Blair’s mom had been cautious when she first brought her 6-year-old to the LGBTQ clinic at Cleveland’s MetroHealth hospital, “trying to figure out why he felt different inside,” as she puts it. She didn’t want to rush her child into treatment. So she was grateful to find the clinicians there took a slow and careful approach to Blair’s health care. Over the years they provided open-ended counseling, monitored his hormone levels and bone development, and only progressed with puberty blockers when it was clear that transitioning was making him happier and more confident. “That was my barometer for doing the right thing,” she tells me.

Today, at 16, Blair (a pseudonym to preserve his privacy) has been going to the clinic for a decade, and, by his mom’s account, thriving. Even when Ohio banned transgender medical treatments for minors in 2024, he could stay on his medication thanks to a grandfather clause in the law. But a few months ago, his mom got a message from MetroHealth alerting the family to a new threat.

On December 18, 2025, Health and Human Services Secretary Robert F. Kennedy Jr. issued a declaration that rebranded transgender medical care as “sex-rejecting procedures” and claimed, erroneously, that the treatments “fail to meet professional recognized standards of health care” when given to minor patients. That same day, his agency proposed a pair of regulations that would curtail access nationwide. The first would forbid federal insurance programs that cover kids in low-income families from paying for puberty blockers, hormone therapy, and the surgery used in rare cases to treat gender dysphoria. The other would deliver an ultimatum to hospitals: Stop providing the treatments to trans kids, or else get kicked out of the federal Medicaid and Medicare programs.