Kaiser Permanente will pause gender-affirming surgeries for young patients starting next month, citing political pressure from the Trump administration.

The healthcare provider, which serves more than 12 million people in California and several other states, announced Wednesday that as of Aug. 29, its doctors will stop performing gender-affirming surgeries for patients under 19. The healthcare giant — founded and still headquartered in Oakland — operates 40 hospitals and 612 medical offices in eight states and Washington, D.C.

“As the legal and regulatory environment for gender-affirming care continues to evolve, we must carefully consider the significant risks being created for health systems, clinicians, and patients under the age of 19 seeking this care,” Kaiser said in an email, citing recent “executive orders instructing federal agencies to take actions to curtail access and restrict funding for gender-affirming care.”