in Mackinac Island, Michigan, will no longer be eligible to remain on her parents\u2019 health insurance. She spent months worrying about switching to work benefits, since her transition care wouldn\u2019t be covered.<\/p>\n

She stressed about the need to pay $170 out of pocket every three months for hormone therapy. She didn\u2019t know whether she\u2019d be able to afford facial feminization surgery, which can cost as much as $50,000.<\/p>\n

Without it, she spends hours on her makeup to alleviate constant worry about not \u201cpassing\u201d as a woman.<\/p>\n

\u201cI have not felt relaxed in a very long time,\u201d she said. \u201cActually, I don\u2019t even know if I\u2019ve ever been relaxed.\u201d<\/p>\n

She ultimately left the Postal Service job this month after her hours were cut, and she is now looking for work with more health insurance benefits.<\/p>\n

Advocates say the federal restrictions stem from a yearslong effort backed by the country\u2019s largest conservative groups, including the American Principles Project and the Alliance Defending Freedom, to paint being trans as an emerging political ideology rather than an inherent human trait. The push has resulted in policies at the federal level and in 17 states that reject trans people\u2019s gender identities by making sex assigned at birth legally unchangeable.<\/p>\n

The conservative Heritage Foundation has been a major driver behind the federal changes, which it outlined in its Project 2025 policy road map. Jay Richards, the organization\u2019s vice president of social and domestic policy, said the foundation also authored model bills used in state policies redefining sex.<\/p>\n

He said the organization doesn\u2019t have \u201ca settled position\u201d on adult transition care but supports banning public funding for the treatment, regardless of age.<\/p>\n

\u201cWe think restrictions, for instance, on the use of federal funds \u2014 Medicare, Medicaid, and things like that \u2014 that\u2019s perfectly within the jurisdiction, in terms of constitutional questions, of the federal government,\u201d Richards said. Any further restrictions, he said, should be left to states.<\/p>\n

During a podcast interview in February, foundation President Kevin Roberts went further. He claimed transition and violent extremism are linked, suggesting that gender-affirming surgeries be outlawed.<\/p>\n

Beyond federal restrictions, more than a dozen conservative states have targeted transition care for adults \u2014 and at least one has proposed outlawing it altogether. States like Florida and Texas have led the charge, implementing policies restricting care that the Trump administration is now matching on the federal level.<\/p>\n

The tactics that federal and state governments are using have been adapted from the \u201cabortion playbook,\u201d said Elizabeth Gill, senior counsel at the American Civil Liberties Union.<\/p>\n

\u201cThis looks very similar to what anti-abortion activists did over a range of years, which is passing all kinds of laws that make accessing the care more difficult,\u201d she said.<\/p>\n

Gill said the restrictions on trans care aren\u2019t merely about whether procedures or medications are safe.<\/p>\n

\u201cThe Trump administration has been clear in its intent from basically day one of this administration \u2014 that a priority of the administration is to push trans people, both youth and adults, out of public life,\u201d Gill said.<\/p>\n

The White House did not respond to requests for comment or answer written questions.<\/p>\n

In public appearances and online, Trump often rails against what he calls \u201ctransgender mutilation\u201d of children, often repeating a vague pledge to stop \u201ctransgender for everybody.\u201d<\/p>\n

\u2018Redefining the word child\u2019<\/h2>\n

Days after his inauguration, Trump took aim at transition care.<\/p>\n

His executive order barred federal funding from hospitals that provide the treatment to \u201cchildren.\u201d But \u2014 in a short yet significant definition \u2014 it included 18-year-olds as kids, prohibiting many legal adults from starting or continuing treatment. Eighteen-year-olds enjoy many other rights and freedoms, including the ability to drive, vote, enlist in the military and purchase a rifle.<\/p>\n

Aleksandra Vaca was caught in the fallout. Last year, she moved to the Chicago area for college, making an appointment to refill her estrogen prescription at Northwestern Medicine.<\/p>\n

Vaca had realized she was trans four years earlier, while living in Austin, Texas, just as the state declared transition care for minors to be child abuse. That meant Vaca couldn\u2019t start hormone therapy at the time \u2014 a delay that she said triggered severe depression and led her to contemplate suicide.<\/p>\n

Most days, she struggled to get out of bed. Once she turned 18, she started treatment. Getting up became easy. The brain fog she\u2019d experienced for years vanished.<\/p>\n

\u201cEverything was different,\u201d she said.<\/p>\n

She\u2019d hoped to get a fresh start in Illinois. But hours before her appointment, Northwestern called and informed her that doctors wouldn\u2019t prescribe her estrogen until her 19th birthday, citing Trump\u2019s order. The denial, she said, felt especially ridiculous: Her birthday was later that week.<\/p>\n

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She immediately thought about her time in Texas. \u201cIt just brought it all back,\u201d she said.<\/p>\n

Northwestern Medicine declined to comment on Vaca\u2019s case, citing privacy laws, but said the hospital \u201cdoes adhere to the executive order.\u201d<\/p>\n

Denials and delays take heavy tolls on trans people, often because they have already waited years to access care, said Ash Orr, press relations manager at Advocates for Trans Equality, a prominent trans rights organization.<\/p>\n

\u201cThat emotional toll isn\u2019t just about healthcare access \u2014 it\u2019s about having your stability and your livelihood constantly undermined,\u201d Orr said.<\/p>\n

Other policies defining children as 18 and under are rare. Two states, Alabama and Nebraska, set legal adulthood at 19. The Children\u2019s Health Insurance Program, a joint federal-state initiative providing low-cost health insurance to kids, covers 18-year-olds.<\/p>\n

Simone Chriss, an attorney at the Southern Legal Counsel, a nonprofit civil rights organization based in Florida, said Trump\u2019s order sets a \u201cterrifying\u201d precedent.<\/p>\n

\u201cIf we\u2019re able to ban this care for people who are 18 years old by simply redefinding the word \u2018child,\u2019\u201d she said, \u201cthen we can redefine it to mean under 25, or whenever they think brains are fully developed, and it\u2019s dipping a toe into banning care for adults.\u201d<\/p>\n

Cutting coverage<\/h2>\n

Transition care at the VA had always been comprehensive for S.W., a 37-year-old Army veteran in Texas who served four years and deployed to Iraq. She received hormone therapy, individual mental health services, group therapy, prosthetics, wigs, laser hair removal and referral letters for surgeries.<\/p>\n

Then last spring, nearly everything changed.<\/p>\n

The Trump administration announced that the VA would phase out care for gender dysphoria, eliminating all transition care services except for hormone therapy to veterans already receiving the treatment through the agency. Now-banned trans military members who were receiving treatment during their service are also eligible to continue it.<\/p>\n

\u201cI mean no disrespect to anyone, but VA should not be focused on helping Veterans attempt to change their sex,\u201d the agency\u2019s Secretary Doug Collins said in a statement last spring. \u201cAll eligible Veterans \u2014 including trans-identified Veterans \u2014 will always be welcome at VA and will always receive the benefits and services they\u2019ve earned under the law. But if Veterans want to attempt to change their sex, they can do so on their own dime.\u201d<\/p>\n

Trans veterans described confusion about what is and isn\u2019t covered.<\/p>\n

S.W., who asked to go by her initials because she fears harassment by anti-trans groups, said she needed an exam, including a physical and blood work, before a gender-affirming surgery last year. But she said her VA primary care doctor wouldn\u2019t perform the checkup because it was related to transition care. Instead, she went to urgent care. She paid a $50 copay, and her insurance through her IT job covered roughly $150. She said the visit at the VA would have been free.<\/p>\n

\u201cI do not feel like I\u2019m getting full access to the benefits I earned as a veteran,\u201d said S.W., who set up and maintained antenna sites for radios and a Stryker brigade combat team during her service. \u201cI never know when I\u2019ll find out that there is something the VA can\u2019t do because it\u2019s related to me being trans.\u201d<\/p>\n

VA officials did not answer questions about the policy changes. In an emailed statement, Quinn Slaven, a spokesperson, said that the VA \u201chas received almost no criticism in response to this policy \u2014 proof that the vast majority of Veterans and Americans support it.\u201d<\/p>\n

The VA isn\u2019t the only federal agency that\u2019s cut trans health coverage.<\/p>\n

The Trump administration in January excluded under the Federal Employee Health Benefits and Postal Service Health Benefits programs, which combined cover some 11 million federal employees, retirees and their families. There are exceptions for workers already receiving treatment, but next year, .<\/em>The government cited efficiency and protecting federal dollars as reasons for the changes.<\/p>\n

Studies have found that transition-related care has a negligible impact on overall healthcare costs for employers.<\/p>\n

B., a geologist in Colorado who\u2019s spent roughly a decade working for the federal government, is considering canceling her employee health insurance and buying a marketplace plan with the hope of getting transition surgery covered. But benefits for her alone, she said, would cost what she currently pays to also cover her partner and their child.<\/p>\n

\u201cThe more I continue to learn to accept myself,\u201d said B., who asked to go by her first initial because she did not have permission to speak to the media, \u201cthe less tenable this becomes.\u201d<\/p>\n

When federal restrictions mix with state policies<\/h2>\n

Before the Trump administration started dismantling transition care for adults, states had begun the process. Every year, some consider more stringent moves.<\/p>\n

Add federal restrictions on top of the state ones, and providers must navigate a constantly changing legal maze. They need to track new laws, agency rules, executive orders and declarations as well as legal challenges and rulings \u2014 to know whether they\u2019re in compliance.<\/p>\n

Twelve states bar Medicaid from covering transition-related treatment, regardless of age,and 14 ban state employee health plans from covering such care, according to the Movement Advancement Project, an LGBTQ think tank. Two allow insurers to refuse to cover gender-affirming care.<\/p>\n

The federal and state restrictions have led some institutions to stop offering treatment. The University of Florida, for example, halted transition services through its health center this month, citing the evolving landscape.<\/p>\n

Daniel Hogan, 21, a rising senior at the university studying natural resource conservation, said he was excited to go to UF, because he believed he\u2019d receive stable care for the first time.<\/p>\n

\u201cI thought it would be a solid thing,\u201d Hogan said. \u201cAnd to have that dangled right in front of me and then it taken away is just very, very upsetting.\u201d<\/p>\n

Florida is among the most restrictive states. It is alone in requiring that only physicians prescribe hormone therapy and that they do so in person \u2014 even though nurse practitioners can prescribe many of the same medications via telehealth for other purposes.<\/p>\n

Clinics run by nurse practitioners had to stop providing hormone therapy unless they could hire a licensed physician, causing some to shutter, according to providers in surrounding states and advocates.<\/p>\n

Izzy Lowell, a Georgia-based doctor who runs QueerMed, a national telehealth clinic, told NBC News that in order for her to treat Florida patients, they must leave the state.<\/p>\n

That can mean driving 12 hours from Miami to cross state lines. Her patients sit in a parking lot for their appointment, and afterward, she sends their prescription to a nearby pharmacy. Then, they\u2019ll drive 12 hours home.<\/p>\n

\u201cI get new registrations every day from people in Florida,\u201d Lowell said.<\/p>\n

Increasingly stringent restrictions have been proposed and enacted in other states, too.<\/p>\n

Tennessee Gov. Bill Lee, a Republican, signed a bill earlier this month that requires providers who receive state funding to report \u201c\u201d to the state health department \u2014 including the patient\u2019s age, sex, county of residence, medications, dosages and diagnoses.<\/p>\n

\n\t\t\t\t\t\t\t\tTennessee\u2019s law bans puberty blockers and hormone treatments for transgender minors, but it allows the same drugs to be used for other purposes.\n\t\t\t\t\t\t\t<\/div>\n

This year, Oklahoma state Sen. Shane Jett introduced the first bill to completely ban transition treatments, regardless of age.<\/p>\n

The bill would block transgender adults from procedures like breast augmentation and treatments such as hormone therapy \u2014 but would allow cisgender people to receive them. Asked about the discrepancy, Jett said transition care preys on a person\u2019s \u201cpsychological context\u201d and manipulates people into a lifelong treatment path. Nontransition care, he said, is intended to \u201cget normal function back into the body.\u201d<\/p>\n

Similarly, while the federal government has restricted transition treatments, it has pushed to expand access to hormone therapy \u2014 including potentially removing testosterone\u2019s classification as a controlled substance \u2014 for cisgender men and women.<\/p>\n

Leslie Dvorak, the owner and medical director at Pride Health Clinic in Omaha, Nebraska, said that every person, regardless of identity, receives care that could be considered gender-affirming, such as hair removal, breast augmentation and hormone therapy. Dvorak, who spent 21 years in the U.S. Air Force, started providing transition care eight years ago while working at a federally funded health center.<\/p>\n

Now in her private clinic, she said she is navigating not only Nebraska\u2019s restrictions on transition care for minors and its ban on Medicaid coverage, but also laws in 10 other states where she\u2019s licensed to practice via telehealth. This year, Nebraska floated a bill that would have allowed patients to sue transition care providers for up to 12 years after treatments \u2014 creating a statute of limitations a decade longer than for any other medical malpractice claim in the state.<\/p>\n

Dvorak said she plans to keep practicing, especially since many of her 2,500 patients came to her after other providers stopped offering transition care. She\u2019s not afraid.<\/p>\n

Read more Video shows suspect taken into custody after pursuit and foot chase ends in Miami Gardens<\/a><\/p>\n

\u201cSue me,\u201d she said. \u201cGood luck.\u201d<\/p>\n

Jon Schuppe contributed.<\/em><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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