For transgender and nonbinary youth across Wisconsin, access to gender-affirming medical care is not abstract or political—it is deeply personal, often hard-won, and central to their sense of safety and wellbeing. As of this week, many of those young people and their families were abruptly forced to reconsider their care after two major health systems announced they will stop providing certain gender-affirming services to patients under 18.

Children’s Wisconsin and UW Health both confirmed they are pausing services such as puberty blockers and hormone therapy for minors. The decisions come amid proposed federal policy changes that could threaten Medicare and Medicaid funding for providers that offer gender-affirming care to youth—funding streams that most Wisconsin hospitals depend on to operate.

Hospital leaders at both systems cited the same concern: proposed rules from the U.S. Department of Health and Human Services that could restrict federal funding for institutions providing gender-affirming care to minors. Faced with the risk of losing essential funding, both systems say they felt compelled to pause care, even as medical consensus continues to support these treatments for some patients.

In a statement, Children’s Wisconsin said it can no longer provide gender-affirming pharmacologic care due to “escalating legal and federal regulatory risk,” though it will continue offering mental health and behavioral health services. UW Health similarly confirmed it is pausing puberty blockers and hormone therapy for patients under 18, while maintaining other forms of care and support.

Advocates stress that these decisions were not driven by doctors or by changes in medical evidence. Major medical organizations—including the American Academy of Pediatrics and the American Medical Association—continue to recognize gender-affirming care as evidence-based and medically necessary for some patients. Instead, advocates say, political pressure is increasingly dictating what care is available, overriding the judgment of families and health care providers.

State Rep. Francesca Hong, a Democrat from Madison running for governor, responded by calling UW Health’s decision “dangerous and wrong.” In a statement shared on social media, Hong said the pause “violates our state’s values of fairness, compassion, and looking out for one another,” adding that it places “real harm on families who are already navigating complex medical needs.” She emphasized that parents should be able to make informed medical decisions for their children in partnership with qualified health care providers, free from political interference.

Community organizations warn that the consequences of these decisions will be felt immediately by young people. Steve Starkey of OutReach LGBTQ+ Community Center in Madison said denying youth the ability to express their gender and access appropriate medical care can have serious mental and physical health impacts. He noted that the loss of care is likely to exacerbate already high rates of anxiety, depression, and suicidal ideation among transgender youth.

GSAFE, a statewide organization that supports LGBTQ+ youth, echoed these concerns. Its leaders said repeated political attacks on transgender people have taken a heavy toll on young people’s wellbeing and that restricting access to puberty blockers and hormone therapy risks causing both physical and emotional harm.

At the state level, Wisconsin Attorney General Josh Kaul has joined other states in a lawsuit challenging federal efforts to limit access to gender-affirming care. Kaul argues that the proposed federal changes exceed legal authority and undermine states’ ability to oversee medical decision-making.

For families whose children received care through Children’s Wisconsin or UW Health, the pauses mean uncertainty and difficult choices. Some may be forced to seek care out of state, pay out of pocket, or delay treatment entirely—options that are not equally accessible to all families and that deepen existing disparities in health care access.

Even as access narrows, Wisconsin’s LGBTQ+ community continues to mobilize. Advocates are calling for policies that protect gender-affirming care and ensure that young people can make health decisions with their parents and trusted medical providers—not through political mandates.

Fair Wisconsin will host a virtual briefing on how to respond to these developments on January 15 at 7:15 p.m. More information is available at linktr.ee/fairwisconsin or on Fair Wisconsin’s social media pages, @fair_wisconsin.