Children’s Minnesota suspends pediatric gender-affirming health services amid Trump funding threats

Children’s Minnesota is suspending some pediatric gender health services in response to threats by the Trump administration to cut off millions of dollars in federal funding that keep its hospitals running.

The health system made the move reluctantly, according to a written statement, in response to “federal actions directed at pediatric health systems like ours that provide this care.” The suspension will take effect Feb. 27.

Other health care providers such as Duluth-based Essentia Health might take similar steps or face severe financial losses.

“This is not the decision we wanted to make,” Children’s said in its statement. “This is the decision we had to make to protect our hospital and our providers.”

The Trump administration late last year proposed rules that would cut federal Medicaid and Medicare support for hospitals and clinics that provide minors with certain forms of gender-affirming care — an umbrella term that ranges from counseling for children making gender transitions to medications and surgeries at age-appropriate stages for teenagers and adults.

The proposal, still under public review until later this month, would have a cataclysmic effect on Children’s finances. Medicaid, known primarily as Medical Assistance in Minnesota, is a government-supported health insurance program for children and low-income Minnesotans. The program covered about 48% of the patients admitted to Children’s hospitals in Minneapolis and St. Paul in 2023.

Children’s will continue to provide mental health care and support to transgender patients, but will no longer provide puberty-suppressing medications or hormones to patients younger than 18. The pediatric health system did not previously provide gender-affirming surgeries.

The federal funding pressure by the Trump administration undermines efforts by Gov. Tim Walz and DFL lawmakers to preserve transgender health care and offer a refuge to people who lost access to care in other states.

About 2% of high school juniors identified themselves as transgender males or females in the 2025 Minnesota Student Survey, while about 5% were unsure or identified themselves by multiple genders or no genders.

Iowa and the Dakotas are among the 27 states that have issued laws that restrict or ban certain forms of transgender medical care based on concerns that they are unproven or pressed on children before they are psychologically ready to choose them.

Some of the concerns center on surgeries, such as so-called top surgeries to reduce breast tissue among transgender men, that aren’t routinely provided to children in Minnesota. The American Society of Plastic Surgeons on Tuesday discouraged such surgeries for anyone 18 or younger based on inadequate proof of the psychological pros and cons of such irreversible procedures.

M Health Fairview provides adult and pediatric gender health services and is monitoring the proposed changes at the federal level. The U.S. House in December passed legislation that would make it a felony to provide gender-affirming surgeries or medications to minors.

“We have a responsibility to our staff and our patients to plan for different scenarios and ensure that we are complying with legal requirements,” Essentia said in a written statement. “Doing so is critical to continue effectively serving our communities.”

One Duluth woman is worried that her teenager will lose access as soon as this month to the hormone medications that she described as “life-saving care.”

If Essentia no longer provides gender health services, families in northern Minnesota have few options, said the mother, who asked for her name to be withheld for the privacy of her family.

“It’s hard to tell your kid that the federal government is attempting to interfere with their needed health care,” she said. “It’s very frustrating, because we felt fairly safe and secure in Minnesota.”

Children’s opened its specialty clinic in 2019 and has become a high-profile target of the Trump administration. HHS General Counsel Michael Stuart singled out Children’s on Jan. 5 for a federal investigation over its billings for hormone medications. The mounting pressure contributed to Children’s decision to suspend services now rather than wait for new federal rules to take effect.

“Even a so-called ‘temporary pause’ causes real harm: it disrupts care, disrupts patient-provider relationships, forces families to scramble for alternatives, and drives people away from healthcare altogether,” they wrote.

They urged Children’s to “immediately resume care” if legal challenges later this year overrule the federal funding changes.