Editor’s note: This is the second part in a two-part series following young transgender people and their families dealing with new restrictions in access to healthcare in and near western Massachusetts. Part one told the stories of some of these families. Part two focuses on organizing efforts to fight rollbacks in gender-affirming care. Throughout the series, The Shoestring has allowed some sources to use pseudonyms for fear of targeting due to their identities.
Earlier this spring, something atypical sat outside Baystate Medical Center in Springfield.
On the manicured grass outside the hospital’s entrance, several people held up a large banner. On it, a cerulean bus with the Baystate logo read: “Baytstate Bows To Trump.” Handcrafted legs, made of fabric, poked out from underneath the bus. There were speech bubbles painted on signs around the bus, too. “Gender affirming care gave me my life back,” one read. “I don’t want to live if I can’t live as myself,” said another.
The message that the gathered protesters had for the hospital’s leadership was written, word by word, on signs staked into the grass: “Baystate bows to Trump, throws trans kids under the bus.”
There was no one organization behind the demonstration, but rather a decentralized group of activists and concerned community members. They are part of a wave of people demanding that Baystate Health reverse the decision it made earlier this year to stop providing gender-affirming care to patients under age 19 — a broad spectrum of services that includes puberty blockers, hormone therapy, and visits with a psychologist. That decision forced families and their children to scramble to find medical care elsewhere at a time when powerful figures’ anti-trans rhetoric, and right-wing legislation targeting trans people, have spread nationwide.
Baystate’s leadership has connected its decision to President Donald Trump’s threats to cut federal reimbursement to institutions providing gender-affirming care to minors. And the hospital isn’t the only one that has stopped the care. Fenway Health in Boston and Outer Cape Health Services on Cape Cod have taken the same step. In response, people across the state have begun to fight back, advocating for the restoration of medical care that many professionals consider life-saving.
Baystate declined an interview with The Shoestring. Peter Banko, the hospital system’s president and CEO, released a press statement earlier this month stating that “inclusion is a core expression” of Baystate’s mission. Though Banko did not address any particular event or protest, he said that there is polarization and tension that everyone is feeling and working through.
“We must continue to delicately balance our functional realities with the rapidly changing legal and reputational landscape,” Banko said in the statement.
Banko said that Baystate’s commitment to serving the community and the values of the hospital are not political. He called for the celebration of LGBTQ+ members of its team, for reflection on how to build a better community, and for learning from the stories of others.
But amid the criminalization of trans life across the country, activists in western Massachusetts have said Baystate’s actions were premature and are causing significant harm to the LGBTQ+ community.
Ali Wicks-Lim, a long-time western Massachusetts resident and someone who identifies as non-binary, is one of those organizers.
Wicks-Lim said that the protest in front of the hospital grew from conversations in the community after Baystate cut off services to trans youth. The organizers wanted to help people understand the emergency this represented for youth, and to move them to action.
“We actually want people to have to struggle with how uncomfortable it is, because it’s what’s happening,” they said. “We are dealing with a medical treatment that can be life-saving for youth, and we want people to be aware of what’s at stake. There really are trans lives at stake here.”
Earlier this month, the protestors were at Springfield Pride — an event that Baystate Health was also attending. One of the demands that organizers have made from Baystate is that the hospital not attend any pride events as long as its leadership maintains its decision to end gender-affirming care for minors.
They’ve also protested in cities like Northampton and outside of Baystate’s facilities elsewhere. Last month, Wicks-Lim said the hospital called the police to disperse a protest being held outside of Baystate Franklin Medical Center in Greenfield.
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Many have considered Massachusetts to be a safe-haven for queer rights, having been the first state to legalize gay marriage and a place where many trans people have sought care, safety, and refuge.
But some families say that the commonwealth isn’t safe enough for trans people anymore.
Madison is the mother to two kids, one of whom is trans, and is a spouse to a trans partner. She and her family, currently in eastern Massachusetts, are planning to leave the country — again. (“Madison” is a pseudonym.)
Madison told The Shoestring that her family moved back to Massachusetts because, among other reasons, she believed there were less threats to trans rights after Biden took office in 2020. But in November 2024, on the cusp of Trump’s re-election, she said that it was time for her family to move again.
Madison and her partner woke up every day and used the news to assess the threat level to trans rights, deciding just how safe their family really was.
Her biggest fear is that the government will take away her children, finding her unfit to be a parent just because she allows her son to get gender-affirming care.
Organizers across the state have come out against healthcare providers who have cut gender-affirming care for minors.
Protect Trans Futures is a Boston-based organization led by people concerned about Fenway Health’s decision. Protestors have organized several events, including vigils, pride events, and marches, and have recently mobilized to demand that Attorney General Andrea Campbell enforce queer civil rights.
Some of the organizers with Protect Trans Futures have been harmed by a lack of access to trans healthcare. Teddy Walker, a 21-year-old organizer, moved from Texas to Massachusetts when they were a teen for their education.
“It feels so personal that [it] could have been me,” Walker said.
He said that he knows many people who aren’t allowed to start gender-affirming care because of their parents and have to wait until they’re 18 to pursue it. Walker said that waiting for that healthcare is a struggle and that “some people don’t live long enough to see it.” Studies have found that trans people have access to puberty blockers and hormones have better mental health outcomes, including lower rates of depression and suicidal thoughts.
Walker said that advocates founded Protect Trans Futures in early October, after members started hearing that Fenway Health was sending out messages to their patients about the organization’s decision to end gender-affirming care for minors.
“It felt like a moral imperative,” Walker said. “It felt like something we had to do, not just to stand up for and protect the trans kids and youth that we so recently have been, but also knowing that our care is next.”
Fenway Health actually emerged in 1971 from the context of the HIV epidemic, when many providers systematically denied queer people care, resulting in the deaths of thousands. The clinic started out in the basement of a Christian Science church as a one-day drop-in center, where volunteer medical staff provided care to the neighborhood, according to the organization’s website.
Fenway Health declined an interview with The Shoestring, but in a statement said that the institution is “deeply committed” to providing gender-affirming care to its patients and that ”while there has been a change to one specific aspect of care, the vast majority of care for transgender and gender-diverse youth continues uninterrupted at Fenway, including primary care, behavioral health, sexual and reproductive health services, and family support.”
Protect Trans Futures has also been organizing pressure campaigns on local politicians to enforce civil rights for people who receive gender-affirming care.
In an Instagram post, the organization said that protestors have sent over 1,000 pages of letters from impacted families and concerned community members to the state’s Office of the Attorney General asking officials to investigate Fenway and Baystate Health’s decisions. In the post, Protect Trans Futures criticized Campbell, the attorney general, for not enacting consequences in line with anti-discrimination laws, not requiring reinstatement of that healthcare, and for shifting the responsibility of legal action onto constituents.
In a recent press release, Campbell’s office said that it has issued a legal advisory, stating that the federal law “does not prohibit medical professionals from providing transgender healthcare, including hormones and puberty blockers, to patients under the age of 19.”
“My office remains committed to ensuring providers and the patients and families they serve have clear guidance about their obligations under state and federal law,” Campbell said in the statement.
The Massachusetts Attorney General’s Office, in a coalition with other states’ attorneys general, sued the U.S Department of Health and Human Services after Robert F. Kennedy, the secretary of health, published a declaration that his department can disqualify medical providers and hospitals from federal funding if they provide transgender healthcare. The reason, he claimed, was that transgender healthcare does not meet the standards of care from professionals.
In April, the U.S District Court of Oregon sided with the coalition, stating that the declaration does not have any legal effect and is unlawful.
The attorney general’s office declined an interview, but in a statement, a spokesperson said that gender-affirming care is “critical for transgender young people’s wellbeing, and it remains legally protected in Massachusetts.”
“My office has been in direct contact with transgender individuals, advocates, families, and healthcare providers across the Commonwealth, including through a listening session in Western Massachusetts, and we remain closely engaged as this situation develops,” Campbell said in the statement. “I will continue to fight back against the Trump Administration’s illegal policies that undermine access to healthcare and violate our residents’ rights.”
Boston-based organizers aren’t the only ones demanding action and enforcement from the attorney general’s office.
Gabe Peeples is a local activist and social worker who works with neurodivergent LGBTQ+ youth. They’re also a client with Baystate Health who learned that the hospital would no longer offer gender-affirming care to minors through a social media post that Baystate made.
“I was very upset and angry. I’m still pretty upset and angry,” Peeples said.
Peeples works with Wicks-Lim and other local activists, and has attended several protests accompanying the Baystate bus protest art. After thinking through ways to take action, Peeples decided on filing a complaint with the attorney general’s office alleging discrimination by Fenway Health and Baystate Health. They described the process as easy and said that they had gotten a response from the office within the expected timeframe.
According to a post from Protect Trans Futures, the attorney general’s office held a few listening sessions to hear from residents about their concerns with Fenway’s and Baystate’s decisions. Peeples said that it went better than they had expected, and that the office seemed to be in disagreement with the clinics’ decisions. However, despite judges in other states ruling that the Trump administration’s stance has no legal bearing on hospitals, Campbell’s office hasn’t taken any action against Massachusetts providers that have stopped providing gender-affirming care to minors.
“I’m not sure at this point why they’re not filing suit,” Peeples said.
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Those who spoke to The Shoestring for this series said that although right-wing politicians are behind the efforts to target transgender people, Democrats have not done enough to protect trans civil rights. The majority of Democratic officials, including those in Massachusetts, distance themselves from trans issues, they said.
“They’re afraid of losing votes. They’re afraid that we’re somehow a splinter issue. People blamed the loss of the last election on us,” said Nicole, the parent of a transgender daughter who was a patient at Baystate before the hospital ended gender-affirming care for minors. (“Nicole” is a pseudonym.) “I cannot say that the Democratic Party have made themselves allies to the trans community. They have not.”
Nicole said that she had recently been to a virtual town hall where several lawmakers were present.
“They told me all about how they are trying to block the proactive actions taken by Republicans to curtail trans rights,” Nicole said. “But they could name not a single thing that they’re doing proactively to secure or restore care for trans folks, children especially.”
Earlier this year, the Human Rights Campaign published a statement about the organization’s concern about a severe nationwide threat to transgender patients’ healthcare in the United States. According to data from the think tank Movement Advancement Project, over 700,000 youth from the ages of 13 to 17 identify as transgender and nearly 40% live in states where access to gender-affirming care is banned.
With federal elections coming up in November, U.S. Sen. Ed Markey has released a report detailing discriminatory actions that the Trump administration has taken against transgender people in the United States and testimonies from those impacted locally.
In the report, Markey said he had called on the Centers for Medicare and Medicaid Services “to withdraw two proposed regulations that would place unprecedented restrictions on healthcare providers and hospitals providing evidence-based medical treatment for gender dysphoria to young people” in late February. Earlier this year, in partnership with House members from Washington and California, Markey reintroduced a “Transgender Bill of Rights” in the Senate. Markey had originally tried to pass the bill of rights in early 2023.
Among other things, the bill would ban “conversion” therapy, increase funding for mental health services, and expand access to healthcare.
As of 2026, the American Civil Liberties Union has identified over 500 anti-LGBTQ+ bills across the nation, five of which have been introduced in Massachusetts. Many of the bills are school-based. Three of them would exclude trans students and athletes from playing on the sports team that corresponds with their gender. One bill proposed informing guardians about their child’s gender identity, which could out students to unsupportive caretakers. Another bill proposes restrictions to healthcare for LGBTQ+ youth and penalties to providers who offer inclusive care.
Republican lawmakers have introduced all of those bills in Massachusetts, none of which appear likely to pass.
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Last year, a research article in the peer-reviewed journal JAMA Pediatrics said that the number of transgender youth who access gender affirming care is relatively low — only 0.1% of teenagers under private insurance who both identify as transgender and receive medication as part of their gender affirming care.
Theo Schall is an assistant professor of health policy and management at the University of Massachusetts Amherst. He said that the number of trans youth in families who are able to articulate their needs, have familial support to access gender-affirming care, and receive the care itself is quite low and that these families typically have more socioeconomic privilege.
For those without means, access, or interest, transition can look different. According to a poll conducted by KFF and The Washington Post, transitioning means something different for every individual. Almost 90% of trans people included in the survey made changes to their name, pronouns, and style, but much fewer reported taking hormones or undergoing surgery as forms of transitioning.
For such a small population of people that are able to access gender-affirming care, Schall said that there are many forms of violence that the trans community is facing — including administratively. He said that trans people are being “disappeared,” essentially, “because they don’t fit into existing structures.” Systems of data collection and classification in institutions, from prisons to hospitals, “just don’t have capacity for non-binary answers to gender and sex,” he said.
What that leads to, Schall said, is those systems — including the healthcare system — abandoning those people.
According to Schall, this can cause other issues as well. One example he named was identification discrepancies at places like airports, where someone’s assigned gender at birth doesn’t match their appearance. And at hospitals, where a trans person could be seeking care that doesn’t traditionally align with their gender marker — like a trans man seeking reproductive care — it can mean difficulty getting needed treatment.
The risks to criminalizing access to trans healthcare are immense, experts say. A study published in the New England Journal of Medicine found that in just two years of hormone therapy, youth reported higher life satisfaction and lower rates of anxiety and depression. The Stanford University School of Medicine also found that “transgender adults who started gender-affirming hormone therapy as teens had better mental health than those who waited until adulthood or wanted the treatment but never received it.”
However, denial and restriction to care can have the opposite effect. Transgender people are more at risk of adverse socioeconomic outcomes like homelessness, unemployment, as well as poor mental health outcomes. One literature review conducted by the University of Washington found that bans were having adverse effects on trans youth and their caregivers as early as 2024.
Schall brought up the concept of a child’s right to an open future — a phrase popular in the field of bioethics. To him, that concept applies to the ability for youth to be able to choose when and how to go through the process of puberty.
“Puberty blockers were our best way of preserving for trans and gender-diverse kids — who thought they might want medical interventions — future opportunities. We used to have this miraculous opportunity to open the door to a big, wide-open future,” Schall said. “And now what we’re doing instead to these kids is constraining their opportunities by making them live through the first puberty, which of course we know has negative consequences.”
“We need to push back there and point out the ways that that assumes that children are only property, that children are only a blank slate, that children are only an extension of their parents’ desires in the world,” he added. “They’re, in fact, complicated.”
Sally Pirie is an arts-based ethnographer at UMass Amherst. She studies transgender childhood from the lens of anthropology in her multi-year project called Gender Moxie. In her work, she uses different research methods and analysis combined with the comics that the transgender children she works with create.
“Being transgender is a normal human variation,” Pirie said. “Like eye color or hair color. And again, we see it in every culture all over the world, throughout every period of history, everywhere. They may not have had social media in the Iron Age, but I guarantee you they had trans people.”
Pirie said she often sees in “the popular press” that cisgender children are never questioned about their cis identity, which she says isn’t the case for transgender children.
“Trans kids are constantly having their sense of self challenged by the establishment and by adults,” she said.
It’s that attack on trans children that activists say they’re fighting against. And according to some, the stakes couldn’t be higher.
“Make no mistake. We have been in a state of trans genocide for as far as I know, forever,” Nicole said. “They’ve been trying to make us not exist. It’s not that the previous administration was super friendly to trans people in any kind of way. Just, you know, this present administration is more overtly hostile.”