Ann & Robert H. Lurie Children's Hospital is pulling back on gender-affirming medical care for minors, trimming a program that for years has served transgender and gender-diverse young people in Chicago. The hospital said it will no longer start gender-affirming medications for patients under 18 who are not already on such treatments at Lurie, a major shift arriving just as the federal government turns up oversight on pediatric gender care and the legal and financial stakes rise for hospitals.
In a statement to the Chicago Tribune, Lurie linked the move directly to "actions by the U.S. Department of Health and Human Services, including its announcement referring Lurie for investigation." Hospital leaders said they are reshaping services while they gauge how those moves could affect Lurie's participation in federal programs. As outlined to the Tribune, new patients under 18 will not be started on gender-affirming medications, while mental health support and other elements of the gender-care program will continue for existing patients.
The change follows an expansive HHS action in December that labeled puberty blockers, cross-sex hormones and certain surgeries as "neither safe nor effective" for children and proposed rules that would cut Medicare and Medicaid participation for hospitals providing those interventions, according to HHS. That declaration has already helped spark lawsuits and prompted legal guidance warning hospitals about the risk of being shut out of federal health programs. Systems across the country are reexamining their pediatric gender services in light of the agency's stance.
Federal pressure ratcheted up again when HHS officials publicly signaled referrals for investigation. The department's general counsel posted on X that several children's hospitals had been sent to the HHS Office of Inspector General, and Bloomberg Law reported that Lurie was among those named. Such referrals open the door to audits or even exclusion from federal programs for hospitals that rely on federal dollars, a scenario administrators say they have to take seriously.
What This Means In Chicago
Lurie treats a large share of kids covered by Medicaid and leans heavily on federal funding; reporters have noted that in 2022 about half of its patients were insured through Medicaid, which raises the stakes for any threat to its federal ties. As WBEZ reported last year, the hospital had already paused gender-affirming surgeries for patients younger than 19 in response to earlier federal moves, and other local providers have tightened their offerings as well. Families say that combination has meant canceled referrals, scrambled appointments and a lot more stress trying to maintain stable care for their kids.
Medical Community Response
The American Academy of Pediatrics still backs developmentally appropriate, gender-affirming care as part of standard pediatric practice, according to its policy statement from the AAP. At the same time, systematic reviews and long-term studies have generally found that gender-affirming medical treatments are associated with improvements in depression, suicidality and overall well-being for many young people, as outlined in a recent scientific review on PMC. The gap between federal policy signals and the positions of major medical groups sits at the heart of the public fight and the growing stack of legal challenges.
Legal implications
Those legal battles are already underway. A coalition of states has sued HHS over the December declaration, according to the Associated Press, while pediatric organizations pursue their own claims in defense of gender-care programs. Legal analysts note that exclusion by the HHS Office of Inspector General, which would keep a hospital from billing Medicare and Medicaid, is among the possible enforcement tools flowing from the declaration, a risk laid out in an analysis by Reed Smith. For hospitals serving large numbers of publicly insured children, that prospect is a key reason many are now pulling back.
What's Next
HHS has moved its proposed rules into the public comment process, and legal and policy observers expect the court fights and regulatory wrangling to stretch into 2026. State officials and advocates in Illinois have signaled they plan to push back if access is cut off, while Lurie maintains that it will keep providing mental health and other supports for current patients as it studies the shifting rules, according to the Chicago Tribune. For families on the ground, that likely means more weeks of uncertainty while regulators, attorneys and hospital leaders sort out where the lines will be drawn.
