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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.

Status of federal agency’s lawsuit against Capital One unclear

A lot has happened since Jan. 20, as the Trump White House employs “shock and awe” tactics at lightning speed. Among the consequences is the shutdown of the Consumer Financial Protection Bureau, a government watchdog over private industry.

Specifically, the CFPB’s pause in work leaves in question a major federal lawsuit against McLean-headquartered Capital One and its parent company, Capital One Financial, filed in the U.S. District Court for the Eastern District of Virginia.

On Jan. 14, in the waning days of the Biden administration, the CFPB filed suit in federal court against the credit card giant and its holding company, alleging the companies cheated millions of consumers out of more than $2 billion in interest payments.

The CFPB alleged that Capital One misled consumers about “high interest” accounts, claiming Capital One Financial illegally deceived consumers and that Capital One N.A. — a national bank and wholly owned subsidiary of Capital One Financial — violated the Truth in Savings Act by falsely representing the 360 Savings accounts as providing a variable interest rate that was “one of the nation’s” “top,” “best” and “highest” and that customers would earn much more interest than with the average savings account.

Capital One responded with a statement last month following the filing: “We are deeply disappointed to see the CFPB continue its recent pattern of filing eleventh-hour lawsuits ahead of a change in administration. We strongly disagree with their claims and will vigorously defend ourselves in court.”

Just over a week later, Donald Trump entered office and since then has issued dozens of executive orders, some of which shut down entire government agencies, including the CFPB. The bureau’s director, Rohit Chopra, was fired, and Trump named Office of Management and Budget Director Russell Vought as its acting director on Friday, Feb. 7.

Over the weekend, the agency, which has a mission to protect consumers in the financial sector, reportedly sent multiple missives to workers telling them that its Washington, D.C., headquarters were closed and that they should not do any work.  On Monday, the White House issued a news release calling the CFPB, which was created by Congress in 2010 in response to the 2008 banking crisis, a “woke, weaponized arm of the bureaucracy that leverages its power against certain industries and individuals disfavored by so-called ‘elites.’”

“Under the administration of President Donald J. Trump, the weaponization ends right now,” the release stated.

What that means for the lawsuit

CFPB’s case against Capital One remains on the docket at the U.S. District Court of the Eastern District of Virginia’s Alexandria courthouse. However, several legal experts have speculated publicly that any CFPB enforcement actions will be shut down.

On Feb. 4, attorneys representing CFPB filed a request for an emergency motion for a temporary stay of deadlines related to whether the case should be consolidated with a class-action multidistrict lawsuit brought by Capital One 360 Savings accountholders “to promote consistency with the goals of the new Administration.”

A judge denied the motion for a temporary stay and gave the CFPB until Friday to file its position on consolidation.

“I’m very curious to see what happens tomorrow and how the bureau is going to proceed, because they’re in a court that moves very quickly and they want to know the CFPB’s position about how they’re going to move forward, but it doesn’t seem like they’re really willing to accommodate too many extensions to hear from the CFPB about that,” explained Erin Witte, the director of consumer protection for the Consumer Federation of America (CFA), a Washington, D.C., association of nonprofit consumer organizations.

Witte shrugged off the fact that the lawsuit was filed in the final days of the Biden administration.

“It’s clear Capital One intentionally steered their customers out of a product that would have paid them more money, and they did it in a way that made it difficult for their account orders to figure out that that was even happening,” she said. “I mean, this is not a political football. This is a pretty clear violation of law when you read the allegations.”

Neither attorneys representing Capital One Financial in the lawsuit or the company’s spokespeople or the media office for the CFPB responded Thursday to requests for comment.

U.S. Sen. Mark Warner, Virginia’s senior Democratic senator, said Thursday in a media availability that he doesn’t follow individual actions filed by the CFPB, when asked about the Capital One lawsuit.

“In certain areas, I think they were very aggressive,” Warner said. “I have no problem with CFPB doing its job, but do it the way where you try to work with the litigant first.”

Warner pointed to the CFPB’s report that it has returned billions of dollars to consumers through law enforcement activity since its creation.

“What I do have the problem with is an organization that’s returned over $20 billion to consumers because of fraud, because of rip-off scams, arbitrarily being shut down with no warning,” he said. “I mean, what happens if it’s the FBI next? What happens if it’s…. [the] Environmental Protection Agency, just because it’s in the political crosshairs of some of the very wealthy folks who make up the Trump administration.”

Warner said that if President Trump wants to reform CFPB or any federal entity, he should present his ideas to the U.S. Congress, rather than taking unilateral action.

“Then we can try to come to agreement,” Warner said. “What we can’t come to is by executive fiat and a stroke of a pen, this president dismantling wide swaths of government that have broad bipartisan support. That’s just not the way the Constitution and system works.”

The CFPB’s shutdown comes amid fast-moving agency takeovers by Trump adviser Elon Musk, the world’s richest man and head of the newly created Department of Government Efficiency, or DOGE. Although some federal judges have put injunctions in place, Musk and his DOGE aides have received access to sensitive federal data, including personal and financial information of the nation’s more than two million federal workers.

Trump has given Musk the authority to cut the federal workforce and spending in many sectors, although the U.S. Post Office, military branches and border enforcement are mostly immune to cuts.

In the Feb. 10 press release, the Trump White House made several claims about the CFPB, including that in the waning hours of the Biden administration, “it gave itself the authority to regulate Americans’ checking accounts by dictating government price controls and unilaterally buried $50 billion in medical debt.”

That was in reference to the CFPB’s finalizing a rule in January under Biden that would keep medical debt from being included on credit reports. It was set to take effect in March. However, an executive order issued by Trump paused all rulemaking activity for 60 days.

Pushback on CFPB’s closure

The CFA issued a press release Sunday noting Congress transferred consumer financial protection functions to the CFPB when it formed. “Unless Congress passes legislation, the suspension of supervisory work by the CFPB will not result in those responsibilities being returned to the agencies that formerly had them,” the association stated.

“The CPFB was created after excessive risk-taking by financial companies, many of whom were not supervised by a federal regulator, crashed our economy,” Adam Rust, CFA’s director of financial services, said of the CPFB’s shuttering in a statement. “Millions of people lost their homes, work, savings, and businesses. It was created to protect people, not empower Elon Musk. If this administration chooses to cover its eyes from the facts, people will be put in harm’s way. This is a free pass for financial institutions to take advantage of consumers.”

The National Treasury Employees Union filed two federal lawsuits Sunday against Vought, alleging that “the administration has unlawfully trampled the power of Congress to create a federal agency that it deemed necessary to protecting American consumers” and that the CFPB violated the Privacy Act by disclosing employee records to the U.S. Department of Government Efficiency.

Associate Editor Katherine Schulte contributed to this article. 

Trump’s steel, aluminum tariffs could impact Va. economy

President Donald Trump imposed 25% tariffs on steel and aluminum imports Monday. Now, the world waits to see what impact they will have.

“If you look at the behavior of investors, investors are signaling again that they don’t believe these tariffs will be long-lived,” said Bob McNab, chair of Old Dominion University’s Department of Economics and director of the Dragas Center for Economic Analysis and Policy. “If you’re looking at statements from the administration and president, they are suggesting that the tariffs may be in place for a while.”

After all, McNab noted, U.S. stocks rose Monday.

So far, Trump’s threatened tariffs on Mexico and Canada have led to deals to delay enforcement, preventing retaliatory tariffs by those countries, so investors are not sure whether the steel and aluminum tariffs are for real or a bargaining chip. Trump told reporters about the tariff announcement as he flew to Louisiana for the Super Bowl on Sunday.

But depending on how long the tariffs are enforced, McNab said, Virginia consumers and business owners could take a hit to their pocketbooks.

“If we see the tariffs come into play and remain in force for an extended period of time, then prices of imported steel and aluminum obviously are going to rise, but the price of domestically produced steel and aluminum will rise as well, and those costs will be passed along to American businesses and consumers,” he said.

McNab described a person standing in an empty pool and holding a hose to fill it with water.

“It might start off barely nipping at your toes, and at some point it’s at your knees, and at some point it’s at your nose, and then it’s above your head,” he said. “Sort of like that, the effects will accumulate over time and grow larger over time as the costs of goods increase, and then we start to see firms and consumers make decisions about consumption due to the higher price of goods.”

The tariffs will have a bigger impact on states where steel and aluminum production is concentrated than it will on the commonwealth, McNab believes.

“I haven’t seen anything that suggests that we’re wildly different from any other state,” he said of Virginia.

In 2018, Trump imposed tariffs of 25% on steel and 10% on aluminum, although some countries — including Australia, Canada and Mexico — got breaks on the duties.

The Biden administration later rolled back some trade restrictions on steel and aluminum tariffs with the European Union, the United Kingdom and Japan.

Fred Treyz, CEO and chief economist of REMI, a Massachusetts based policy modeling firm, said northern states with economies that rely heavily on automotive manufacturing stand to take larger hits, because those companies work hand in hand with Canada.

“That’s disruptive to the auto industry, even to the U.S. side of the auto industry because they’re working together,” he said.

For Virginia’s aluminum manufacturers, he said, tariffs could actually help business by providing protection from competition outside the United States, Treyz said. “So it does tend to give the domestic manufacturer more pricing power, so they can increase their prices and increase their output if they’re not facing the international competition.”

Neither Crown Holdings, which has a beverage can manufacturing facility facility in Henry County, nor Belvac, which produces technology for the two-piece can industry at a Lynchburg facility, immediately returned a request for comment.

Chris Gregory, executive vice president at SteelFab, a steel fabricator with a fabrication plant in Emporia, sent an email Monday night, explaining that the company was waiting to learn more details about the tariffs. “But we are bracing ourselves for pricing increases across the board,” he wrote. 

Ben Phelps, vice president of Frederick County’s Winchester Metals, explained in an email that tariffs would impact the steel distribution, processing and fabrication facility, but added that it won’t necessarily be in a negative way.

“We generally pass on any raw material increases that we incur to our customers,” he wrote. “Our business is more transactional as opposed to contractual, so we’re not locked into price points.”

Impact on data centers

It’s well established that Virginia is popular with data center developers because of its location near Washington, D.C., and internet exchange points, as well as its business friendly environment.

Data center developers are also fans of steel, which they often use for the exteriors of buildings and for use in things like enclosure racks and HVAC systems.

David Smith, a senior vice president with Cushman & Wakefield | Thalhimer, doesn’t think the tariffs on steel imports will cause data center developers to hit pause on their plans, however.

“I wouldn’t expect the tariffs to have a long-term negative impact on data center development at all,” said Smith, who specializes in land sales in the Richmond area and often works with data center developers.

The cost of real estate and the cost to put up data center buildings “relative to what the data centers generate in income is very small,” he said.

The increased cost of materials due to tariffs won’t be enough to erase that profitability, according to Smith. For developers who are just beginning their journey to get data centers built, he said, tariffs are likely be a nonfactor. It takes developers an average of four to seven years to get the necessary approvals from localities and utilities after purchasing land to build data centers, according to Smith.

“It would be my expectation that the tariff situation on steel and aluminum by that time will be long ironed out and resolved,” he said.

Last week, Trump threatened to impose 25% tariffs on goods from Canada and Mexico as retaliation for illegal immigration and fentanyl trafficking. However, he later agreed to pause those discussions for 30 days after leaders in both countries issued plans to increase border security. Trump implemented a 10% tariff on China last week and Chinese tariffs of 10% to 15% on some U.S. products were set to take effect Monday.

NoVa could feel pain if Trump cuts federal office space

Northern Virginia is sure to weather aftershocks if the Trump administration moves forward with plans to shutter half of the properties owned and leased by the federal government.

“We’ll see some strong reverberations,” said David Tarter, executive director for the Center for Real Estate Entrepreneurship and the master’s in real estate development program at George Mason University. “That’s a lot of office space coming back on the market.”

Michael Peters, commissioner of the U.S. General Services Administration’s Public Buildings Service, publicly stated last week that the agency, which builds and acquires office space for other federal agencies, plans to cut the square footage in the agency’s portfolio by 50%. Additionally, he said the GSA plans to cut the amount of office space it uses (along with cutting the number of employees at the agency).

Peters, who was appointed to his new role by President Donald Trump at the end of January, spoke Jan. 28 during a meeting of the Public Buildings Reform Board, which has a mission to make recommendations about whether federal properties should be sold or redeveloped. The Federal News Network reported that at the meeting Peters said the agency probably won’t be able to shed that much of the federal government’s office space in six months, but he added, “we’re going to try to do this as rapidly as we can.”

It’s part of an overall effort to shrink the federal government’s footprint, as Trump and world’s wealthiest person Elon Musk, head of the Department of Government Efficiency (DOGE) and owner of X, SpaceX and Tesla, aim to persuade 5% to 10% of federal employees to resign or face layoffs in the near future.

The GSA did not respond to a request for comment for this story.

It’s too soon to have a detailed analysis of what this plan could mean for Northern Virginia’s office market, according to Marcy Owens Test, the Washington, D.C.-based head of the Federal Lessor Advisory Group for CBRE, a Texas-based global commercial real estate services and investment company.

“It’s really an evolving situation,” she said. “It seems like things are happening really, really fast, but it will take some time for all of this to get clear.”

The GSA’s National Capital Region — which includes the cities of Alexandria and Falls Church, and Arlington, Fairfax, Loudoun and Prince William counties in Virginia, as well as Washington and parts of Maryland — has a portfolio of about 44 million square feet of leased space.

The Virginia section of the National Capital Region has 16 million square feet of leased office space and 185 leases, according to CBRE data. Leases for just over 5 million square feet expire over the next four years and about 500,000 square feet expires in the next four years if termination options are executed, Test explained.

As far as federally owned property, the Virginia section of the GSA’s National Capital Region has six buildings, according to Test.

“This is just GSA portfolio,” she stresses. “It doesn’t have anything to do with the Pentagon.”

Playing defense

Having a heavy occupation of federal agencies connected to defense is one thing that Northern Virginia has going for it, according to Steven Teitelbaum, faculty coordinator for real estate specialization at the Kogod School of Business at American University in Washington, D.C.

Northern Virginia has less to worry about since more of its office spaces are occupied by defense-oriented federal agencies than Maryland or Washington.

“I’m just guessing that, given the emphasis of the current administration on defense, that they’re not going to be terminating defense leases,” he said.

Teitelbaum, previously a commercial real estate lawyer, stressed that the government is locked into office space leases “pretty much the same as a private sector tenant.”

Even so, he also acknowledged that President Trump and some of his associates have shown “that they’re willing to bend the rules or break the rules and see if anybody tries to prevent them from doing that.”

“They may just say, ‘We’re out of here. Come after me.’ Right?” Teitelbaum said.

And that could have broader ramifications. “That really turns a lot of things on its head and sends a certain message to the market,” he said.

Ryan Touhill, director of Arlington Economic Development, said it’s too early to worry about the federal government downsizing its portfolio of leased office space.

“We have a strategic plan for economic growth that we are focused on, and we recognize the importance of the federal government, but …things are way too early to make any kind of shifts in our strategy or policy,” he said.

If the federal government does ultimately decide not to extend leases of office space in Arlington County, “we’ll have to deal with that if that comes,” Touhill said.

Circumstances vary

Still recovering from the pandemic when massive numbers of employees began working from home, Northern Virginia had an office vacancy rate of 17.8% in the final quarter of 2024, according to data provided by Virginia Realtors. A high vacancy rate is typically considered anything about 10%.

The hit could be more or less painful depending on how quickly the GSA sheds its inventory, according to GMU’s Tarter, who’s also a former commercial real estate lawyer.

If the federal government sets a policy to not renew office building leases as they expire, he explained, vacancies will be spread out over a period of years, giving the market more time to absorb the available space.

If the federal government decides, on the other hand, to pay the remaining owed rent on a lease and gets out of dodge, Tarter said. “I think it’ll have a much more significant impact because it’s sort of a flood of office space hitting the market all at once.”

Overall office rent in Northern Virginia was $34.35 per square foot in the fourth quarter of 2024, according to data provided by Virginia Realtors.

If the federal government sheds 50% of its office portfolio in Northern Virginia, Tarter speculated, it will keep rent prices where they are, or “rents could go down beyond what they are now.”

An increase in office vacancies, according to Tarter, generally can lead to lighter coffers for localities, who collect property taxes from the owners of office buildings.

“When commercial buildings are unoccupied, or they’re mostly vacant, they’re not worth as much, so that means that local governments will get less [in] property taxes,” he said.

Judge hits pause on Trump/Musk federal workforce buyout deadline

Less than 12 hours before the Trump administration’s midnight Thursday deadline for 2 million federal workers to decide whether to accept a controversial buyout plan, a federal judge temporarily paused the clock, setting a hearing on the matter for Monday. Three unions representing about 800,000 federal workers filed the lawsuit to stop the deadline.

In an email sent to more than 2 million federal workers last week, the Office of Personnel Management set a deadline of 11:59 p.m. Thursday for employees to accept the buyout, which has prompted confusion and uncertainty among Virginia’s large population of federal workers who were promised a seven months’ salary severance package if they resigned by the deadline.

As of Wednesday night, more than 40,000 federal workers, or about 2%, had accepted Trump’s offer, according to a Washington Post report, well below the 5% to 10% in resignations President Donald Trump and his selected Department of Government Efficiency (DOGE) head, Elon Musk, have been aiming for.

On Tuesday, U.S. Sen. Tim Kaine, D-Virginia, sent a message to Virginia’s federal workers, many of whom aren’t sure whether their jobs will exist this time next year, to not trust or accept the buyout.

Kaine noted that Virginia has about 140,000 residents who work for the federal government. Some employees have been locked out of their offices and computers. Musk, the world’s wealthiest person and the owner of SpaceX, Tesla and X, has gained access to millions of federal employees’ personal information, including salary details and addresses, according to news reports.

“I know it has been — and will continue to be — tough,” Kaine said. “Donald Trump and his cronies are determined to do anything they can to knock you off course. They’ve even dangled a phony buyout in your face. But make no mistake: That buyout is a trap. Donald Trump has no authority to offer you a resignation buyout. Don’t trust a guy with a long history of stiffing contractors by taking him up on a sham deal that he won’t follow through on.”

Kaine’s Virginia colleague, senior Democratic U.S. Sen. Mark Warner, said in Robert F. Kennedy Jr.’s confirmation hearing for health secretary last week that federal workers should consider whether Trump “in his business world ever fulfilled his contracts or obligations to any workers in the past.”

On Jan. 28, the federal Office of Personnel Management sent an email to approximately 2.3 million federal workers bearing the subject line “Fork in the Road,” the same language Musk used in a buyout offer email to his employees when he first purchased social media platform X, formerly Twitter.

The “deferred resignation” deal is available to all full-time federal employees except for military personnel and employees of the U.S. Postal Service, immigration enforcement and national security, according to the Trump administration. People who stay in the federal workforce must agree to return to their offices five days a week and abide by new “performance standards” and “standards of conduct” that require employees who are “loyal, trustworthy and who strive for excellence in their daily work.”

Meanwhile, in Richmond, Virginia House of Delegates Speaker Don Scott on Wednesday announced the creation of the bipartisan Emergency Committee on the Impacts of Federal Workforce and Funding Reductions, a 12-delegate committee that will collect and analyze data on the potential scope of federal workforce and funding cuts, assess economic and budgetary impacts on the state and listen to state agencies, businesses and nonprofits to “understand their concerns and gather mitigation strategies.”

The committee will provide policy recommendations for the 2026 General Assembly session and present a final report by Dec. 15.

In a Feb. 4 letter to the House of Delegates’ clerk, Scott wrote, “This administration has stated its intent to dramatically reduce the size of the federal workforce and to shift workers from the Washington, D.C., region to other areas of the country. Likewise, the newly formed advisory Department of Government Efficiency has a stated goal to significantly cut the size of the federal government.”

He also noted the hiring freeze put in place by executive order Jan. 20, the day Trump was inaugurated. Also, Scott wrote, Virginia is the “top state in the nation for place of performance of federal contracts,” with total contracts in 2023 at $106 billion. If the White House reduces federal contracts along with workforce layoffs, “Virginia will see a disproportionate impact on the economy,” the letter says.

Chaired by Democratic Del. David Bulova, the committee includes five Republican delegates and seven Democrats.

Gov. Glenn Youngkin, however, has defended the new administration’s actions, saying in a news conference late last month that Trump “received a massive, massive vote of confidence by the American people,” following a Trump-led freeze on $3 trillion in federal funding that was quickly rescinded. Youngkin also has expressed support for a five-day-a-week return to office order, saying it would help the Metro system overcome its recent funding shortfalls.

As for losing federal jobs in the commonwealth, Youngkin has said that former federal workers can qualify for private-sector jobs in Virginia, where 295,000 jobs were vacant in November 2024, according to the U.S. Department of Labor’s Bureau of Labor Statistics report released Jan. 17.

CHKD is latest Va. system to halt gender-affirming treatment for minors

Days after UVA Health and VCU Health suspended all gender-affirming medical treatments for people under age 19, Norfolk-based Children’s Hospital of The King’s Daughters has followed suit, a spokesperson confirmed Tuesday.

In a statement, CHKD noted that it has never offered surgical treatments to patients.

“With the utmost concern for our patients and our caring team of pediatric professionals, CHKD has determined that we must suspend medical treatments associated with gender-affirming care to be in compliance with the White House executive order of Jan. 28. This means that we must suspend the prescribing of hormone therapy and puberty blockers specifically for gender-affirming care. Our determination is consistent with actions taken recently by our colleagues at UVA, VCU and other hospitals across the nation.

“CHKD will remain vigilant in monitoring guidance related to this executive order and will be prepared to adapt rapidly if the situation changes,” the statement said.

To respond to patients whose treatment has been suspended, CHKD said in its statement, “our team is expediting access to appointments with physicians and with our mental health team to offer guidance, consultation and mental health services. We are wholeheartedly committed to the dignity of our patients and to the sacred trust they place in CHKD and our team of devoted physicians and clinicians.”

Unlike the two university-affiliated systems, CHKD did not receive a letter from Virginia Attorney General Jason Miyares, who last week sent a memo to UVA Health and VCU Health, informing the health systems that they must stop providing treatments to minors seeking puberty blockers, hormone treatments or surgical procedures.

In the memo from Miyares titled “Protecting Children from Chemical and Surgical Mutilation,” the Republican attorney general referred to President Donald Trump’s executive order issued Jan. 28 by the same name.

CHKD’s announcement comes as many health care systems — both public and private — consider halting gender-affirming treatments for minors, even though under Virginia law, minor patients must have their parents’ or guardians’ permission to seek such treatments.

Del. Rodney Willett, a Democratic delegate representing Henrico County who serves on VCU Health’s board of directors, said Tuesday in an interview that health systems rely heavily on federal funding, which they could lose if they don’t comply with the White House’s executive order.

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’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.

Willett, who blasted Trump’s executive order as “inhumane,” said VCU Health’s leaders’ “hands were tied. It was a devil’s choice. You’re damned if you do, you’re damned if you don’t.”

If VCU lost federal funding, “hundreds of thousands of patients” would be impacted, he said, “as it is for UVA Health.”

Private health care systems also will likely be impacted, Willett added.

On Tuesday, Roanoke-based Carilion Clinic said its status had not changed from last week, when it released this statement: “We are reviewing the latest federal directive to determine potential next steps and deliver care in compliance with regulations. We will share more with our patients and their families as this evolves.”

Bon Secours and Inova Health did not immediately respond to requests for comment, and Sentara Health said last week it “does not have a gender reassignment program for minors.”

Federal lawsuit

On Tuesday, 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 ending access to gender-affirming medical care for people under age 19. One 17-year-old plaintiff, Willow, lives in Richmond; her last name was not included in the lawsuit or news release to protect her privacy.

In a statement, Willow’s mother, Kristen Chapman, said they moved to Virginia in 2023 after the legislature in Tennessee, where they lived before, passed a law banning gender-affirming care for minors.

“We moved to Virginia in the summer of 2023, but struggled to find a provider that would accept our Medicaid insurance. As paying for her care out-of-pocket became prohibitively expensive, I tried for months to get an appointment at VCU, and I finally got an appointment for Jan. 29, 2025,” Chapman said. “The day before our appointment, President Trump signed the executive order at issue in this case. The next day, just a few hours before our appointment, VCU told us they would not be able to provide Willow with care. I thought Virginia would be a safe place for me and my daughter. Instead, I am heartbroken, tired and scared.”

According to the legal complaint, VCU Health informed Willow that her appointment was canceled.

The lawsuit says that VCU and its Children’s Hospital of Richmond received nearly $7.3 million in federal grants from the Health Resources and Services Administration (HRSA) and nearly $107 million in grants from the National Institutes of Health (NIH) in fiscal 2023, and UVA Health received more than $200 million in grants from NIH in fiscal 2023.

US trade war could raise prices, economists say

Mexican President Claudia Sheinbaum and Canadian Prime Minister Justin Trudeau managed to separately negotiate a monthlong pause on Monday with U.S. President Donald J. Trump on a trade war that was scheduled to begin on midnight Tuesday.

However, as of late Monday afternoon, the Trump administration was still prepared to impose a 10% tariff on China, though Trump was said to be planning to hold talks with Chinese leader Xi Jinping.

On Saturday, Feb. 1, citing illegal immigration and fentanyl trafficking, Trump announced he would be levying 25% tariffs against Mexico and Canada, with a 10% tariff carve-out for Canadian oil, natural gas and other energy products. Initially, Canada pledged to retaliate with a 25% on American goods, aimed particularly at red states that supported Trump. Meanwhile, over the weekend, Mexico and China were said to be mulling their trade responses.

But in a post to X Monday, Sheinbaum posted that she and Trump had reached a deal to hold off the tariffs for 30 days, saying that the U.S. agreed to help crack down on “the trafficking of high-powered weapons” over its southern border, while “Mexico will immediately reinforce the northern border with 10,000 members of the National Guard to prevent drug trafficking from Mexico to the United States, particularly fentanyl.”

Later Monday on social media, Trudeau wrote that he too had reached a temporary deal with Trump, promising that Canada would implement its $1.3 billion border plan, including “enhanced coordination with our American partners, and increased resources to stop the flow of fentanyl. Nearly 10,000 frontline personnel are and will be working on protecting the border.”

However, if Mexico and Canada aren’t able to ultimately come to an agreement with the Trump administration after the 30-day postponement, the impact of a prolonged trade war with China and our closest neighbors could result in higher prices for consumers in Virginia and nationwide, a fact that Trump had acknowledged could result in “pain” for Americans.

“WILL THERE BE SOME PAIN? YES, MAYBE (AND MAYBE NOT!),” Trump posted to social media. “BUT WE WILL MAKE AMERICA GREAT AGAIN, AND IT WILL ALL BE WORTH THE PRICE THAT MUST BE PAID.”

Meanwhile, in a Sunday BBC interview, Trump threatened to levy tariffs “pretty soon” against the European Union nations over their trade practices.

If the administration were to move forward on tariffs against Canada, Mexico and China, said Stuart Malawer, distinguished service professor emeritus of policy and government in the Schar School of Policy and Government at George Mason University, Virginia’s farmers might be hit the hardest.

During the first Trump administration, the United States imposed tariffs on about $370 billion worth of Chinese products. Former President Joe Biden kept those in place, adding tariffs on $18 billion more in Chinese imports.

“Those tariffs remain in place, pretty much and were indeed expanded,” said Malawer, a former member of the Virginia Advisory Committee on International Trade.

Virginia’s top five export markets for agriculture in 2023 were China, Canada, the United Kingdom, Taiwan, and Belgium, according to the Virginia Department of Agriculture and Consumer Services.

Virginia’s agricultural exports to China in 2017 amounted to approximately $1.7 billion. The state exported $1.45 billion in agricultural exports to China in 2022.

Prime Minister Justin Trudeau said Saturday, Malawer pointed out, that Canadians should consider Canadian rye over Kentucky bourbon or skip buying Florida orange juice. Both states have Republican U.S. senators, and Canada has aimed its tariffs primarily at the red states that supported Trump.

“We’re kind of fortunate to have Senators Warner and Kaine in office because … they don’t support [the] tariffs,” Malawer said.

The Port of Virginia could feel impacts from the tariffs, but it’s too early yet to know to what extent, according to Joe Harris, the Port of Virginia’s spokesperson.

“The Mexico issue has sorted itself out to a certain extent,” Harris said. “Trade with Canada is overland trade — it doesn’t have a lot of bearing on us at the port. And then [with] China, it remains to be seen.”

The American Association of Port Authorities, based in Washington, D.C., bluntly called tariffs taxes Monday.

“Though the port industry supports President Trump’s efforts to combat the flow of illicit drugs, tariffs will slow down our supply chains, tax American businesses and increase costs for hard-working citizens,” AAPA President and CEO Cary S. Davis stated in a news release. “Instead, we call on the administration and Congress to thoughtfully pursue alternatives to achieving these policy goals and exempt items critical to national security from tariffs, including port equipment.”

After Trump promised to impose tariffs on Canada, Mexico and China in November 2024, many importers likely hustled to send goods to the United States prior to his inauguration, according to Ricardo Ungo, director of the Maritime, Ports and Logistics Management Institute at Old Dominion University.

“I expect that many of them, they already took action and advanced some of those shipments,” he said.

In Virginia, Hampton Roads-based health care system Sentara Health purchases about $1.6 billion in medical supplies from Mexico, China and Canada, according to Aubrey Layne Jr., Sentara’s executive vice president and chief administrative officer. Last week, Sentara leaders learned that tariffs might have a $40 million to $50 million impact on the health system, he said, adding that Sentara plans to conduct a more extensive analysis on the potential impact this week.

“We’re looking through what our options are in terms of either finding other vendors or somehow getting other supply,” Layne said.  “I suspect there are a lot of companies around the commonwealth … [that are] doing the same thing this morning.”

As for the impact on fuel, Canada’s oil predominantly goes to the West Coast and the Midwest, “so Virginia is less exposed to the impacts of the 10% tariffs on crude oil coming from Canad,” said Bob McNab, chair of Old Dominion University’s Department of Economics and director of the Dragas Center for Economic Analysis and Policy.

The cost to buy a new house, however, could increase in Virginia if tariffs remain in place, according to Ryan Price, chief economist for Virginia Realtors.

More than 70% of the imports of softwood lumber and gypsum, which is used for drywall, come from Canada and Mexico, according to the National Association of Home Builders.

“We would see lumber prices increase,” Price said. “We would see drywall prices increase significantly, which would then likely be passed on to the consumers.”

Additionally, Price pointed out, “tariffs tend to put upward pressure on mortgage rates,” which could further impact Virginia’s sluggish real estate industry.

Virginia consumers, said Virginia Tech economist David Bieri, will probably see spikes in inflation, as anticipated nationwide if tariffs go into effect and persist. And while Virginia’s economy is “more resilient than that of other states,” Bieri said, “this tariff experiment is so unprecedented and far-ranging that it is simply too early to say anything about its impact.”

In the short term, McNab cautioned Virginians to stay calm.

“Uncertainty is high, and my best recommendation is not to panic, not to make ill-advised moves in the short term that could harm your retirement or your business,” he said. “Much like every other sort of crisis that occurs, we have to get away from the immediacy of the now and take a deep breath and kind of engage in long-term planning, which is very difficult when the news is changing on an hour-to-hour basis.”

Virginia Business Associate Publisher and Editor Richard Foster contributed to this story.

Trump 2.0: Making real estate great again?

Let Trump be Trump.

A campaign staffer’s now-famous motto during President Donald Trump’s 2016 bid for president nods to the mercurial nature of the real estate mogul and former reality television star — as well as a similar slogan from “The West Wing.” And Trump himself has repeatedly said he trusts his gut over his advisers.

It’s a quality that may be the secret to the president’s success. It does, however, make it tricky to predict what direction the new Trump administration may take on policy decisions. And that’s especially true when considering what impact Trump’s second presidency could have on the real estate industry.

“We really don’t know what he’s going to do,” says Laura Lafayette, CEO of the Richmond Association of Realtors and the Central Virginia Regional Multiple Listing Service.

“I get this question from our 6,500 agents all the time about what I think is going to happen,” says Patrick Bain, president and CEO of Fairfax-based The Long & Foster Cos., one of the nation’s largest real estate and mortgage firms. “I can think of all sorts of things, but until we see some sort of bona fides coming out of the administration, there’s a lot of guessing going on.”

High rates, low inventory

For real estate professionals, the million- dollar question is, what will happen with the federal funds rate under Trump 2.0?

Both fixed- and adjustable-rate mortgages are impacted when the Federal Reserve adjusts the federal funds rate, which is the short-term interest rate banks charge each other for loans to meet reserve requirements.

In December 2024, as part of its ongoing strategy to manage inflation, the Fed cut that key interest rate by 0.25 percentage points, to a target range of 4.25% to 4.5%.

Generally, that move would have been expected to result in a drop in mortgage rates, but instead, the 30-year mortgage average hit an eight-month high of 7.13% in January. In short, economists say that was likely due to messaging from Federal Reserve Chair Jerome Powell, who said in December that the Fed would be cautious about making rate cuts in 2025 due to persistent inflation.

Experts say that despite rate cuts by the Fed, yields in the 10-year Treasury are high, and there are lingering concerns about inflation related to Trump’s threats of tariffs and geopolitical warfare.

This has added to an ongoing sluggish housing market, with sales and inventories still well below pre-pandemic levels, as homeowners who may have refinanced or purchased during the pandemic when 30-year fixed-rate mortgages dipped as low as 2.65% now are disincentivized to purchase homes with interest rates in the 6.8% to 7.1% range and sales prices climbing.

The Virginia market had 18,870 active listings at the end of November 2024, a 12% increase from November 2023, but still 34% down from 2019, when 28,615 homes were on the market.

On the campaign trail, Trump said he would bring down interest rates and opined that the president should have a say in setting the federal funds rate. The problem, of course, is that the Federal Reserve is designed to operate independently of the White House.

“The Federal Reserve has made clear that they intend to act independently, and I think they’ll continue to act independently,” says Lafayette.

Trump “can get Powell to resign,” Bain says. “I’m sure he can compel him to put a new Fed chair in, but the problem is … interest rates right now are largely driven by federal spending, and if he’s going to ramp up spending without pretty significant budget cuts, I don’t see the Fed having a lot of power to influence the [10-year Treasury yield], which is what drives mortgage rates.”

Mortgage rates decreased following the Great Recession and stayed historically low, dropping to 2.1% for 15-year fixed-rate mortgages during the pandemic. To ward off fast-climbing inflation, the Fed hiked rates 11 times between 2022 and 2023, and 30-year mortgage rates rocketed to 8% for the first time in 23 years.

The mortgage rates “put a shock on so many people,” says J. Van Rose Jr., CEO and executive chairman of Chesapeake-based Berkshire Hathaway HomeServices RW Towne Realty.

As of the first quarter of 2024, about 76% of people with mortgages had a rate below 5%, according to an analysis by Redfin, a Seattle real estate company. And there were about 1.3 million fewer U.S. home sales from spring 2022 through the end of 2023, according to a paper from the Federal Housing Finance Agency.

That said, interest rates don’t have to sink to 2.5% to spur activity in the market, according to Martin Johnson, interim CEO of Virginia Realtors, the state industry association. “It just needs to be lower,” he says.

It would take a 5% mortgage rate, Rose hypothesizes, to unfreeze the market. But Terry Clower, professor of public policy at George Mason University’s Schar School of Policy and Government, doesn’t think that’s likely any time soon.

“I just don’t see a scenario in this coming year where we see — no matter what policies are implemented — much of a change in mortgage rates,” he says. “It’s possible that they fluctuate down a little bit, but they’re not going to go to 5%.”

Regulations and tariffs

In a November editorial published in The Wall Street Journal, billionaire Elon Musk, who is leading Trump’s new Department of Government Efficiency, promised that the incoming administration will eliminate thousands of federal regulations. Residential and commercial real estate professionals like the sound of that.

“I think that if you ask the development community, they would tell you that there are some federal regulations that affect development that really don’t necessarily affect health, safety, welfare,” Lafayette says.

More regulations, Johnson points out, “leads to a higher cost of the end product that gets passed along to buyers.”

Rose points to sites in Hampton Roads that are currently off-limits to builders because they were deemed protected wetlands. “Well, two years ago, they weren’t wetlands,” he says. “Today, they’re wetlands. And I guarantee you, probably in a year and a half or so from now, they won’t be wet again, and it’s not by the climate, it’s by regulations.”
In 2020, Trump claimed to have cut nearly eight regulations for each new one enacted.

During his first term, Rose says, “we had some pretty good runs at it, because we didn’t have the same amount of hoops to jump through.”

While real estate leaders interviewed for this story are universally bullish about the prospects of Trump cutting red tape to benefit the industry, many had concerns about the potential impacts of Trump’s stated plans to impose additional tariffs on goods coming from Mexico, Canada and China.

Tariffs will drive up the cost of building materials, according to Brent Smith, the CoStar Group Endowed Chair in Real Estate Analytics at Virginia Commonwealth University. And “if materials get expensive, then it’s going to raise the cost of housing.”

R. Robert Benaicha, a partner at Richmond-based law firm Hirschler who represents national and local real estate developers, investors and lenders, is concerned that added tariffs “could create pretty massive inflationary pressures across the entire economy.” And that could lead to the Fed raising rates.

Michael Silver, chairman of Vestian, a Chicago-based corporate real estate services firm, takes a glass-half-full view, noting that additional tariffs could boost one segment of commercial real estate: warehouses. Tariffs, after all, could be reciprocated in a trade war and businesses that normally export products might have increased need for storing goods.

While tariffs could hurt the real estate industry, Trump may believe that that’s a price worth paying, points out David Bieri, associate professor of urban affairs and planning at Virginia Tech and a former adviser to the CEO of the Bank for International Settlements in Switzerland. “Under the rubric of national self-sufficiency, you can justify tariffs extremely well,” he says.

Immigration crackdown

Trump also has pledged to deport millions of undocumented immigrants, a move many experts say could also harm the real estate business.

The construction industry already has a labor shortage problem. A model created by national trade association Associated Builders and Contractors found that construction companies would need to hire more than 450,000 new workers in 2025 “on top of normal hiring” just to meet industry demand.

Laura Lafayette, CEO of the Richmond Association of Realtors and the Central Virginia Regional Multiple Listing Service Photo by Matthew R.O. Brown

The Baker Institute, a Texas-based nonpartisan think tank, estimates that the U.S. construction labor force is about 25% foreign-born. Determining how many construction workers are undocumented is difficult since many of those workers operate in the shadows. The American Immigration Council reported in September 2024 that undocumented immigrants represented about 23% of all construction workers in Texas in 2022.

In general, hiring undocumented workers has kept construction labor costs down, says Robert M. Diamond, senior counsel in the real estate group at Reed Smith, a global law firm with offices in Tysons. “You could get sufficient laborers, and it was hard for them to press for higher wages,” Diamond says.

If Trump follows through on his deportation plans, construction companies may be forced to limit the number of jobs they take, according to Timothy Faulkner, president and CEO of The Breeden Co., a Virginia Beach-based real estate development and management company. “Some of these trades may not be able to work on as many jobs, so that would slow down the pipeline as well as drive up costs.”

Political candidates often say one thing on the campaign trail, Rose notes, and govern another way. He points to the people Trump has selected to be part of his administration.

“Most of these people are very wealthy businessmen and women,” he says. “I’ll guarantee you, a big part of their portfolios in life are in real estate. … I think they’re pretty smart people. They didn’t become billionaires for no reason.”
Those individuals, he reasons, are not going to act against their own self-interests.

Draining the swamp

Additionally, on Inauguration Day, Trump ordered federal agencies to return workers to the office five days a week “as soon as practicable.”

Matthew Cypher, director of the Steers Center for Global Real Estate at Georgetown’s McDonough School of Business, celebrates this policy. “Making sure we have vibrancy in our downtown is important, and I’m hopeful that that is part of what he’s endeavoring to do,” he says.

J. Van Rose Jr., CEO and executive chairman of Berkshire Hathaway HomeServices RW Towne Realty Photo courtesy Berkshire Hathaway HomeServices RW Towne Realty

Following the pandemic, office space has been the softest part of the commercial real estate industry, according to Eric Robison, executive vice president of the Capital Markets Group for Cushman & Wakefield | Thalhimer, a Glen Allen commercial real estate firm.

The Washington, D.C., office market closed out 2024 with a 19.9% vacancy rate, down from a high of 22.4% earlier in the year. Much of that was driven by the region’s largest tenant, the federal government, which accounted for “nearly half” of the district’s decline of 500,000 square feet in office space in the second quarter of 2024, according to CBRE. That was largely due to stalls in the Biden administration’s return-to-office initiatives.

“Getting federal workers and their contractors back into the office will help the performance of a number of office buildings, specifically in the Northern Virginia area, but also in the Hampton Roads market, [which] is deeply dependent on government contractors in the military,” Robison says.

Nevertheless, Smith foresees a number of federal workers handing in their notice over this mandate, especially those who may have relocated during the pandemic when they were allowed to work remotely.

The Trump administration has also pledged to cut the federal workforce, and move some offices out of the D.C. region.

Layoffs for federal workers could free up some Northern Virginia housing supply, adding thousands of properties to active listings, according to Bain, but it probably won’t happen in 2025.

“I think there’ll be some early wins with streamlining or making the government more efficient,” Bain says. “I don’t know that that’s going to be immediately felt in the [District of Columbia, Maryland and Virginia].

There are many additional ways the Trump administration could impact commercial and residential real estate markets, too.

Northern Virginia Association of Realtors CEO Ryan McLaughlin is eager to see what Trump does with the 2017 Tax Cuts and Jobs Act, which imposed a $10,000 cap on deductions for state and local taxes. Eliminating that cap or raising it “could be beneficial for Northern Virginia,” he notes.

Other possible Trump administration moves could be as far-reaching as looking to privatize Fannie Mae and Freddie Mac or reeling in Justice Department oversight of the real estate industry.

Then there’s the psychological impact for many voters, who feel optimistic about the new president’s potential impact on the economy. After all, confidence is key for would-be home shoppers.

“If they feel like their retirement portfolios are in good shape and continuing to go up, and they feel like that nest egg is growing,” says Johnson, “and they feel like they have — or are even going to have — more discretionary income, then they’re more apt to want to get involved and want to buy or sell and buy up.”

Virginia Business Associate Publisher & Editor Richard Foster contributed to this report.

Trump White House says tariffs will be enacted Feb. 1

The Trump administration says it will impose tariffs on Canada, Mexico and China beginning Saturday, Feb. 1.

“The president will be implementing tomorrow 25% tariffs on Mexico, 25% tariffs on Canada and a 10% tariff on China for the illegal fentanyl that they have sourced and allowed to distribute into our country, which has killed tens of millions of Americans,” White House Press Secretary Karoline Leavitt said during Friday’s briefing.

She did not provide details on the tariffs, instead stating that information would be available for the public in 24 hours.

U.S. Sen. Mark Warner, Virginia’s Democratic senior senator, responded a little after 3 p.m. Friday in a video statement posted on X, saying that voters elected President Trump because he promised to lower the cost of living, and increasing tariffs will not accomplish that.

“That’s going to mean higher prices for American cars,” Warner said in a video. “It’s going to mean higher prices for avocados. It’s going to mean a host of higher prices that you will see literally as soon as next week if this cost increase gets pushed onto you.”

U.S. Sen. Tim Kaine, Virginia’s junior Democratic senator, and Sen. Chris Coons, D-Delaware, introduced a bill Friday that would require Congress’ approval before the president could impose new or additional tariffs on U.S. allies and free trade agreement partners. Kaine said the tariffs are expected to raise costs of gas, cars, groceries and home goods.

“Virginians want costs to go down, not up. But President Trump’s plans to impose broad-based tariffs would raise the price of everyday goods and hurt our economy,” Kaine said in a statement. “It’s time for Congress to make it clear that no president should abuse existing tariff authorities designed to protect America’s national security from threats posed by our adversaries to slap tariffs on our allies and closest trading partners. I’m proud to introduce this legislation with Sen. Coons to take that step to protect Americans’ pocketbooks from sharp price hikes and safeguard our relationships with our allies.”

To speculate on the impact tariffs could have on the commonwealth and the country, Bob McNab, chair of Old Dominion University’s Department of Economics and director of the Dragas Center for Economic Analysis and Policy, said Friday that he would need to know whether oil imports will be included in the policy.

“We’re sort of in a wait-and-see mode until we know exactly what goods from Canada, Mexico and China would be subject to a 25% tariff for Canada and Mexico and a 10% tariff for China,” McNab said.

Broad-based tariffs, according to McNab, could lead to an increase in prices in Virginia and across the United  States. “Given that inflation has been somewhat sticky over the last several months, this would likely lead to higher rates of inflation in the short term,” he said.

As for Virginia-specific consequences, McNab pointed out that China is one of the countries with the highest volume of imports at the Port of Virginia.

“Even a 10% tariff on a broad volume of goods from China would lead to higher costs for importers through the Port of Virginia, and potentially lower demand through the port over time,” he said.

UVA Health, VCU Health halt gender-affirming treatments for minors

UVA Health and VCU Health systems have suspended all gender-affirming treatments for patients under 19 years old, after receiving a written opinion Thursday from Virginia Attorney General Jason Miyares.

In a memo from Miyares titled “Protecting Children from Chemical and Surgical Mutilation,” the Republican attorney general referred to President Donald Trump’s executive order issued Jan. 28 by the same name.

He advised the two publicly funded university-affiliated health systems that the 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.”

Miyares concluded the memo, stating, “The chemical and surgical mutilation of children must stop immediately. Hospitals and institutions that continue to mutilate children place themselves at significant legal risk and face substantial financial exposure. Given these risks, my office will be closely monitoring this issue and the actions of the commonwealth’s agencies.”

Under state law, minor patients require parental consent to receive such treatments.

UVA Health issued a statement Friday: “In response to the recent federal executive order and related Commonwealth of Virginia Office of the Attorney General guidance, UVA Health has suspended all gender-affirming care for patients under 19 years of age. Like many health systems across the country, the University of Virginia and UVA Health are working to analyze and interpret the federal order and related state guidance, as well as monitoring other potential policy changes and impacts to ensure we are always delivering care in accordance with the law.”

VCU Health released the following statement: “VCU Health and Children’s Hospital of Richmond at VCU have suspended gender-affirming medication and gender-affirming surgical procedures for those under 19 years old in response to a White House executive order and clear guidance from the state provided to VCU.

“We are committed to ensuring that we’re always delivering care in accordance with the law. Appointments will be maintained to discuss specific care options for patients in compliance with the most recent guidance.”

Norfolk-based Sentara Health, which operates 12 hospitals in Virginia and North Carolina, confirmed in a statement: “Sentara does not have a gender reassignment program for minors.”

Roanoke-based Carilion Clinic, which serves nearly 1 million people in western Virginia, issued this statement Friday: “We are committed to ensuring that we’re always delivering care in accordance with the law. We are reviewing the latest federal directive to determine potential next steps. We will share more with our patients and their families as this evolves.”

Bon Secours and Children’s Hospital of The King’s Daughters did not immediately respond to requests for comment Friday.

The Virginia Senate Democratic Caucus lambasted the attorney general’s opinion, saying in a statement that “Miyares’ actions mirror Trump’s unconstitutional attacks on personal freedoms. Instead of standing up for Virginia families, Miyares and Governor Youngkin are taking orders from MAGA extremists — putting politics over parental rights.

“Let’s be clear: Virginia law already requires parental consent for gender-affirming care. Trump’s baseless executive order doesn’t protect families — it strips them of the right to make personal medical decisions for their children.”

Concern about youth

Side by Side, a Richmond-based nonprofit organization that provides workshops, services and housing for LGBTQ+ youth and young adults in the Richmond area, called the two health systems’ decision to suspend services “not just disappointing; it is harmful,” in a statement Friday. “VCU Health and UVA Health have been critical partners and the primary providers of gender-affirming care for many of our families.

“While we understand the difficulty in making these decisions, we welcome and invite these providers to communicate their plan to transition the life-saving care for the families being impacted,” the statement said. “We also look forward to engaging with them both on the decision-making process that led to this reduction in care and what support for our LGBTQ+ community can look like in the future.”

Marquis D. Mapp, Side by Side’s executive director, said in an interview Friday that a hastily arranged conference call drew more than 200 people registered with the organization, including young people who had been receiving treatments and their parents.

“They’re scared, they’re worried,” he said. Side by Side on average sees 60 to 80 youth under the age 18 for its workshops and other activities each week, many of whom are receiving some sort of gender-affirming medical treatment. “Access to treatment is pretty difficult because of waitlists or levels of access,” Mapp noted, and UVA Health and VCU Health are the “two primary providers” for teens they see.

Most of the people Mapp and his colleagues have spoken with are concerned about access to care now that the two health systems have suspended treatment for minors, regardless of parental consent.

“We’re talking about people who were receiving treatment. [There was] not enough of a plan to connect people with resources,” including medical facilities that are still offering gender-affirming care, Mapp said. “It’s a scramble to identify where they can get treatment. It’s not illegal in Virginia. I think there are a lot of places that are able to but are afraid to come forward.”

Another issue, he noted, is concern that youth who can’t access treatments may experience suicidal ideation or harm themselves physically.

“To the best of our ability, we will keep our doors and arms open,” Mapp said.