As more hospitals in Chicago cut back care for trans youth, advocates have launched a rapid response team to connect families with other doctors and cover the cost of everything from appointments to medication.
The response team has built a network of at least 30 doctors and nurse practitioners in private practice throughout Illinois who provide hormone therapy or blockers to delay puberty. It also includes roughly 10 physicians who will perform surgeries, said Asher McMaher, executive director of Trans Up Front Illinois, an advocacy organization that put out the call to providers for help.
Many of these physicians and nurse practitioners don’t rely as heavily as hospitals on federal payments — or at all. As a result, they aren’t under as much pressure as the Trump administration threatens to cut federal funding to providers offering gender-affirming care, McMaher said. But even though these private providers offer care, not all patients will be able to afford the cost if they have to pay out of pocket.
Dr. Jessica Lapinski is a family medicine physician in suburban Bloomingdale who opened her practice three years ago. More than 50% of her patients receive gender-affirming care, and since UChicago Medicine suddenly stopped this treatment for youth earlier this month, she said her phone has been buzzing with panicked parents.
Lately, Lapinski’s conversations with her patients have extended beyond their health. They ask about escape plans and safe places to live, including outside the U.S.
“It’s very heartbreaking,” she said.
Lapinski doesn’t take government-funded health insurance, including Medicaid, which covers people who are low income or have a disability. She charges a $150 monthly membership fee for a kid seeking gender affirming care, and she says she works with families who can’t afford that.
A ‘go’ box, cash and medication
Hospitals in Chicago started scaling back gender affirming care earlier this year after an executive order on Jan. 28 from the Trump administration. Medical professionals across the U.S. are “maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions,” the order said. “This dangerous trend will be a stain on our Nation’s history, and it must end.”
In February, Lurie Children’s Hospital near downtown stopped performing gender affirming surgeries for patients younger than 19. Many of Lurie’s patients were referred for surgery to nearby Northwestern Memorial Hospital, which then canceled their appointments.
This month, Rush University Medical Center on the Near West Side said it would no longer provide hormones for new trans patients under 18, and the U of C on the South Side stopped all pediatric gender-affirming care. Many families are hoping to get appointments instead at UI Health on the Near West Side, McMaher said.
Rush treats a small number of trans youth, but U of C treated more than 200 young people, McMaher said. Hospital spokespeople declined to confirm the numbers.
The rapid response team of volunteers has connected about 100 young people with providers, based on the patient’s age and treatment needed, McMaher said. Not all providers take patients younger than 16, for example.
“We want to be able to match them with the appropriate providers because we also know the amount of emotional and mental work these parents are going through to protect their children,” said McMaher, who is trans and has a trans teen. “To just simply say, well, ‘here’s five places that you could call,’ we know how draining that can be to be turned away again and again.”
Losing access to medication could mean that within six months, a girl transitioning to a boy could get an unwanted period, or facial hair on a boy transitioning to a girl starts to come back, said Dr. Michelle DallaPiazza, a medical director at Howard Brown Health, which specializes in treating LGBTQ+ patients. These changes can be distressing and devastating for some patients, she said.
Ben Garcia, a trans patient at Lurie who takes testosterone, is preparing for his freshman year of college this fall and is stretching his medication to have a few extra months supply in case his access is cut off.
“A loss (of) my hormones would be a huge loss to me, but I think I would be able to handle it better than some people,” said Garcia, who is 18 and lives in Chicago.
For one, Garcia is at a point in his transition where his voice will remain deeper even if he misses some testosterone injections.
He said he’s talked with his mom about bringing a “go” box to college with his passport, some cash and a month or so supply of medication if he needs to leave the U.S. quickly.
‘Those words are empty’
Many trans families have told WBEZ about how they feel threatened and marginalized by hateful rhetoric around the country.
Providers, patients and research underscore how lifesaving transgender medical care can be. It can help decrease depression and anxiety, for example.
A 2023 study from the federal Centers for Disease Control and Prevention found that one in four U.S. high school students who were transgender or questioned their gender identity attempted suicide in the past year.
“We can’t keep losing these kids,” McMaher said. “These hospital systems don’t understand the gravity of these actions, and at our organization we deal with the repercussions of their actions.”
That’s one reason trans advocates and families are calling on Democratic Illinois Gov. JB Pritzker and Attorney General Kwame Raoul to do more to protect trans rights.
“So often we see elected officials say they stand with us in private, and in public play the neutral, and we’re seeing that now,” McMaher said. “It’s disheartening, and it harms our children because they’re looking for it. They’re watching.”
The Illinois Human Rights Act prohibits health care providers from discriminating against patients because of their gender identity.
But Raoul has declined repeated requests to explain how hospitals in Chicago aren’t violating the law. In April, he told WBEZ he didn’t see Lurie or Northwestern as “a bad actor.” “You can’t (be) said to be acting discriminatory when the federal government is holding a gun to your head,” he said.
Dozens of families and advocates have written to Raoul asking him to enforce the law and demand that hospitals keep providing treatment. In a statement, a spokeswoman for Raoul said federal agencies are using government resources to attack health care providers and “are driving a wedge between patients and the providers they need. The Attorney General’s office will take additional action soon to protect access to medically necessary health care for transgender patients.”
Pritzker has defended hospitals, too. Advocates and families know Raoul and Pritzker support trans rights, but they want them to hold hospitals accountable. They point to how much these politicians have publicly supported abortion care, such as at press conferences alongside abortion providers and legally fighting to protect access.
“I think the frustration for a lot of parents is that Illinois consistently touts itself as a safe state for gender-affirming care,” said Michelle Vallet, who is Garcia’s mom. “And it’s not. Those words are empty.”
McMaher wants Pritzker to meet with trans families — Raoul has met with some — and stand alongside advocates when they rally for trans rights.
“He should be in front of U of Chicago saying, ‘Explain to me what’s going on,’ McMaher said of the governor. “This is an unprecedented time. ... We’re heading towards, in my opinion, like a war, right? And this is a war on trans people, and these are the people who should be protecting us.”
In a statement, a spokesman for Pritzker said: “In a moment when Donald Trump is stripping health care away from millions of Americans, and attacking our hospital system, Governor Pritzker remains committed to doing everything within his power to fight the administration’s overreaches at every step of the way and protect the LGBTQ community.”
Members of Pritzker’s senior team are meeting with hospital leaders in Illinois to assess what can be done in light of threats from the Trump administration, the spokesman said.
For hospitals, big losses in federal payments they receive for patients who have Medicaid and Medicare health insurance could mean service cuts across the board. At Lurie, for example, Medicaid makes up more than 50% of their revenue. Lurie still offers puberty blockers, hormone therapy and mental health services for trans youth.