Why Should Delaware Care?
Youth experiencing gender dysphoria face higher risks of depression and suicide. The use of puberty blockers and hormone treatment has been shown to reduce those risks. Recent federal threats over that treatment have restricted families’ ability to access gender-affirming care in Delaware. Though state officials have begun to take action against the threats, it is uncertain whether they will make a difference in the availability of care in the state.
Delaware Attorney General Kathy Jennings sent a letter to Nemours Children’s Hospital earlier this month urging its officials to “reconsider” a decision to stop accepting new patients into a clinic serving transgender youth.
In June, Nemours implemented the policy to end hormone and puberty blocker therapies for new transgender youth patients. Hospital officials previously said they made the decision in response to “evolving communications and actions from federal agencies directed at healthcare providers related to gender-affirming care.”
Jennings’ letter, which was addressed to Nemours CEO Dr. R. Lawrence Moss, warns of harm that could come to transgender youth who face reduced care – particularly to their mental health. It also struck an aspirational tone, stating that “history is replete with physicians and scientists who risked life and liberty to uphold patient care.”
“While I recognize that you may worry about being placed in a precarious business position, I worry that your decision makes our state less caring, less healthy, and less safe,” the letter stated.
The letter is the state’s latest in a string of actions to support gender-affirming care for youth in Delaware, which has grown scarce following threats from the Trump administration that it would pull Medicaid funding from hospitals that offer such treatment.
Just before Nemours made its decision in June, Gov. Matt Meyer signed an executive order that provided legal protections to people providing such treatment so that they cannot be prosecuted in other states absent a court order from a Delaware or federal judge.
When asked about the letter, officials from Nemours stated they are committed to maintaining a “safe and inclusive healthcare environment for all patients, families, physicians, and staff.” They did not state whether they would reconsider their decision.
“Nemours will continue to abide by all local, state, and federal regulations while providing the highest quality care for the children we serve,” Nemours spokeswoman Shelly Meadowcroft said in a statement to Spotlight Delaware.
Attorney General’s office spokesman Mat Marshall said last week that Nemours had not yet responded to the letter. When asked what Jennings expects the letter to accomplish, Marshall said the office wanted to amplify voices of their constituents, which he says has become more important after recent actions taken by the White House.
“When business leaders — especially those with clout — show that they’re willing to pick on kids for the sake of bending the knee, it’s important that they hear pushback,” he said.
In the letter, Jennings also bluntly contrasted Nemours’ decision with its prior lobbying against Delaware’s Hospital Cost Review Board. She said hospital officials previously argued that “government intermingling, no matter how benign, in hospital operations would threaten a doctor’s advice to their patients.”
“It was thus with considerable surprise that I learned of your executives’ decision, unburdened by any scientific or medical basis, to preemptively comply with President Trump’s cruel scapegoating of transgender kids,” she said.
New cuts to Medicaid, Medicare?
Since January, the Trump administration has developed policies to curb access to gender-affirming care for transgender individuals under the age of 19. Those actions include threats to withhold Medicaid funding from hospital systems; demands from federal agencies for data and policies on such care; and guidance instructing hospitals to disregard established treatment standards.
In early August, the National Review reported that the Trump administration would announce a new regulation that would cut Medicaid and Medicare funding to all hospitals that offer gender-affirming care, even for treatment that is unrelated to such care.
If implemented, the policy could halt care for gender-affirming care patients of any age in the state.
The Nemours Foundation, which operates facilities across Delaware, Florida, New Jersey, and Pennsylvania, received more than $800 million from Medicaid and other federal grants in 2023, according to financial reports. That figure represented close to half of its $2 billion revenue for that year.
Nearly half of the children Nemours cares for are Medicaid patients.
Trump’s policies have prompted more than 15 other hospital systems across the nation to limit access to gender-affirming care for youth, including the University of Pittsburgh Medical Center, Penn Medicine, Virtua Health, Kaiser Permanente, and Children’s National Hospital.
Earlier this month, the state also joining a multi-state lawsuit, asking a federal court to block the president’s policies that restrict gender-affirming care for transgender youth.
A ruling on the lawsuit, which was filed on Aug 1. has not been made yet.