California attorney general Rob Bonta accused Children’s Hospital Los Angeles of illegal discrimination over its decision to halt sex-changes for kids—a necessary move to protect its bottom line after President Donald Trump issued an executive order barring federal funds from going to hospitals that provide such interventions.
The Jan. 28 order declared that the federal government won’t “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another.” It threatens to withhold federal money from hospitals that provide puberty blockers, hormone therapy, or surgical procedures to transgender youth under the age of 19.
The contradicting demands from Trump and Bonta puts Children’s Hospital Los Angeles in an especially tight bind since it receives significant funding from Medicaid.
Bonta has “jeopardized their funding through Medicaid, Medicare, and the Affordable Care Act,” Heritage Foundation senior legal fellow Sarah Parshall Perry said. “He understands that in a battle between the U.S. and California, California is going to lose.”
Children’s Hospital Los Angeles announced Tuesday that it would stop providing hormones for new patients under the age of 19 for sex-change purposes and would continue a pause on surgeries for minors. The hospital told the Los Angeles Times officials it needed time to “to fully understand” the implications of Trump’s executive order.
The next day, Bonta warned the hospital’s general counsel that providing hormones to children with delayed puberty issues but barring them from being used for sex-changes amounts to discrimination.
“Electing to refuse services to a class of individuals based on their protected status, such as withholding services from transgender individuals based on their gender identity or their diagnosis of gender dysphoria, while offering such services to cisgender individuals, is discrimination,” California’s senior assistant attorney general Neli Palma wrote Wednesday on Bonta’s behalf.
The letter also suggests that a ruling on a separate executive order nullified Trump’s directive regarding trans interventions on minors. Two federal judges have put temporary restraining orders on the president’s executive order freezing payments for federal grants and other programs, requiring agencies to continue funding existing awards. Those rulings don’t explicitly mention Trump’s executive order regarding youth sex-changes.
The letter also asks the hospital to confirm within 10 days whether it’s canceling transgender-related appointments for minors, but didn’t outline any consequences.
Erin Friday, a San Francisco lawyer who leads California’s grassroots parent movement to end gender transitions for kids, said Bonta’s letter has “no teeth” and misinterprets the court orders.
“The attorney general cannot force medical providers to perform treatments on children that are not medically necessary,” Friday said. “Hospitals are realizing that the financial risks are just too high to continue these so-called treatments, and they are pulling back. The overwhelming evidence that is being published is that gender interventions do not improve a child’s mental health, they do not prevent suicide and that there are experimental.”
Failing to comply with Trump’s order would also be detrimental to Children’s Hospital Los Angeles. More than 72 percent of its inpatient revenue and 62 percent of its outpatient revenue come from the state’s Medicaid program, according to 2022 data from the California Department of Health Care Access and Information. The federal government pays for roughly half of that program.
Other hospital systems across the country, including the Virginia Commonwealth University Health and Denver Health, have similarly suspended youth sex-change interventions.
The Children’s Hospital Los Angeles is California’s most prolific provider of youth sex-changes, according to the medical ethics group Do No Harm. Its staff have given sex-change treatments to at least 265 young people, 165 of whom have received surgeries, and have written nearly 900 prescriptions for puberty blockers and hormones. They’ve billed insurance for nearly $1.75 million in exchange, according to Do No Harm’s claims analysis.
Children’s Hospital Los Angeles has recently faced several high-profile controversies surrounding regret from detransitioners, an issue Trump highlighted in his executive order.
“Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding,” the order states. “Moreover, these vulnerable youths’ medical bills may rise throughout their lifetimes, as they are often trapped with lifelong medical complications, a losing war with their own bodies, and, tragically, sterilization.”
In December, a detransitioner named Clementine Breen filed a lawsuit against Children’s Hospital Los Angeles, naming its most prominent gender-focused pediatrician Johanna Olson-Kennedy and other doctors as defendants. Breen said she received fast-tracked puberty blockers at age 12, testosterone at 13, and a double mastectomy at 14, and alleges these interventions “profoundly damaged” her body “in ways that can never be repaired.” She’s accused her practitioners of “coercion, concealment, misrepresentations, and manipulation” to push her on the medical transition path. The hospital has said its medical interventions follow “guidelines from professional organizations” like the American Academy of Pediatrics.
Olson-Kennedy is also dealing with a separate controversy. After receiving nearly $10 million in federal taxpayer funds to study potential benefits of puberty blockers, she told the New York Times in October that she withheld findings for fear of political backlash. Her study showed that those drugs didn’t improve mental health in children that received them for gender transitions. Olson-Kennedy has also argued that detransitioners’ regret is a sign of “cis gender fragility.”
Before the November election, Children’s Hospital Los Angeles advertised that it “rejects the gatekeeper model of care,” which requires rigorous therapy for gender-confused youth before they can change their bodies. That language was scrubbed following Trump’s victory, archived versions of its website show.
Bonta, who is positioning himself as a leader of the anti-Trump blue state coalition, was backed by influential LGBT groups like Equality California, which last quarter spent nearly $640,000 to lobby Bonta’s Department of Justice and the state legislature.
Children’s Hospital Los Angeles and Bonta did not respond to a request for comment.
