Under the threat of losing federal reimbursement, Rady Children\u2019s Hospital in San Diego notified families Tuesday that it will stop offering direct forms of gender affirming care, including \u201cmedical interventions, procedures and prescriptions,\u201d limiting its offerings to supportive services such as \u201ccounseling, mental health resources and care coordination.\u201d<\/p>\n
The move, which was immediately decried by the region\u2019s main transgender advocacy group, comes as many children\u2019s hospitals pull back on such care, which President Donald Trump targeted with an executive order<\/a> shortly after beginning his second term in office.<\/p>\n In a short statement, Rady, the region\u2019s only hospital dedicated solely to serving children and adolescents, cited recent federal pressure to end gender-affirming care or potentially lose access to all federal Medicaid and Medicare reimbursement.<\/p>\n \u201cTaken together, these developments affect our role and responsibilities as a provider participating in federal programs such as Medicaid and Medicare, which are essential to caring for children and families in our communities,\u201d Rady said, confirming that its decision also pertains to operations in Orange County.<\/p>\n The hospital, which completed a merger with Children\u2019s Hospital of Orange County in early 2025, made it clear that this was not a decision that it wanted to make.<\/p>\n \u201cThis was a very difficult decision, made to ensure we can continue serving all children and families across the communities we serve,\u201d Rady said.<\/p>\n But Kathie Moehlig, executive director of TransFamily Support Services, a San Diego-based nonprofit advocacy group that offers its members a wide range of assistance, from support groups to health insurance coverage advice, said that those who are affected directly believe that Rady\u2019s decision to severely curtail gender-affirming services is premature.<\/p>\n \u201cOur families are devastated,\u201d Moehlig said. \u201cThis is definitely early capitulation by the leadership of Rady Children\u2019s Hospital, because all of the federal policies that have been introduced are not law.\u201d<\/p>\n She noted that two rules that seek to cut funding for hospitals that provide gender-affirming care to minors, what the U.S. Department of Health and Human Services terms \u201csex-rejecting procedures for individuals under the age of 19,\u201d remain proposals. Indeed, the two proposals in question, according to listings<\/a> in the<\/a> Federal Register, are still open for public comment, with the window for making statements for or against open until 5 p.m. on Feb. 17, 2026.<\/p>\n Rady\u2019s statement indicated that the pressure has only increased, stating that it was \u201crecently referred to the U.S. Department of Health and Human Services Office of Inspector General for investigation.<\/p>\n Moehlig added that her members, and members of the nationwide coalition that is pushing back against limits on gender-affirming care with lawsuits, believe that concerns over referrals to the Department of Justice are overblown.<\/p>\n \u201cI believe that the OIG has issued referrals for investigation to six or eight hospital institutions,\u201d Moehlig said. \u201cThat does not mean that they\u2019re really under investigation, and those have literally been announced over Twitter.<\/p>\n \u201cThe investigator general can refer anybody for investigation; it doesn\u2019t mean that an investigation is happening, and it doesn\u2019t mean that Rady Children\u2019s Hospital is doing anything illegal. This care is still legal in the State of California.\u201d<\/p>\n She added that there is a different precedent that Rady could have followed.<\/p>\n \u201cThere are other institutions in the country that are fighting back, that do have lawsuits against the federal government,\u201d Moehlig said. \u201cBoston Children\u2019s Hospital was referred for investigation; they\u2019re pushing back.\u201d<\/p>\n Rady declined Tuesday evening to respond to those criticisms, indicating in an email that its statement is all that the hospital intends to say about gender-affirming care at this time. It is not alone in deciding to retrench gender-affirming care in the face of heavy federal pressure. Media reports indicate<\/a> that Children\u2019s Hospital Los Angeles pulled back in mid-2025. Children\u2019s National Hospital in Washington, D.C., announced a similar action in July 2025 with Children\u2019s Hospital Colorado reported to have suspended its program in early January.<\/p>\n Rady, which has been named one of the best in the nation by U.S. News and World Report for the specialty care it offers, did not respond when asked how many patients its gender-affirming care program served at the time that notices went out Tuesday.<\/p>\n Moehlig said that TransFamily Services is aware of about 1,000 patients served by Rady\u2019s gender clinic, though many of those in treatment, she added, are in the 19-to-24 age group and thus are no longer technically minors. She said that there is an understanding in the community that this group will continue to receive care but that treatment will eventually be \u201ctransitioning to others.\u201d<\/p>\n