Seattle Children’s Hospital postponed a transgender teen’s masculinizing top surgery only hours before it was scheduled allegedly to comply with one of President Donald Trump’s executive orders targeting health care access for trans people under the age of 19. The family says it’s unclear if or when the procedure would be rescheduled.
According to the family, hospital staff called their 16-year-old son Monday evening and explained the hospital had postponed his surgery in accordance with Trump’s executive order banning all federal support for gender-affirming care for trans people under the age of 19, which among many things, threatens to withhold federal funds from hospitals that provide such care.
The family says they were told during a meeting with surgical center staff Tuesday morning that if the hospital lost access to those federal funds, other children’s care would be at risk, and the decision was made with the entire community's interest in mind.
Seattle Children’s Hospital did not respond to multiple requests for comment.
The American Civil Liberties Union, PFLAG, families, and doctors sued the Trump administration over the order, which they say is dangerous and unconstitutional. New York State’s Attorney General Letitia James has warned hospitals that complying with the order may be violating state anti-discrimination law. The Washington State Attorney General’s office says it has heard from many Washingtonians about how this “anti-trans EO is impacting them directly.”
“In addition to our disgust with how this action cruelly targets marginalized communities, our office is also looking into the legality of the order,” a spokesperson says.
The family has asked to use pseudonyms to protect their privacy, but The Stranger has verified details of their account using medical and phone records.
Just after 5 pm yesterday, the surgery department called Ethan, a trans teen, and said his masculinizing chest reconstruction surgery had been postponed on account of the order. They offered a therapist, but Ethan declined because he was on the bus home from school.
The sudden cancellation was exactly what Ethan feared when he read the executive order last week. But Friday, he says, hospital staff had assured him the procedure he’d waited years for would proceed as planned.
After Ethan told his mom the news, Sarah says she left a message with the hospital asking for more information, and when she called again, staff told her they were not aware that surgeries had been cancelled. They told her to wait by the phone, but never called back. Ethan noticed his surgery had vanished from the online patient portal MyChart. Normally, when appointments are cancelled, Ethan says he receives a notification and explanation of why. He also noticed the plastic surgery page on the Seattle Children’s website had removed a section on gender-affirming surgery.
The hospital has not publicly stated a new policy on gender affirming care. However, the Internet Archive’s Wayback Machine shows on January 13th, the most recent capture, the site did include references to gender affirmation and gender dysphoria. They’re no longer on the site. Since the last Wayback capture of the hospital’s gender clinic page on January 18th, references to gender-affirming surgery have been removed, and since January 16th, an entire page about their Surgical Gender Affirmation Program has been taken down.
After waiting by the phone for answers, the family wanted to speak with someone in person and arrived at the hospital just ahead of their original 6:00 am call time for surgery the next morning. As they expected, his surgery was not on the schedule. Ethan knew it was unrealistic, but he held onto the small possibility that some miscommunication had occurred and the surgery would still happen. “I’ve wanted this since I started developing breasts,” Ethan says. “The fact that I got so close…is hard to deal with.”
After waiting for two hours, the family says they met with a nurse and another staff member from the hospital’s plastic surgery center. They apologized, but did not know when surgeries would be rescheduled, or if Ethan would be first in line when they were, the family says. Ethan told them he would have appreciated the warning if there were any sense this may happen.
Trump’s Executive Order also attempts to ban puberty blockers and hormone therapy, referring to them all as “chemical castration.” But the family says they’ve since heard Ethan would have access to other gender-affirming care at Children’s, just not surgery.
Ethan is not very concerned about losing his access to hormones. This order does not necessarily represent forced detransition for patients in Washington. Even if more hospitals follow suit, patients can still reliably access puberty blockers and hormone therapy through telehealth providers and clinics that don't depend on federal funding. Ethan has that option, but considers himself privileged.
Kids who get hormone replacement therapy (HRT) through Medicaid may not be able to afford those expensive medications out-of-pocket. Ethan says it’s important for trans kids to have access to this case because, at least for him, it makes him feel more comfortable and confident in his body. He doesn’t think he’d be doing as well in school, or as willing to try new things like extracurricular activities, without gender-affirming care.
“The idea of meeting new people was so terrifying,” he says. “I knew they would see me as a girl. I wasn’t sure if they would understand. The same goes for the new school I transferred to—anywhere I have to meet people.”
Ethan’s experience is consistent with studies on gender-affirming care. It’s associated with happier, healthier lives for kids experiencing gender dysphoria. The regret rate is extremely low.
Danni Askini, executive director of the transgender advocacy organization Gender Justice League, says that Seattle Children’s has a “moral obligation to care for their patients until the moment Trump shows up personally.” Washington State has some of the strongest protections for transgender people and their healthcare in the United States. The Washington Law Against Discrimination explicitly protects people on the basis of gender identity.
“They are actively doing harm by delaying these surgeries,” she says. “It is cowardly to comply in advance with an unconstitutional dictate with no enforcement mechanism and in violation of Washington State Law.”
Lawsuits may decide the fate of Trump’s executive order. But Ethan’s family is not waiting. In 2022, they began planning a move outside of the US.
Sarah says the only reason she exists is that her Jewish grandfather left Germany in 1933, the year Adolf Hitler was appointed Chancellor of Germany. Ethan’s dad Mark says despite his “US public school education,” he absorbed the same lesson as his wife.
“It was clear [in 2022] that if he got elected things would get very bad very fast,” he says. “If we had the privilege and the ability to get out–we should.”
“Under an ideal circumstance, I would stay and spend my life on the resistance, but I am disabled and I have a trans child who is also disabled. He’s right, we should get out,” Sarah says.
“That doesn’t mean not fighting, it means putting our mask on first,” Mark says.
Editor's note: A previous version of this story stated that the family met with a nurse and a doctor from the hospital's plastic surgery center. They met with a nurse and another staff member from the hospital’s plastic surgery center.