Kaiser Permanente Halts Gender-Affirming Surgeries for Minors

Kaiser Permanente Halts Gender-Affirming Surgeries for Minors

Kaiser Permanente, a major nonprofit health care provider, has announced that it will pause gender-affirming surgeries for patients under the age of 19. This decision, which is set to take effect on August 29, follows similar actions taken by other large health care organizations in California, including Stanford Medicine and Children's Hospital Los Angeles. The policy applies to all Kaiser locations across the United States.

The company emphasized that all other forms of gender-affirming care will continue to be available to its members. Kaiser serves over 12 million people in eight states, making this decision impactful for a significant portion of the population seeking transgender health services.

Legal and Regulatory Challenges

Gender-affirming care for young people has become a contentious issue, especially under the Trump administration. In January, an executive order was issued directing federal agencies to prevent hospitals receiving certain federal grants from offering gender-affirming care to children. More recently, the Justice Department has subpoenaed doctors and clinics involved in providing such care as part of ongoing federal investigations.

Kaiser cited these developments in its statement, explaining that the evolving legal landscape necessitated a careful review of the risks associated with surgical treatments for minors. The organization stated that after extensive consultation with internal and external experts, including physicians, it made the difficult decision to pause surgical procedures for patients under 19.

“We continue to meet with regulators as well as our clinicians, patients, their families and the community with the goal of identifying a responsible path forward,” the statement read. “We recognize this is an extremely challenging and stressful time for our patients seeking care, as well as for our clinicians whose mission is to care for them. We will work closely with each patient to support their care journey.”

Reactions from Medical Professionals

The decision has drawn strong criticism from medical professionals, including the California Nurses Association, which represents about 25,000 registered nurses at Kaiser hospitals. Lady Rainsard, a registered nurse in plastic surgery at Kaiser San Francisco, called the move a surrender to government overreach.

“This is pre-emptively giving in to government overreach in health care,” Rainsard said. “Medical providers, not politicians, know what's best for our patients. Gender-affirming care is safe and effective…we deem it a much greater risk to cave to this kind of government overreach than it is to provide this care for our patients, no matter their age.”

Legal Cases and Guidelines

In 2023, Kaiser faced a lawsuit from Chloe Cole, a teen who received puberty blockers and hormone therapy starting at age 13, underwent a double mastectomy at 15, and later de-transitioned at 17. The case, brought by the conservative nonprofit Center for American Liberty, accused Kaiser of providing inappropriate gender hormone therapy and surgical procedures.

Federally accepted guidelines for gender-affirming care for trans youth typically include puberty blockers to halt the permanent changes that occur during early adolescence, followed by hormone therapy. Surgery is generally not recommended for minors and is reserved for older teens with extreme gender dysphoria. Experts estimate that a few hundred teenagers under 18 receive top surgery annually, and fewer than 20 undergo genital procedures.

Ongoing Debate and Future Steps

As the debate over gender-affirming care continues, health care providers are navigating a complex landscape of legal, ethical, and medical considerations. For many, the focus remains on ensuring that patients receive appropriate and compassionate care, regardless of their age or gender identity.

Kaiser has pledged to continue working with regulators, clinicians, patients, and families to find a responsible path forward. However, the decision to pause surgeries for minors has sparked concern among advocates who believe that such measures could have long-term consequences for the well-being of transgender youth.