UVA Health resumes gender-affirming care after federal judge’s order

Updated Feb. 15

A federal judge in Maryland on Thursday issued a temporary restraining order that suspended President Donald Trump’s Jan. 28 executive order banning gender-affirming medical care for people under the age of 19, impacting patients and hospitals across the country, including in Virginia.

Trump’s original order — as well as Virginia Attorney Gen. Jason Miyares’ interpretation of it — led to a pause in transgender care for minors by UVA Health and VCU Health in late January, but with the judge’s ruling Thursday, UVA Health said it has resumed treatment for minor patients.

“Now that a federal court has issued a temporary restraining order suspending the federal executive order on gender-affirming care, UVA Health will resume the provision of those services that were previously paused in response to the order,” the health system affiliated with the University of Virginia said in a statement Thursday. “UVA Health will continue to monitor legal developments in this case and provide our patients with the best care possible under Virginia and federal law.”

VCU Health at first issued a statement Thursday that it would be reviewing the order “to determine an appropriate course of action” while continuing the suspension of services, but on Friday evening, it sent out the following statement:

“VCU Health and Children’s Hospital of Richmond at VCU have received verbal guidance from the governor’s office that the Virginia attorney general’s prior directive that prohibits gender-affirming services outlined in the White House’s executive order still stands.

“Our doors have remained open, and will continue to be open, to all patients and their families for screening, counseling and all health care needs not affected by the executive order.

“We will continue to monitor developments and respond with a continued focus on our patients.”

Norfolk-based Children’s Hospital of The King’s Daughters, which suspended the prescribing of hormone therapy and puberty blockers for gender-affirming care in February, did not respond to requests for comment Friday, but still had a notice posted on its website with the following statement: “CHKD is suspending hormone therapy and puberty blocker treatments for gender-affirming care per the White House Executive Order issued on January 28, 2025. We will remain vigilant in monitoring guidance related to this Executive Order and will be prepared to adapt rapidly if the situation changes.”

The hospital noted that it has never offered surgical treatments prohibited by Trump’s order.

Trump issued the executive order Jan. 28, and Miyares, a Republican, sent a memo to UVA Health and VCU Health on Jan. 30 advising the two publicly funded university-affiliated health systems that Trump’s executive order prohibits treating a person under 19 with puberty blockers or hormones such as androgen blockers, estrogen, progesterone or testosterone “to align an individual’s physical appearance with an identity that differs from his or her sex.”

Miyares also interpreted the order as prohibiting any surgical procedures that “attempt to transform an individual’s physical appearance to align with an identity that differs from his or her sex or that attempt to alter or remove an individual’s sexual organs to minimize or destroy their natural biological functions.”

Under state law, minor patients require parental consent to receive any of these treatments.

Miyares said in his memo that “any hospital or other institution … is at risk of losing” federal research or education grants, and “may involve Medicare or Medicaid conditions of participation/coverage.”

CHKD, as a private health system, did not hear directly from Miyares, but like many larger hospitals and health systems, it receives federal funding through Medicaid, which could have been at risk if the hospital had defied the president’s order. “Our determination is consistent with actions taken recently by our colleagues at UVA, VCU and other hospitals across the nation,” the Norfolk health system said in its statement Feb. 3.

CHKD’s website notes that Medicaid covers approximately 55% of its inpatient days, “the highest percentage by far of any acute care hospital in Virginia.” Also, CHKD “has a large annual shortfall between the costs we incur caring for Medicaid patients and the reimbursements we receive from Medicaid,” including $33 million in fiscal 2022.

Federal lawsuit

A few days after Trump’s order took effect, a group of transgender youth, young adults and family members joined the ACLU, GLMA and PFLAG in a federal lawsuit challenging Trump’s executive order filed in a federal court in Maryland.

One 17-year-old plaintiff, Willow, and her mother live in Richmond; according to the lawsuit, Willow had a Jan. 29 appointment canceled at VCU Health, where she sought gender-affirming medical treatment with her mother’s permission.

U.S. District Judge Brendan A. Hurson ruled Thursday that the temporary restraining order will be in effect for 14 days, and that the plaintiffs and defendants must file status reports next week.