Trump targets transgender care: What does it mean for Worcester families, providers?

USA Today

07-02-2025

Trump targets transgender care: What does it mean for Worcester families, providers?
WORCESTER — It would be an understatement to say Danielle Killay is concerned about an executive order from the White House that targets the transgender community.
Killay's 14-year-old daughter, Ava, was assigned male at birth and is in the process of transitioning to become female. She has a scheduled appointment this spring to begin hormone therapy after years of consultations with her medical team.
Killay, who lives in Worcester with her husband and four children, isn't sure where things stand with the scheduled treatments. The source of the uncertainty is President Donald Trump's executive order to end federal government support for transgender health care services to anyone younger than 19.
Some health care providers nationally have canceled or postponed appointments due to potential lawsuits and loss of federal funding.
'If this order is not a full-out attack for gender-affirming care for youth, then it's the first step in getting there,' said Killay. 'We're still trying to figure out what this means for our family.'
Ava told her parents when she was 9 that she had always felt like a girl. She started taking puberty blockers at 12 and never wavered in her desire to transition, Killay said.
'She's insistent, consistent and persistent in who she is,' said Killay.
What's in the executive order?
Titled "Protecting Children from Chemical and Surgical Mutilation," the executive order is forcing Killay and others in Worcester to take a hard look at its implications.
Doctors are 'maiming and sterilizing' children, said the order, adding, 'This dangerous trend will be a stain on our nation's history, and it must end.'
The secretary of the U.S. Department of Health and Human Services will report back in 90 days after a review of existing data on best practices and 'increase the quality of data' to guide those practices. Any medical institution that receives federal education and research grants must end the 'chemical and surgical mutilation of children,' the order says.
Health and Human Services will set conditions for Medicare and Medicaid coverage of transgender services, and coverage of those services by the military's TRICARE insurance program will end for anyone younger than 18.
The Department of Justice has a role to play in the order. It's instructed to work with state attorneys general to enforce laws against 'female genital mutilation." Also, to develop laws with Congress that extend the statue of limitations for children and parents to sue doctors responsible for poor transgender care.
Within 60 days, federal agencies will report on their progress to implement the order and give a timeline for action.
White House directive: Follow the order
Meanwhile, reports indicate the Trump administration sent directives to states and health care institutions nationwide to end all programs that get federal funds tied to gender identity and those connected to diversity, equity and inclusion.
The messages arrived after two federal judges issued a temporary freeze on Trump's order blocking federal funding for transgender services. One of the rulings resulted from a lawsuit filed by Massachusetts Attorney General Andrea Campbell and 13 other attorneys general.
Gov. Maura Healey's office did not respond to an inquiry on whether it had received the directive. The office provided a statement from Healey that pledged its commitment to transgender health services in Massachusetts.
"As the governor of a state that's a global leader in health care, I'm deeply concerned by President Trump's efforts to undermine public health — from restricting information sharing, to scrubbing government websites of essential resources, to attacking health care for women and the LGBTQ+ community," said the statement.
It added: 'Here in Massachusetts, we are going to stay true to who we are and continue to deliver high-quality health care for all of our residents, including protecting access to care for the LGBTQ+ community."
UMass Memorial Health: 'Our policies have not changed'
UMass Memorial Health's department of LGBTAIA+ Health Services will continue to provide transgender health care services, including for adolescents and young adults.
'Our long-standing commitment to improving the health of the diverse communities we serve through culturally sensitive excellence in clinical care, service, teaching and research is unwavering,' said a UMass statement. It added the health system will continue to evaluate potential implications of the executive order, but 'our policies have not changed.'
The Edward M. Kennedy Community Health Center provides transgender services, including hormone therapy, mental health counseling and referrals for surgery. Those services will continue, according to the center's website.
"In light of recent challenges to equitable and inclusive health care, we want to reaffirm our unwavering commitment to providing the comprehensive care you rely on," said the website. ".... We also want to reassure you that there are no plans to change or reduce access to any of the services we offer."
Stephen Kerrigan, the health center's president and chief executive officer, told the Telegram & Gazette the center 'stands firmly by our patients, so they can live healthy lives. We will work with the (Trump) administration to do that, and continue to provide health care for our patients.'
Kerrigan, long active in Democratic politics, is the chair of the party in Massachusetts, according to the group's website.
Family Health Center of Worcester also offers transgender health care services, but declined to comment.
Support in Worcester for Trump's order
The Worcester Republican City Committee said in a statement from chairwoman Mary Ann Carroll that it 'applauds' Trump's order.
The committee points to a National Institute of Mental Health assessment that the human brain doesn't fully develop until the mid- to late 20s. Therefore, the committee's statement said, people younger than 19 don't have the mental capacity to fully understand the long-term consequences of medical procedures linked to gender transition.
'Transgender medical intervention should not be an option for individuals until such time the individual is able to fully comprehend the lifelong effects resulting from the process of transitioning," the statement said. 'The Worcester Republican City Committee commends President Trump for protecting the children of the United States of America."
The Massachusetts Republican Party did not respond to a request for comment.
The Diocese of Worcester declined to comment on President Trump's order.
The Vatican last year declared transgender surgery to be a violation of human dignity as part of a 'Indefinite Dignity' declaration approved by Pope Francis.
MA lawmakers criticized
Beyond Trump's order to end federal funding for transgender health care for minors, advocates for LGBTQ+ rights are concerned about numerous Trump executive orders that, they say, discriminate against transgender people.
These include the federal government recognizing only male and female sexes and baring transgender people from serving in the military. Trump on Wednesday added to the list when he signed an executive order that bars transgender athletes from participating in girls' and women's sports.
That last issue filtered down to the Massachusetts State House on Wednesday, where some lawmakers faced criticism from an advocacy group for sponsoring a bill that, it says, impedes transgender students from participating in school sports. The bill is cosponsored by Sen. Ryan Fattman, R-Sutton, and Rep. John Gaskey, R-Carver.
MassEquality called out lawmakers who joined with the conservative Massachusetts Family Institute at a State House press conference to support the bill.
'It sickens me to see that any legislator in Massachusetts would partner with this organization to incite fearmongering and disinformation at the expense of children,' said Tanya Neslusan, MassEquality's executive director.
The bill would allow student athletes to sit out games if players of the opposite sex are competing. Supporters say it would protect the safety of female athletes and preserve the right of teams to protest unfair competition.
Also, on Thursday, the U.S. Department of Education said it would investigate the Massachusetts Interscholastic League for potential Title IX violations over its policy allowing student athletes to compete on teams that correspond with their gender identity.
City Council in the fray
Transgender issues have dominated recent Worcester City Council meetings. On Tuesday, the council heard jeers from some members of the LGBTQ+ community after it postponed a vote on a petition that calls for Worcester to become a sanctuary for transgender and gender-diverse people.
Some councilors expressed concern the city could lose federal funding if it backed the resolution.
Last week, the council sent two petitions related to gender issues to the city manager, one urging the city to commit to working with local LGBTQ+ communities to create an action plan around safety concerns and the second a commitment to an annual allocation of $500,000 for a 'Queer and Trans Resilience Fund."
Noah Rose, one of the architects of the resolutions, is worried that Trump's executive order could cut off federal funds for Worcester should the council support money for the resilience fund.
Rose feels that Trump's order to end federal support for transgender care for minors could further embolden some to target the transgender community.
'My fear, as queer leaders, is we won't be taken seriously in spaces where we're demanding our right to exist,' said Rose.
More education needed
Joshua Croke, president and founder of Love Your Labels in Worcester, which supports LQBTQ+ youth through art, fashion and design programs, believes the public needs to be educated about the realities of what gender-affirming care means.
It's not true, said Croke, that transgender care automatically means a high rate of surgeries for young children. In fact, he said, surgeries in this age group are "incredibly rare."
One study appears to back him up.
Researchers at the Harvard T.H. Chan School of Public Health found a small number of gender-affirming surgeries by transgender and gender-diverse minors in the United States in 2019.
There were no surgeries performed in the 12 and younger age group. That was expected, according to the study, since current international guidelines don't suggest medical or surgical interventions before puberty.
For teenagers 15 to 17, the surgery rate was 2.1 per 100,000 people. In the 18 and older age bracket, the rate was 5.3 per 100,000 people. Many of the surgeries were chest procedures.
Another study by Columbia University, published in 2023 in the Journal of the American Medical Association, showed a nearly threefold increase in the number of gender-affirming surgeries between 2016 (4,552 surgeries) and 2019 (13,011 surgeries). The number dropped to 12,818 surgeries in 2020.
Overall, 25,099 patients (52.3%) fell in the 19 to 30 age range; 10, 476 (21.8%) in the 31 to 40 group, while 3,678 (7.7%) were 12 to 18.
Breast and chest procedures accounted for a greater percentage of surgeries in younger patients, and genital surgeries had higher numbers in older patients.
The most common surgeries were breast and chest procedures for 27,187 patients (56.6%), followed by 16,872 for genital reconstruction (35.1%) and 6,669 for facial and cosmetic procedures (13.9%).
Youth perspective
Caelum Lam, 19, was born and raised in Worcester, identifies as gender queer, and said he gives advice to high school and college students seeking transgender health care.
Lam feels it's important for teenagers and late teenagers to have access to this care as they navigate into adulthood.
It's especially important in Worcester, he said, because a significant number of the city's youth who want to transition rely on Medicaid to pay the bills. If Trump's executive order cuts off access to that government-funded insurance, then Lam, a freshman at the College of the Holy Cross, said the consequences would be unsettling.
"Removing care strips away happiness and the future of our children," he said.
Is Trump's order legal?
'I think the executive order is dangerous and unconstitutional,' said Jessie Rossman, legal director at ACLU Massachusetts. The ACLU field a lawsuit Tuesday in federal District Court in Maryland on behalf of two transgender young adults and five transgender adolescents and their families that challenges the executive order.
Rossman declined to speculate on how the court would rule, and explained the ACLU's lawsuit is grounded on several legal fronts. One is that Congress, not the president, has the authority to restrict federal grants.
Another is that the executive order violates the Affordable Care Act's ban on sex discrimination in health care programs and services that receive federal financial assistance. It also, said Rossman, violates the disability discrimination provisions in the Rehabilitation Act of 1973.
In addition, the order violates the U.S. Constitution's equal protection clause, she said.
'Waking nightmare'
The Killay family will be watching developments closely.
Danielle Killay said her family loves Worcester and wants to stay. However, if federal policies make it difficult for Ava to live the life she wants, Killay said her family may have to uproot.
'It's a waking nightmare,' she said.
Contact Henry Schwan at [e-mail]. Follow him on X: @henrytelegram.