TYEP - Used With Permission
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Over the last several years, many red states have banned gender-affirming care for transgender youth. Since Trump returned to power, that campaign has shifted to blue states, with the administration threatening hospitals and healthcare systems with the loss of federal funding unless they stopped providing care. This week, those threats escalated sharply: a new federal rule, now in its public comment period, would bar any hospital that provides transgender healthcare from receiving Medicaid funds—a move that would effectively force most major hospital systems to end that care altogether. In response, an organization that has already helped families navigate care bans in red states is stepping in again. The Trans Youth Emergency Project (TYEP), spun up by leaders at the Campaign for Southern Equality, says it has capacity to help parents of transgender youth locate independent clinics that may be less vulnerable to the administration’s current and incoming policies and can provide, in some cases, travel assistance.
TYEP’s latest outreach follows the release of a sweeping new federal rule that would bar any hospital system—and any clinic affiliated with those systems—from providing gender-affirming care if they accept Medicaid. The rule contains no carveouts for patients already receiving care, meaning many transgender youth would be forced into abrupt medical detransition unless they can quickly secure alternative providers, should the rule take effect. It explicitly claims to preempt state shield laws in places like California, Minnesota, and New York. The proposed rule further destabilizes an already fragile healthcare landscape for transgender youth, as hospitals and clinics continue to shutter services in preemptive compliance with the administration’s escalating threats.
The rule does leave one narrow avenue for transgender youth to continue accessing care: private, independent clinics and physicians who do not accept Medicaid. Earlier this year, as hospital systems began shutting down services, advocates spoke about spinning up independent clinics to meet the need. Massachusetts advanced a measure intended to funnel funding toward that kind of care, and in New York City, mayor-elect Zohran Mamdani pledged millions to help preserve treatment capacity. But for many families, the talk of these clinics have felt like vaporware—plans discussed publicly that have yet to translate into accessible appointments. There may, however, be a quieter reality beneath the surface: clinicians and small practices that are not advertising openly but remain prepared to provide care. That is where TYEP steps in, working behind the scenes to connect patients with providers who are still able and willing to treat them.
When asked whether TYEP has the capacity to absorb a surge of families seeking alternatives in the wake of the new rule, organizers said unequivocally that they do. They noted that the organization has repeatedly scaled up during previous waves of clinic and hospital closures without issue. Adam Polaski explained, “At every turn, we have been able to pivot and scale up and show people the reason that this is important. Folks have stepped up with their dollars, and also folks have requested support and spread the word. So right now, I don’t want folks to feel like they shouldn’t reach out because they ‘don’t really need it’ or someone else ‘needs it more than them.’ Everyone needs the support right now, and it’s ok. We have the capacity to take it on.”
Polaski compared what the group is doing to efforts that spun up for abortion access in the wake of recent restrictions and bans. “A lot of folks are recognizing that this kind of, you know, practical support network that the abortion access movement has crafted so powerfully is going to be necessary for trans folks.”
The group is likely to face real stress testing in the coming weeks. While the rule change has not yet taken effect—the process will include a 60-day public comment period, additional time for the administration to review comments and finalize the rule, and near-certain litigation that could delay or block implementation entirely—we have already seen that the mere threat of new anti-trans rules is often enough to prompt hospital systems to fold. Even now, EITM is aware of hospital systems actively discussing the proposed rule and weighing preemptive closures in anticipation of compliance pressures. That means independent clinics may begin seeing an influx of patients well before any rule is finalized. In that environment, organizations like the Trans Youth Emergency Project will be essential in helping families navigate a rapidly shrinking and increasingly opaque care landscape.
Families wishing to contact the TYEP about their situation can do so here by filling out their intake form. The national project offers family navigation through one-on-one phone calls to help identify providers unimpacted by restrictions, as well as travel grants of $500.
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