Lavier Pounds, a volunteer with TransYOUniting, of the North Side, rallies the crowd in the rain outside UPMC’s Downtown headquarters as they call for UPMC to reinstate gender-affirming care for people under 19, on Thursday, April 3, 2025. “It’s okay to be ourselves,” said Pounds. “I’m here to help us uprise.” (Photo by Stephanie Strasburg/PublicSource)
Pittsburgh’s dominant health care system has said that it is monitoring federal directives on care to patients under 19, and continues “to offer necessary behavioral health and other support” while empathizing with affected patients and families.
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About 200 people turned out in rainy weather to rally outside UPMC headquarters in downtown Pittsburgh Thursday evening. Standing under rainbow umbrellas and waving trans pride flags, they rebuked the health care giant for rolling back young people’s access to gender-affirming care.
Advocacy groups including TransYOUniting, the Pennsylvania Youth Congress and others organized the action after learning that UPMC Children’s Hospital of Pittsburgh had stopped providing gender-affirming health services to LGBTQ+ kids. They viewed the move as a capitulation to the Trump administration’s plan to exclude trans people from public life.
Several children were in attendance, including Oliver, 10, of Lawrenceville who waved a “Protect Trans Kids” sign while chanting slogans with the crowd. “I’m mad because I’m transgender,” they said.
PublicSource is withholding Oliver’s last name at the request of their parent, K.T. Fishbein, an echocardiographer at Children’s Hospital. Like most trans and nonbinary children, Oliver isn’t seeking gender-affirming care yet. But Fishbein “was pretty upset” by their employer’s decision to deny care to the children who need it, and worries that Oliver and others may not have access in the future.
“I love what I do at Children’s. I love my community there,” Fishbein said. “But this makes you feel really let down.”
During the rally, organizers attempted to deliver a letter signed by Mayor Ed Gainey and 14 other state and local officials to UPMC leadership. It wasn’t accepted, but it called on the executives to:
- Immediately restore access to gender-affirming care at Children’s Hospital
- Establish an advisory committee that includes trans youth to oversee administration of care
- Fund alternative providers if a court order bars it from providing gender-affirming care, among other demands.
“… You are choosing to send a devastating message to the entire trans community that their health and futures are negotiable under political pressure,” they wrote to UPMC executives. “Continuing to provide comparable medical care to cisgender young people but not transgender youth is discrimination.”
In a speech, Gainey told rallygoers to “stand up and force UPMC to do the right thing.” Asked if the city has the leverage to pressure UPMC to restore access to gender-affirming care, he wrote, “the City of Pittsburgh has laws on the books to ensure people have equal access to health care regardless of gender identity or sexual orientation.”
“My administration’s law department is examining legal avenues to enforce our city’s non-discrimination policies, and we expect health systems that operate here to follow the law,” he said in a statement to PublicSource after the rally.
Rallies were also held today in Erie, Altoona, Lancaster, and Lewisburg — all cities where UPMC operates.
In January, President Donald Trump issued an executive order that threatens to pull federal funding from hospitals, medical schools and other institutions that provide gender-affirming care to minors, which it defines as those under age 19. The order’s language specifically mentions puberty blockers, hormone therapy and surgery — all of which are medically necessary for those who suffer from gender dysphoria, according to a consensus among major medical associations.
A federal judge in Maryland extended a nationwide injunction last month that blocks enforcement of the order. The White House didn’t immediately respond to a question about its compliance with the court, though it said in February that the order is “already having its intended effect.” The statement listed six hospitals, including one in Philadelphia, that were pausing or reviewing gender-affirming services for minors.
Some large health systems quickly bent to the pressure and began turning young LGBTQ+ patients away just days after Trump signed the executive order. UPMC may have waited longer before quietly changing its policies around gender-affirming care for minors. Patients and their families told reporters last month that its providers had stopped prescribing puberty blockers and hormones. And it canceled an 18-year-old’s top surgery, which was scheduled for March 24.
A spokesperson wrote that UPMC is monitoring federal directives that affect its ability to provide “specific types of care” to patients under 19. “We continue to offer necessary behavioral health and other support within the bounds of the law. We empathize with the patients and families who are directly affected by these ongoing changes.”
The spokesperson didn’t answer detailed questions about UPMC’s rationale for denying young patients who need gender-affirming care, the role federal funding may have played in that decision, and the specific services it chose to eliminate.
Advocates characterized UPMC’s actions as a shocking and premature indulgence of the administration’s anti-trans agenda. They pointed to lawsuits arguing the executive order is unconstitutional, the nationwide injunction blocking its enforcement and the City of Pittsburgh’s sanctuary laws shielding providers from criminalization.
“What UPMC is doing is preemptive and there’s no basis for it,” said Dena Stanley, a lead organizer of the rally and the executive director of TransYOUniting. The nonprofit serves LGBTQ+ and HIV-positive people, and helps run the QMNTY Center, a safe haven for the community on the North Side.
“We all understand what Trump is trying to do, but they also have power,” she said, noting that UPMC has the legal resources to “stand up and fight back.”
Stanley pointed out that UPMC is a major provider of gender-affirming surgeries in Western Pennsylvania. Its domination of the regional market leaves young people who need top surgeries with few alternatives unless they can afford to travel. “These children are just devastated,” she said. “And their families are devastated.”
Allegheny Health Network, the region’s other big health system, offers gender-affirming care at its Center for Inclusion Health, a low-barrier clinic on the North Side. Its Transgender Health Program provides primary care and surgical services including facial feminization and chest reconstruction.
“AHN remains committed to supporting the comprehensive needs of these patients, including primary care, surgical care and mental health support, while complying with all applicable laws,” a spokesperson wrote in response to detailed questions.
Some independently owned clinics are opening their doors to the young trans and queer patients who were denied care by UPMC. About two weeks ago, providers from Children’s Hospital started referring these patients to Allegheny Reproductive Health Center— an East Liberty clinic offering a range of gender-affirming services, according to Sheila Ramgopal, the center’s chief executive and an obstetrician and gynecologist.
Ramgopal said the providers were distraught while they spoke with the center’s staff, explaining they had been pulled into “a closed-door meeting” with UPMC executives. The executives reportedly told them they could no longer provide gender-affirming services to LGBTQ+ children, including hormone therapy and surgical services.
“We’re getting emails and messages from these providers who are desperately trying to find their clients care … My hats off to them for really trying to find places where people can go and still be safe, and hopefully they don’t get in trouble for doing that.”
If UPMC continues this policy in the long-term, Ramgopal predicted that some gender-affirming care providers will leave its system to treat young patients elsewhere. But non-compete agreements may bar them from working for other employers in the county, which means the region would lose their medical expertise unless UPMC agrees to not to enforce those agreements, they said.
Ramgopal said there’s precedent: UPMC allows abortion providers to leave its system for jobs at Allegheny Reproductive Health Center, Planned Parenthood of Western Pennsylvania and other independent facilities in the county. But they’re still barred from joining the AHN system.
“My hope is this would be a negotiable issue with UPMC,” they said. “There’s a lot of providers who live and work in Pittsburgh who want to continue to do this work here.”
A spokesperson didn’t answer a question about UPMC’s flexibility around non-compete agreements.
Venuri Siriwardane is PublicSource’s health and mental health reporter. She can be reached at venuri@publicsource.org or on Bluesky @venuri.bsky.social.
Stephanie Strasburg is a photojournalist with PublicSource who can be reached at stephanie@publicsource.org, on Instagram @stephaniestrasburg.
The Jewish Healthcare Foundation has contributed funding to PublicSource’s health care reporting.
This article first appeared on PublicSource and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
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