EJ, a nonbinary person from Pennsylvania, spent nearly a decade preparing for gender-affirming surgery. After months of emotional, physical, and financial preparation, the day had finally arrived. But just 13 hours before the procedure, EJ received a call that changed everything: the surgery was canceled.

Video still of EJ speaking in front of a concrete wall. A caption at the left of the image shares EJ's name and they/them pronouns. A caption at the bottom of the screen also reads "My name's EJ."
EJ, a nonbinary Pennsylvanian, spent nearly ten years preparing for life-changing gender-affirming surgery—only to be denied hours before the procedure due to a hospital’s religious affiliation. In this powerful video, EJ shares the emotional toll of being refused care and the broader implications of religious refusals in health care.

No explanation could soften the devastation. EJ had navigated countless hurdles—insurance approvals, medical evaluations, and the emotional weight of waiting—only to have essential, life-affirming care denied at the last moment. EJ’s story is not an anomaly. Across the country, transgender and nonbinary individuals are facing mounting barriers to care, and these attacks should concern us all.  

This isn’t just about one community—it’s about everyone’s right to make personal health care decisions.

What Is Gender-Affirming Care? 

Many people are unfamiliar with what gender-affirming care actually includes. It is a broad range of services that helps people align their physical, emotional, and social well-being with their gender identity. Currently, the access to gender-affirming care is under attack for transgender and nonbinary individuals. 

Gender-affirming care includes: 
  • Social support, such as changing names and pronouns, wearing clothes that match one’s identity, and changing hairstyles.
  • Mental health care, including therapy to help individuals and families explore their gender identity and manage stress caused by discrimination and stigma.
  • Medical Care, which is tailored to each person’s needs and follows established medical guidelines. For youth, this may include medications to delay puberty, giving families and doctors more time to make informed decisions about other medical options. Hormone replacement therapy (HRT) or gender-affirming surgeries, such as chest reconstruction, may also be considered, though these treatments are very rare for adolescents. 

Gender-affirming care is evidence-based and supported by decades of research. Studies have shown that access to this care significantly reduces anxiety, depression, suicidal ideation, and substance use, improving overall health outcomes. In many cases, it is life-saving. 

Major medical organizations—including the American Medical Association, American Psychological Association, the Endocrine Society, and the American Academy of Pediatrics—overwhelmingly support access to gender-affirming care for both youth and adults. These organizations have publicly opposed bans on this care, emphasizing that medical guidelines already support providers in delivering developmentally appropriate care.

When Politicians Dictate Care, We All Lose

Attacks on gender-affirming care are part of a broader effort to control personal medical decisions. Health care should be guided by medical professionals and the needs of patients and their families—not politicians with an agenda. When lawmakers interfere in gender-affirming care, they set a dangerous precedent that threatens all of us. 

If lawmakers can block access to gender-affirming care today, what’s stopping them from restricting other forms of essential care tomorrow? 

These bans do not prohibit the medical services themselves—they only restrict access to them for transgender, nonbinary, and gender-diverse people. Cisgender youth continue to have access to the same interventions that are being denied to trans youth. For example, chest reduction surgery remains available for cisgender boys with gynecomastia, and hormone replacement therapy (HRT) is still prescribed to cisgender adults for a variety of reasons, including menopause and other hormonal conditions. The inconsistency exposes the real motivation behind these policies: they are not about safety or medical ethics, but about discrimination. 

Policies that target transgender people reinforce the dangerous idea that some people deserve care while others do not. When one group is denied care, the entire health system is weakened. Health care is a human right. No one should have to fight for medically necessary care because of their identity. 

These policies are also part of a broader push to strip away patient protections and state-level health care rights. From the first days of the Trump administration, executive orders and policies targeted LGBTQ+ individuals, particularly transgender people. These actions attempted to undermine medical expertise, strip decision-making power from patients and families, and dismantle federal protections against health care discrimination. Today, we see this legacy continuing as lawmakers attempt to use the government to block certain people from receiving care while allowing others access to the same treatments. 

Progress Doesn’t Mean Protection 

Even in states with strong LGBTQ+ protections, barriers to gender-affirming care persist. Catholic hospitals, which now make up a significant portion of health care systems nationwide, often deny gender-affirming and reproductive health services due to religious doctrine. These hospitals are not required to disclose non-medical or policy-based restrictions on care, making it even harder for people to find the services they need and further obscuring the ways hospitals engage in discrimination. This lack of transparency leaves patients vulnerable and uninformed, a serious concern that advocacy groups are working to address as a key policy priority. 

Meanwhile, federal policies have eroded civil rights and health care access. Efforts to limit state flexibility in Medicaid and the Affordable Care Act (ACA) prevent states from expanding coverage for gender-affirming care. These policies harm not just transgender people but also millions of low-income individuals, families, and military personnel covered under TRICARE. 

It’s Bigger Than Gender-Affirming Care 

The rollback of health care rights is not new. When the Supreme Court overturned Roe v. Wade, millions lost access to reproductive health care. Attacks on gender-affirming care follow the same playbook—limiting bodily autonomy, restricting access, and fueling discrimination. These are not isolated issues; they are interconnected assaults on personal freedom. 

This is why advocacy groups, including Lambda Legal and other national civil rights organizations, continue to fight back in the courts. Their efforts are critical in ensuring that patients, families, and doctors—not politicians—make health care decisions.

Why This Matters—For All of Us 

Supporting transgender and nonbinary people is about safeguarding everyone’s right to access health care without political interference or discrimination. EJ’s story could be anyone’s story. None of us should have to fear losing access to the care we need. 

Health care decisions belong to patients and their doctors—no one else. We all deserve a system that respects dignity, honors personal choices, and ensures care for everyone. 

Now is the time to act. When one group is targeted, we all are. Let’s stand together against policies that threaten access to care—because this fight is about all of us.