Tucson clinic ends gender-affirming care for teens

Parents of transgender teens who received treatment at Tucson’s El Rio Community Health say it is crushing to have it taken away, after the clinic said it is discontinuing hormone therapy for transgender youths under age 18 due to Trump administration orders.

“The loss of this is devastating,” said Veronica Camacho, breaking into tears. She is mother to a 16-year-old transgender daughter who was receiving hormone treatments from El Rio for the last two years. “It’s going to reverse everything that she’s done thus far. There’s not many options left in Tucson or in Arizona for us to do, so at this point, it’s been really stressful. We have to look at different places that we can find care.”

El Rio, a major and leading provider of transgender health care in Southern Arizona, conveyed its decision to parents and families a week and a half ago.

Camacho found out May 1 in a phone call from her daughter’s child-care provider, but said Thursday she hadn’t received written confirmation from El Rio. Other parents whose children received care from El Rio said they received a list of alternative pediatric gender services, including clinics in California and Mexico, as well as online health-care providers. Camacho said she hadn’t received the list, however.

El Rio marketing coordinator Nathan Holaway provided a statement to the Arizona Daily Star, which confirmed the health-care clinic “does not currently prescribe nor dispense pubertal suppressants or gender-affirming hormones for patients under 18 years of age.” It also detailed federal orders from the Trump administration.

“Shortly after his 2025 inauguration, President (Donald) Trump reversed many of the policies put in place by the Biden administration by Executive Order (EO) that directly affects transgender Americans and their families,” El Rio’s statement said.

“The Office of the Attorney General recently issued a memorandum enforcing President Trump’s EO by seeking to criminalize gender-affirming care for minors and committing the DOJ (Department of Justice) to prosecute offenders to ‘the fullest extent possible,’ while encouraging ‘whistleblowers’ to report offenders directly to the Department of Justice.”

On Jan. 28, the president put out an executive order titled, “Protecting Children from Chemical and Surgical Mutilation,” which stated, “Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding.”

It also stated it is U.S. policy to not “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”

‘I have a different child now’

Camacho described her family’s journey of starting treatment for her daughter, Niko, after she came out as trans when she was 11 years old.

“We chose to use the hormone blockers, which stops puberty from progressing from whatever stage you’re at, at the time,” said Camacho.

“My child was going through puberty, and she was very depressed, she was suicidal, she wasn’t eating, and she was just going in the down-road trajectory really fast,” she continued. By contrast, “Within about six weeks of us starting this hormone therapy, she was a different person. She started doing better in school, she joined clubs, she had confidence. It was just like, I have a different child now.”

In previous Star articles, El Rio doctors have described their lengthy discussions with families, emphasizing the different kinds of medical interventions available and which are reversible, partially reversible or irreversible, and about risks that are still unknown. Anyone hired at El Rio must go through training in caring for marginalized populations, and that includes the LGBTQ+ community, the Star reported in 2018.

Russ Toomey is a family and developmental scientist at the University of Arizona who examines sexual and gender minority populations. Toomey’s opinion is that El Rio engaged in “patient abandonment” by ending the doctor-patient relationship without “reasonable notice or a reasonable excuse” and without giving the patient the opportunity to find a replacement care provider.

Holaway sent a statement responding to the “patient abandonment” claim, saying patient-provider discussions are “privileged and protected information.” Within the patient-provider relationship, “the eventuality and possible impact of future federal dictates was strongly encouraged to be discussed since the inception of Executive Orders,” he said.

“We are currently unable to provide pediatric gender affirming care in the form of hormone or hormone blocker therapies but remain committed to providing primary and behavioral health care to all the impacted youth,” Holaway added. “We encourage our patients to continue their relationships with their clinicians as we continue to support our patients through this challenging time.“

Single mom Kat Stratford’s 16-year-old transgender son, Erik, came out as non-binary when he was 10 and trans when he was 11. Stratford said she was informed by her El Rio doctor on May 2 and told she had to pick up Erik’s prescription by May 3, essentially a 24-hour notice. She also said she was told El Rio would be putting out a statement, but she hadn’t seen anything on its website as of Thursday.

Stratford, whose family has used El Rio since 2022, said her child didn’t receive puberty blockers since they didn’t understand enough about it, but started hormone replacement therapy after a long process with a very low dose of testosterone. He’s been receiving a dose of testosterone for a year now.

“Having hormone therapy, according to my child, it’s his first time feeling at home in his body. It’s the most complete he’s ever felt as a person, the most validated he’s felt as a person. And everyday that he sees these changes in his body — like his voice has gotten much deeper, he’s going through such normal teenage moments,” said Startford. “You know, every teenage boy is so excited when they first start sprouting whiskers. …He’s so excited about it, and to see that kind of joy in your child is the greatest gift a parent can ever have. To have it taken away is devastating.”

Toomey, who submitted a letter to El Rio board members with links to research summaries showing benefits of this type of medical intervention, said the canceling of hormone therapy has tremendous impacts not just on the Tucson and Southern Arizona communities, but across the state in terms of transgender youths being able to access care.

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One of El Rio’s reasons for the cancelation was an April 22 memorandum from U.S. Attorney General Pam Bondi titled, “Preventing the Mutilation of American Children,” which went into detail about a “radical ideological agenda” it said was being pushed through every aspect of American life including television, films, books and school classrooms.

It called gender-affirming care procedures “junk science” used to justify “the barbaric practice of surgically and chemically maiming and sterilizing children.”

Toomey, however, a researcher into sexual and gender minority populations, said the benefits of gender-affirming care include improved mental health with decreases in depressive and anxiety symptoms, decreases in suicidality, and improvement of life satisfaction.

Derrick Fiedler, the parent of a 13-year-old Tucson boy who came out as trans when he was 9, said he and his wife started treatment for him in 2021-2022. Fiedler said it is critical for their son to continue living his life “authentically.”

Fiedler was also the only parent of the three who spoke to the Star who said they were given a reason for the stop in hormone therapy: the attorney general’s memo.

The treatment is vital, Fiedler said, “because he was pretty anxious about going through any sort of puberty or even minor physical changes relating to the sex assigned at birth. Getting the puberty blocker was vital for his well-being and mental health. He’s established a group of friends that are also primarily boys, and he can continue to hang out with them.... Because at this point, they know that he is transgender, but it’s really so far in the background that I don’t think they think about it much.”

Some trans youths ‘terrified’

Camacho said her daughter is “terrified” right now that she’s going to have to stop the hormone blockers and “start de-transitioning as a teenage girl.” “It’s already hard enough and you care so much about your appearance and your body, and she’s just devastated right now,” Camacho said.

Stratford echoed those statements and said her family is discussing obtaining antidepressants for her son, saying he’s “hopeless and tired and so sad.” She said he’s been very anxious since the news came out and that the clinic’s decision removes a lot of stability for him.

Fiedler, though, said his son is doing okay since he’s “pretty resilient” and he “knows we’re going to do whatever it takes to get him the care that he needs.”

What are families looking to do?

Camacho said her family’s future plans of action include looking at other countries, including Mexico, since it’s the closest. She acknowledged they are not “easy” or “cheap” options, but said she thinks medical care in other countries is better priced.

Stratford said she is already talking to clinics south of the border, and that she will go out of state to find alternatives. She doesn’t want to go to another Tucson-based clinic if that would take the spot of a family with less resources, she said. Tucson has a few private practitioners who are still providing gender-affirming care, but they have long waitlists, she said.

“It pushes families to just the absolute corners, because if you can imagine, there are plenty of families using public transportation here in Tucson and those families obviously will not be able to access any out-of-state resources unless it’s at tremendous personal cost,” said Stratford. “They’re looking at a years-long fight to gain access to basic medication.”

Both Stratford and Fiedler said they will continue working with their doctors at El Rio for regular pediatric care for their children, while working to get gender-affirming care prescriptions from other places.

Fiedler said his family will have to find a state that still provides the care, such as California, or start looking in Mexico if needed. He also expressed concern over not knowing what the next “attacks” will be from the Trump administration, saying they escalate week after week.

For now, the administration is targeting providers, hospitals and pharmaceutical companies on this issue, he said. “When is the next step going to be, to come after parents, try to say that we’re abusing our children and try to take our children away?” he said. “That could come at any time.”

Stratford said she would prefer that organizations not comply in advance with executive orders she believes violate the U.S. Constitution, but she also acknowledged El Rio, which helps “a great number of people” aside from her “tiny community,” is almost completely funded by the federal government.

Fiedler said he can understand El Rio’s perspective in being concerned about having federal funding to provide health care for everyone else. “At the same time, if every hospital and every university would take the same stand, it’s hard to imagine that the government could very long persist in not getting those funds out,” he said.

“My frustration is primarily with the administration of the hospitals, like the administrative leaders, and not with our doctor,” said Fiedler. “Our doctor is so phenomenal and so supportive. And then this is so hard on the doctors because they don’t have the decision (authority) there.”

Toomey said he wants to know why organizations are complying with orders he said they know are harmful.

“Just as a transgender person in the Tucson community, I’ve lost my trust in El Rio,” he said. “El Rio has, for decades now, touted itself as the LGBTQ+ culturally competent provider in the area. And so, to do this with such poor communication, with 48 hours’ notice to parents, has really broken trust of the community.”