Two major U.S. hospital systems have announced they will be scaling back or halting some pediatric gender-affirming care services by the end of the month, citing evolving legal and regulatory challenges.

Kaiser Permanente, which operates 40 hospitals across several states including California, Oregon, and Virginia, will pause gender-related surgeries for patients under the age of 18 beginning August 29. The organization stated that other forms of gender-affirming care, such as counseling and support services, will continue.

Meanwhile, Children’s National Hospital in Washington, D.C., will stop prescribing gender-affirming medications for minors as of August 30. This follows a move made earlier this year when the hospital suspended all puberty blockers and hormone therapy for children and adolescents.

These decisions reflect a broader national trend that has accelerated since the start of President Donald Trump’s second term in January. According to recent data, at least 17 major hospital systems across nine states and the District of Columbia have paused or discontinued pediatric gender services in response to heightened scrutiny and policy changes.

Earlier this year, President Trump signed an executive order barring federal support for gender transition services for individuals under 19. The order also emphasized strict enforcement of laws limiting access to such procedures, which the administration described as “destructive and life-altering.”

Healthcare professionals and advocacy groups have raised concerns about the implications of these policies. Critics argue that medical decisions involving gender care should remain between patients, their families, and their doctors — not subject to political directives.

“This is health care provided by licensed clinicians in accordance with well-established standards,” said Kellan Baker, a senior health policy adviser at the Movement Advancement Project, a nonprofit that focuses on LGBTQ+ issues. “Government interference in these private medical decisions is a significant overreach.”

Medical organizations including the American Academy of Pediatrics, the Endocrine Society, and the World Professional Association for Transgender Health have long supported gender-affirming care as medically necessary and evidence-based treatment.

As the policy environment continues to shift, health care providers, patients, and families face increasing uncertainty about the future availability of such care across the country.