Anger after University of Michigan shuts down gender-affirming care for youth

by Jon King, Michigan Advance

Fear and anger have rippled through the trans community following the University of Michigan Health System’s announcement this week that  it would stop providing medically necessary gender-affirming care service for minors under pressure from the Trump administration.

For many families of trans loved ones, the fear is not just that medically proven health care is being withdrawn. It’s also that a White House that has been openly hostile to transgender people may seek legal persecution.

One organization that is seeking to provide comfort, information and resources is Michigan-based Stand With Trans. The group’s director of clinical services speaks about fallout from the decision. 

What follows is a conversation that has been edited for length and clarity. Questions are in bold, and Andrews’ responses are in regular type.

How are your clients reacting to the decision by the University of Michigan and what steps are they taking to try and deal with it? 

I think a lot of families are panicked and are very anxious, and I actually think a good representation is the Trevor Project, which put out a survey a year ago. One of the questions was, “How many youth have been affected by political or policy making in their state, and has that caused an increase in depression and anxiety?” I think it was about 90% had been impacted by these policies in a negative way. 

I see that on an individual level with the clients that I serve. I have several families where they’ve been with [The University of Michigan gender clinic] since forever. I have a kid that socially transitioned when she was 5 and now is 16 and so it feels so close to the finish line, and it feels like the rug has been pulled out.

I think that the internalization that people feel is, “Well, people don’t care about me. They don’t care about my dignity. They don’t care about my health. They don’t care if I live, they don’t care if I die, so why does it matter? Why does my life matter?”

How do you talk a 16-year-old off the ledge when it is very clear that the government around them doesn’t care and keeps trying to strip them of their rights? It’s very sad, but there’s a lot of people fighting and it’s not hopeless. I do think that there is a lot of hope. I do think that there is a lot of change that is trying to be made, but in this moment, it just is hard I would say. 

For the broader public, the idea that gender-affirming care is life-saving is largely either misunderstood or just disbelieved, and many have bought into the notion that gender-affirming care is cosmetic in nature.

Yes, that is absolutely 100% true. I do think there’s lots of misinformation, and I think it also should be stated that gender-affirming care is not just medical care. There are some levels of affirmation, and gender-affirming that comes from social transition or the clothes you wear or the therapist you can have or the name you have or someone respecting your pronouns or your family finally acknowledging your pronouns. All of that is care and I think that gender-affirming care is just seeing someone as they are. 

I do think gender-affirming care has gotten a bad reputation, because also a lot of times people hear about surgery, where most of the time it’s very, very, very, rare for someone under the age of 19 to get surgery. I’m not going to say that it doesn’t happen, but I do think it is very rare and that that part is misunderstood, that people are just chopping off body parts and all of these extremes where that’s actually not true most of the time. It is very small, again a name change, a haircut, a different style, things that are also very typical for youth and sometimes adults, too, that we go through, you know, different things where we are trying to find who we are.

The University of Michigan made this decision after being sent a subpoena by the Department of Justice, looking for medical records, including names and medical procedures. The federal government wants personal, private medical information, and while today they’re going after trans individuals’ medical records, doesn’t it open a door that maybe next they’re going to go after someone else’s records for some other reason? 

Absolutely. I think that any type of infringement on your rights or pushing the boundaries of what the federal government can or cannot do will always be nerve-racking and a little bit scary. I think this comes back to when people were really scared in Texas when they were trying to remove kids from the care and put them in child welfare or foster homes if they caught the parents doing any type of gender affirming care and there was a panic of, “Am I on the list? Is there a list somewhere?” Sometimes it’s a little bit paranoid, but I think sometimes in moments like this where it feels very valid. It’s a slippery slope. It’s not just about trans health care, this is about all of us and the access and the rights that we have as individuals and as American citizens to have privacy, and that is definitely being infringed on.

I understand Stand with Trans is putting together a list of resources for families? 

Yes. We have started to build some resources and some other referrals of places that are known in Michigan, in the Midwest, that at least today are still taking patients.

If people have questions and they would like to find out if there’s a resource they can turn to, should they just call your hotline? 

Stand with Trans does have a hotline number (833-HELPSWT or 833-435-7798) where people can call, and it is staffed [from 9 a.m. Eastern to midnight] by volunteers. We also have an info email (info@standwithtrans.org) that people can email and that is checked regularly. 

People can also join our support groups. There are still support groups for both young adults to use and parents and caregivers.

We also have our mental health care that we do and we still are taking patients, so if someone is maybe needing more individualized care or family therapy, then we can see them as well for that.