Citing Funding Risks, Clinics Cancel Gender-Affirming Treatment for Adults

A late Friday announcement from the Centers for Medicare and Medicaid Services (CMS) has prompted some Arizona providers to cancel gender-affirming care for transgender adults, limiting access to what doctors consider life-saving treatment for thousands of Arizona residents.

In a letter dated April 11, CMS State Deputy Administrator and Director Drew Snyder claimed that surgery and treatment for gender dysphoria lacked sufficient evidence and could cause “long-term and irreparable harm.”

The letter relied heavily on the United Kingdom's use of the Cass Review, a medical study on transgender youth that gave anti-trans lawmakers ammunition in denying medical care and passing transphobic legislation. But that review has been hotly contested, mainly for the way it conducted the research and its long-term effects globally.

Other research—though limited—indicates that gender-affirming care is successful in battling depression and negative feelings. In one study, access to gender-affirming care for minors has shown reduced feelings of self-harm, including suicide. Most recently, studies in transgender adults showed that after receiving treatment, feelings of depression lowered. And people who regret their surgical intervention—which is already rare among transgender people—is significantly lower when compared to people who had more common surgeries, such as knee replacements.

Phoenix Children’s Hospital “Indefinitely” Ending Gender-Affirming Care

The move comes alongside other major city’s children’s hospitals doing the same.

LOOKOUTJoseph Darius Jaafari (he/him)

Still, CMS Director Dr. Mehmet Oz—who ran as a pro-Trump candidate in Pennsylvania and lost to Sen. John Fetterman in the 2022 election—announced Friday that the agency would no longer cover transgender medical services. He said any providers continuing to offer such services would risk losing federal funding.

“Medicaid dollars are not to be used for gender reassignment surgeries or hormone treatments in minors,” Oz said. That directive now appears to include adult patients as well.

The impact is already being felt in Arizona. At least one adult patient receiving gender-affirming care at Planned Parenthood’s Mesa clinic was told the organization would no longer provide services, citing the threat from the Trump administration.

Clariece, a 23-year-old patient who has been receiving care at the Mesa Health Center for six months, was informed her Monday appointment had been canceled. (LOOKOUT is withholding her last name because she is not out as transgender at work.)

She said the organization told her they were calling transgender patients to inform them that hormone therapy at Arizona clinics was being temporarily paused.

“The type of appointment you were scheduled for is a service line that we are temporarily pausing,” a voicemail left for Clariece at 4:30 p.m. Thursday stated. “We are calling all of our patients over the next week and pausing and canceling all of the appointments.”

Clariece said she called the clinic back at 5 p.m. and was told by the clinic manager that all Planned Parenthood locations in Arizona would pause gender-affirming treatment. Staff said they are working to refer patients to providers that do not rely on federal funding, she told LOOKOUT on Friday night.

In a statement Saturday, a Planned Parenthood Arizona spokesperson said:
“At this time, Planned Parenthood Arizona is pausing gender-affirming care services as we continue to review and evaluate this order. We are committed to keeping our patients updated about the services we provide and will communicate further once we can provide more information.”

Most Planned Parenthood patients in Arizona are on Medicaid and rely on the organization for a broader range of services, including birth control and STI testing and treatment. Continuing to offer gender-affirming care despite the CMS order could jeopardize those services statewide.

Still, critics are sure to call the move a form of “pre-compliance,” similar to what occurred when other clinics across Arizona—most notably Phoenix Children’s Hospital—ended youth-focused transgender care programs in early March. It’s unclear what legal or political avenues are being pursued to challenge the CMS decision.

The pause in adult care marks a significant shift. Until now, federal restrictions have largely focused on transgender minors. Recent efforts to restrict adult care have occurred at the state level: In Ohio, Gov. Mike DeWine proposed limiting transgender care for adults last year, then reversed course. In Kentucky, lawmakers overrode a governor’s veto to ban gender-affirming care for Medicaid recipients.

Federal Court Decision On Trans Youth Care Leave Some In Limbo.

Last week, Prisma Community Care resumed providing gender-affirming healthcare for their youth patients, while Phoenix Children’s remains quiet on their next moves.

LOOKOUTJoseph Darius Jaafari (he/him)

Meanwhile, states such as Colorado are trying to expand coverage for transgender care for both youth and adults.

These developments come amid a national debate—often fueled by misinformation—over transgender medical care. A recent study by the progressive think tank Data for Progress found that while Americans are deeply divided on the issue, a majority believe governments should not interfere with individuals’ medical decisions.