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.