Introduction to the Issue
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.
Background on the Hospitals’ Decision
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.
The Human Impact
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.
Asher McMaher is the executive director of Trans Up Front Illinois. McMaher has been part of the volunteer rapid response team that is helping connect families seeking gender-affirming care with private providers throughout Illinois.
Anthony Vazquez/Sun-Times
The Role of the Rapid Response Team
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.
Personal Stories of Affected Individuals
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.
Ben Garcia receives gender-affirming care at Ann & Robert H. Lurie Children’s
