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Trump’s push to end transgender care for young people opposed by pediatricians

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Trump’s push to end transgender care for young people opposed by pediatricians

A display at the Gender Health Program of Children’s Minnesota hospital. Under a proposed rule announced Thursday, a hospital will lose all its Medicaid and Medicare funding if it continues to provide gender-affirming care for trans people under age 18.

Selena Simmons-Duffin/NPR


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Selena Simmons-Duffin/NPR

Dr. Kade Goepferd watched the Trump administration’s moves on Thursday to ban gender-affirming care for transgender youth with “a mix of sadness and frustration.”

Goepferd, who is the founder of Children’s Minnesota Gender Health Program, says that for the medical community, nothing has changed about the evidence supporting gender-affirming care that could justify the government’s actions.

“There’s a massive propaganda and disinformation campaign that is selectively targeting this small population of already vulnerable kids and their families,” Goepferd says.

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“Men are men”

Federal health officials said many times at Thursday’s announcement that their actions were driven by science and evidence, not politics or ideology. They frequently praised a report published by the Department of Health and Human Services in November. It concluded that clinicians who provide medical care to help youth transition have failed their patients and emphasized the benefits of psychotherapy as an alternative.

At times, health officials cast doubt on the idea that a person could be transgender at all.

“Men are men. Men can never become women. Women are women. Women can never become men,” said Acting CDC Director Jim O’Neill. He added that “the blurring of the lines between sexes” represented a “hatred for nature as God designed it.”

Health Secretary Robert F. Kennedy Jr. said doctors and medical groups had “peddled the lie” that these treatments could be good for children, and that those youth were “conditioned to believe that sex can be changed.”

Doctor groups disagree

The American Academy of Pediatrics, the medical group that represents 67,000 pediatricians across the country, pushed back forcefully on those characterizations.

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“These policies and proposals misconstrue the current medical consensus and fail to reflect the realities of pediatric care and the needs of children and families,” said AAP President Dr. Susan J. Kressly in a statement. “These rules help no one, do nothing to address health care costs, and unfairly stigmatize a population of young people.”

AAP’s official position on this medical care is that it is safe and effective for the young people who need it. That view is shared by the American Medical Association, the Endocrine Society, among other medical organizations.

In a statement Thursday, the American Psychological Association wrote: “APA is deeply concerned about recent federal actions that not only challenge the scientific understanding of gender identity but also potentially jeopardize the human rights, psychological health, and well-being of transgender and nonbinary individuals.”

The most significant proposal released by HHS would withhold all Medicare and Medicaid funding from hospitals — a big portion of their budgets — if they provided gender-affirming care to those under age 18.

The Children’s Hospital Association said that rule — if finalized — would set a dangerous precedent. “Today’s proposed conditions make it possible for all kinds of specialized health care treatments to be withheld based on government-mandated rules,” wrote CEO Matthew Cook. “Millions of families could lose access to the care they need.”

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After a 60-day comment period, the rules could be finalized and then take effect.

Attorneys general in New York and California have said they will fight these rules and protect the rights of trans people to get care in their states. The ACLU has vowed to sue, and more legal challenges are expected.

“I don’t want to be lost”

According to a CDC survey, about 3% of teenagers aged 13-17 identify as transgender, approximately 700,000 people. A poll from health research organization KFF found that less than a third of transgender people took medication related to their identity and 16% had had surgery.

For young people, medical options most commonly include puberty blockers and hormones. Surgery is very rare for minors. “This is health care that evolves over time, is individualized, tailored to a patient’s needs, often after years of relationship with a trusted health care team,” says Goepferd.

NPR spoke to a transgender 15-year old in California this week about the moves Trump administration officials were making to restrict care. “They think what I’m feeling is a phase and that my family should just wait it out and that it’s better I’m unhappy and never receive care,” he says. NPR agreed not to name him because of fears for his safety.

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He says it can be difficult for those who are not transgender to understand that experience, but that, as far as he can tell, these health officials “are not interested in understanding trans people.”

He describes the long and deliberate process he made with his parents and doctors before he began taking testosterone. “The decision to not start gender-affirming care is often just as permanent as a decision to start it,” he says. “Not starting [hormone therapy], for some people, it feels like ruining our body, because there are certain changes we can never have.”

Now, after six months on testosterone, he feels like he’s on the right path, and is worried about the prospect of losing access to his medication if HHS’s efforts to shut down care nationally succeed. “It feels like someone’s throwing me into the bush just off the path I’m on, and that’s kind of terrifying,” he says. “I don’t want to be lost. I want to keep going where I’m going.”

“Deep moral distress”

More than half of states already ban gender-affirming care for young people after a frenzy of laws passed since 2021 in Republican-led states. This week, Republicans in the House led efforts to pass two federal bills that would restrict access to care, including one that could put doctors who provide the care in prison for up to ten years. It’s unclear if the bills will be voted on in the Senate.

Although nothing has officially changed in states where the care is still legal, these efforts to enact national restrictions have doctors and health systems in those states bracing for the possibility that their clinics will have to close down.

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Dr. Kade Goepferd is standing in an exam room at Children's Minnesota hospital.

Dr. Kade Goepferd takes care of transgender and gender diverse young people at Children’s Minnesota hospital.
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“There’s a deep moral distress when you know that there is care that you can provide to young people that will measurably improve their health and the quality of their life, and you’re being restricted from doing that,” Goepferd of Children’s Minnesota says. “And there’s a moral distress in feeling like — as a hospital or a health care system — you have to restrict care that you’re providing to one population to remain financially viable to provide health care for other kids.”

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National Park Service will void passes with stickers over Trump’s face

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National Park Service will void passes with stickers over Trump’s face

The Interior Department’s new “America the Beautiful” annual pass for U.S. national parks.

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The National Park Service has updated its policy to discourage visitors from defacing a picture of President Trump on this year’s pass.

The use of an image of Trump on the 2026 pass — rather than the usual picture of nature — has sparked a backlash, sticker protests, and a lawsuit from a conservation group.

The $80 annual America the Beautiful pass gives visitors access to more than 2,000 federal recreation sites. Since 2004, the pass has typically showcased sweeping landscapes or iconic wildlife, selected through a public photo contest. Past winners have featured places like Arches National Park in Utah and images of bison roaming the plains.

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Instead, of a picture of nature, this year’s design shows side-by-side portraits of Presidents George Washington and Trump. The new design has drawn criticism from parkgoers and ignited a wave of “do-it-yourself” resistance.

Photos circulating online show that many national park cardholders have covered the image of Trump’s face with stickers of wildlife, landscapes, and yellow smiley faces, while some have completely blocked out the whole card. The backlash has also inspired a growing sticker campaign.

Jenny McCarty, a longtime park volunteer and graphic designer, began selling custom stickers meant to fit directly over Trump’s face — with 100% of proceeds going to conservation nonprofits. “We made our first donation of $16,000 in December,” McCarty said. “The power of community is incredible.”

McCarty says the sticker movement is less about politics and more about preserving the neutrality of public lands. “The Interior’s new guidance only shows they continue to disregard how strongly people feel about keeping politics out of national parks,” she said.

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The National Park Service card policy was updated this week to say that passes may no longer be valid if they’ve been “defaced or altered.” The change, which was revealed in an internal email to National Park Service staff obtained by SFGATE, comes just as the sticker movement has gained traction across social media.

In a statement to NPR, the Interior Department said there was no new policy. Interagency passes have always been void if altered, as stated on the card itself. The agency said the recent update was meant to clarify that rule and help staff deal with confusion from visitors.

The Park Service has long said passes can be voided if the signature strip is altered, but the updated guidance now explicitly includes stickers or markings on the front of the card.

It will be left to the discretion of park service officials to determine whether a pass has been “defaced” or not. The update means park officials now have the leeway to reject a pass if a sticker leaves behind residue, even if the image underneath is intact.

In December, conservation group the Center for Biological Diversity filed a lawsuit in Washington, D.C., opposing the new pass design.

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The group argues that the image violates a federal requirement that the annual America the Beautiful pass display a winning photograph from a national parks photo contest. The 2026 winning image was a picture of Glacier National Park.

“This is part of a larger pattern of Trump branding government materials with his name and image,” Kierán Suckling, the executive director of the Center for Biological Diversity, told NPR. “But this kind of cartoonish authoritarianism won’t fly in the United States.”

The lawsuit asks a federal court to pull the current pass design and replace it with the original contest winner — the Glacier National Park image. It also seeks to block the government from featuring a president’s face on future passes.

The America the Beautiful National Parks Annual Pass for 2025, showing one of the natural images which used to adorn the pass. Its picture, of a Roseate Spoonbill taken at Everglades National Park, was taken by Michael Zheng.

The America the Beautiful National Parks Annual Pass for 2025, showing one of the natural images which used to adorn the pass. Its picture, of a Roseate Spoonbill taken at Everglades National Park, was taken by Michael Zheng.

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Not everyone sees a problem with the new design. Vince Vanata, the GOP chairman of Park County, Wyoming, told the Cowboy State Daily that Trump detractors should “suck it up” and accept the park passes, saying they are a fitting tribute to America’s 250th birthday this July 4.

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“The 250th anniversary of our country only comes once. This pass is showing the first president of the United States and the current president of the United States,” Vanata said.

But for many longtime visitors, the backlash goes beyond design.

Erin Quinn Gery, who buys an annual pass each year, compared the image to “a mug shot slapped onto natural beauty.”

She also likened the decision to self-glorification: “It’s akin to throwing yourself a parade or putting yourself on currency,” she said. “Let someone else tell you you’re great — or worth celebrating and commemorating.”

When asked if she plans to remove her protest sticker, Gery replied: “I’ll take the sticker off my pass after Trump takes his name off the Kennedy Center.”

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Federal immigration agents shoot 2 people in Portland, Oregon, police say

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Federal immigration agents shoot 2 people in Portland, Oregon, police say

PORTLAND, Ore. (AP) — Federal immigration officers shot and wounded two people in a vehicle outside a hospital in Portland, Oregon, on Thursday, a day after an officer shot and killed a driver in Minnesota, authorities said.

The Department of Homeland Security described the vehicle’s passenger as “a Venezuelan illegal alien affiliated with the transnational Tren de Aragua prostitution ring” who had been involved in a recent shooting in Portland. When agents identified themselves to the vehicle occupants Thursday afternoon, the driver tried to run them over, the department said in a written statement.

“Fearing for his life and safety, an agent fired a defensive shot,” the statement said. “The driver drove off with the passenger, fleeing the scene.”

There was no immediate independent corroboration of those events or of any gang affiliation of the vehicle’s occupants. During prior shootings involving agents involved in President Donald Trump’s surge of immigration enforcement in U.S. cities, including Wednesday’s shooting by an Immigration and Customs Enforcement officer in Minneapolis, video evidence cast doubt on the administration’s initial descriptions of what prompted the shootings.

READ MORE: What we know so far about the ICE shooting in Minneapolis

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According to the the Portland Police bureau, officers initially responded to a report of a shooting near a hospital at about 2:18 p.m.

A few minutes later, police received information that a man who had been shot was asking for help in a residential area a couple of miles away. Officers then responded there and found the two people with apparent gunshot wounds. Officers determined they were injured in the shooting with federal agents, police said.

Their conditions were not immediately known. Council President Elana Pirtle-Guiney said during a Portland city council meeting that Thursday’s shooting took place in the eastern part of the city and that two Portlanders were wounded.

“As far as we know both of these individuals are still alive and we are hoping for more positive updates throughout the afternoon,” she said.

The shooting escalates tensions in an city that has long had a contentious relationship with President Donald Trump, including Trump’s recent, failed effort to deploy National Guard troops in the city.

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Portland police secured both the scene of the shooting and the area where the wounded people were found pending investigation.

“We are still in the early stages of this incident,” said Chief Bob Day. “We understand the heightened emotion and tension many are feeling in the wake of the shooting in Minneapolis, but I am asking the community to remain calm as we work to learn more.”

Portland Mayor Keith Wilson and the city council called on U.S. Immigration and Customs Enforcement to end all operations in Oregon’s largest city until a full investigation is completed.

“We stand united as elected officials in saying that we cannot sit by while constitutional protections erode and bloodshed mounts,” a joint statement said. “Portland is not a ‘training ground’ for militarized agents, and the ‘full force’ threatened by the administration has deadly consequences.”

The city officials said “federal militarization undermines effective, community‑based public safety, and it runs counter to the values that define our region. We’ll use every legal and legislative tool available to protect our residents’ civil and human rights.”

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They urged residents to show up with “calm and purpose during this difficult time.”

“We respond with clarity, unity, and a commitment to justice,” the statement said. “We must stand together to protect Portland.”

U.S. Sen. Jeff Merkley, an Oregon Democrat, urged any protesters to remain peaceful.

“Trump wants to generate riots,” he said in a post on the X social media platform. “Don’t take the bait.”

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Video: What Trump Told Us About the ICE Shooting

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Video: What Trump Told Us About the ICE Shooting

new video loaded: What Trump Told Us About the ICE Shooting

The New York Times sat down with President Trump in the Oval Office for an exclusive interview just hours after an Immigration and Customs Enforcement agent shot a 37-year-old woman in Minneapolis. Our White House correspondent Zolan Kanno-Youngs explains how the president reacted to the shooting.

By Zolan Kanno-Youngs, Alexandra Ostasiewicz, Nikolay Nikolov and Coleman Lowndes

January 8, 2026

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