After one local door to gender-affirming medicine closed, Heather and her family are bracing for a new routine: a three-hour drive from Bethel to Boston in order to relieve the intense distress of her daughter’s gender dysphoria.

Heather’s daughter had been scheduled for a consultation about puberty-blocking medication at the Yale Gender Program this month — until Yale New Haven Health announced a decision in late July to end medication-based gender affirming care for patients under 19.

[Yale New Haven Health to cut youth gender-affirming care services]

The decision, which came a day after Connecticut Children’s Hospital closed down its gender-affirming program altogether, left Heather’s family scrambling for another option, bumping into long waitlists at other local clinics providing gender-affirming care.

Heather eventually found a physician who could see her 11-year-old daughter in September at Boston Medical Center. On top of traveling there for all in-person appointments, they’ll have to cross state lines into Massachusetts for any telehealth visits.

That’s their plan for now. A plan Heather hopes will remain in place amid a national wave of backlash against transgender rights. A plan that doesn’t feel 100 percent reliable amid the family’s growing sense that states like Connecticut and cities like New Haven, while pitched by politicians as “safe harbors” are ​far from immune to the ramifications of that backlash. 

“Just like what transpired in Connecticut, there’s a risk that can also happen in Boston too,” said Heather.

Heather asked for her last name and her daughter’s name not to be included in this story to protect the family’s privacy.

Heather’s family is not alone. According to Trans Haven organizer Kirill Staklo, he and fellow organizers have heard from numerous transgender youth and families impacted by Yale New Haven Health (YNHH)’s decision. Some families are turning to other programs within Connecticut, Staklo said, while others — like Heather’s family — are searching for gender-affirming care out of state. 

Alyssa-Marie Cajigas, an organizer with the New Haven Pride Center and the Children of Marsha P. Johnson, said that she and her colleagues have been helping trans youth navigate the fallout of YNHH and Connecticut Children’s policy change. She said that she and other organizers are working to find other local sources of gender-affirming health care for youth in the New Haven area.

Staklo argued that YNHH could have held out for longer. ​“It’s absolutely shameful,” he said, ​“that these institutions, especially an institution like [YNHH] that holds the amount of power and resources that it does, would squander an opportunity to stand up for trans people — instead caving to what amounts to political bullying, and is selling out some of its more vulnerable patients.”

“It sets a massive precedent of health care discrimination,” he added. ​“The rationale behind this is completely unscientific. There’s nothing to do with health care.” 

When asked for comment, hospital spokesperson Mark D’Antonio wrote in a statement, ​“We have been carefully monitoring federal executive orders and administrative actions relating to gender-affirming care for patients under age 19.” 

The decision to stop prescribing gender-affirming medication to youth came ​“after a thorough assessment of the current environment,”​ he wrote.“This decision was not made lightly. We are aware of the profound impact that this decision will have on the patients treated in this program, as well as their families.”

D’Antonio wrote that the hospital is ​“committed to offering transitional support” for patients losing access to medication, adding that ​“our providers will continue to provide mental health and other health care services to these patients in a compassionate care environment.”

“She likes seeing herself in this way”

According to Heather, her 11-year-old daughter has known for nearly as long as she can remember that she didn’t want to be a boy. (Her daughter did not want to be directly interviewed for this article.)

Heather recalled that her daughter started experiencing sudden, repetitive tics around the age of 3. Heather took her to the doctor to get assessed for Tourette’s Syndrome, but the pediatrician ruled that out, suggesting instead that the tics were a manifestation of anxiety.

Heather recalled her kid being ​“shy, reserved, held back” and ​“very much on edge” before coming out publicly as a girl. 

By the time her daughter was 5, she would erupt into emotion at seemingly ordinary moments, such as bath time. Her tantrums weren’t the typical outbursts of a 5‑year-old. Over time, they escalated into attempts at self-harm. She’d deliberately bang her head against the wall and start pulling out her hair, telling her parents that she hated herself. ​“You know I’m a girl!” she would say.

“My ex-husband and I, we had no experience with trans kids prior to this,” Heather said. ​“We really did not know what we were dealing with at all.”

Heather found a bundle of dresses through her local Buy Nothing Facebook group in her daughter’s size. Her daughter treated them at first like a ​“secret stash” to try on at home. She would offer a quiet invitation — ​“Do you want to see my dresses?” — only to the people she trusted most.

At the age of 6, her daughter started publicly identifying and presenting as a girl. Heather watched her live with a new sense of freedom, a new ability to enjoy her own childhood. ​“After she transitioned, she just became this very confident, outgoing, very kind and joyous and generally happy kid,” Heather said.

Recently, while sitting through her sister’s softball tryouts, the 11-year-old started taking selfies on her mom’s phone, playing around with the filters and showing her mom with pride. 

“It occurred to me, she likes what she sees looking back at her,” Heather said. ​“She likes seeing herself in this way. She’s proud of it. It makes her happy.”

As Heather’s daughter eventually learned more about puberty, she expressed an intense aversion to the prospect of her shoulders broadening, an Adam’s apple emerging, facial hair starting to appear. Her daughter takes voice lessons; she loves to sing soprano, and dreads the idea of her voice dropping to a low register. 

So the family made plans for Heather’s daughter to begin taking a puberty blocker when her body starts to undergo those changes, planning to do so through the Yale Gender Program. 

Puberty blockers can be prescribed as part of the ​“reversible stage” of pediatric gender-affirming care, according to a technical report issued by the American Academy of Pediatrics. The medication delays the onset of puberty without spurring a medical gender transition; it is not a form of feminizing or masculinizing hormone therapy.

In other contexts, puberty blockers are prescribed for purposes unrelated to gender identity. Some kids who begin to undergo early-onset puberty as young as 6 or 7 years old, for example, take the medication until they reach a more developmentally typical age for puberty. 

Without access to puberty-blocking medication, ​“my biggest concern is she’d have to go through a male puberty when she knows in her heart that she’s not a male,” Heather said. ​“Puberty’s already a very intense time, a very formative time in one’s life.” 

If her daughter loses the ability to take her medication as planned, ​“she’s going to be dealing with some very heavy struggles in terms of how she identifies and how she looks,” Heather said. Her daughter would face an ​“internal struggle,” including the potential for serious mental health setbacks, if her body were to change in a way that ​“she is very repulsed by.”

Heather has tried to protect her daughter from the harshest anti-trans rhetoric that makes the news, but her daughter has become aware of the political push to prevent her from having the option of gender-affirming care. 

Shortly before YNHH’s policy change was announced, Heather recalled her daughter anxiously asking if she’d still be able to take puberty blockers. 

“Are you sure?” her daughter had pressed.

The letter

Heather’s daughter, her family, and her doctor planned an August appointment to evaluate her daughter’s readiness for the medication. But in late July, Heather found a letter in the mail from YNHH.

Inside, a letter signed by Clifford W. Bogue, chief of pediatrics of the Yale New Haven Health system, and Beth Heinz, senior vice president of Women’s & Children’s Services for Yale New Haven Health, announced that the Yale Gender Program would ​“eliminate the medication treatment component of the gender-affirming program for patients under age 19.” The health system would help patients form a ​“transition plan.” 

In other words, Heather’s daughter would not be able to obtain puberty-blocking medication through Yale after all.

The announcement was not exactly a surprise. It came one day after Connecticut Children’s Hospital announced it would shut down its gender-affirming care program entirely, during a wave of political backlash against rights for trans people, and especially trans youth. 

Shortly after taking office for his second term, President Donald Trump signed an executive order attempting to defund gender-affirming care for patients under the age of 19, among several anti-trans directives. YNHH’s letter alluded to those executive orders, citing political climate as the reason behind the change.

On top of reckoning with the policy change, the manner in which that change was communicated angered families and advocates.

The letters’ envelopes were addressed to the patients, regardless of whether they were minors, rather than to their parents. In some cases, the envelope printed their legal names instead of their chosen names.

Melissa Combs, whose 16-year-old son received hormone replacement therapy from the Yale Gender Program prior to the policy change, recalled hearing from parents whose kids opened the letters. ​“In one case, an 8‑year-old thought it was a gift and was really excited about it,” she said. ​“In another case, there was a teen on the younger side that was at home, and the parents were not… They opened it and they got the news at a time when they were home alone” for what was ​“a really fearful moment” about the future of their health care.

The use of legal names, rather than chosen names, was particularly hurtful to some patients. ​“It is well known that honoring a person’s wishes by using their chosen name is one of the ways that you can say to a trans person that you are worthy of dignity, and you are worthy of life-saving medical care, and you are worthy of a future,” Combs said. She stressed that she does not blame the staff at the Yale Gender Program itself for this communication error.

The use of some kids’ prior names was in some ways ​“one of the hardest things we grappled with” while working with youth and their families, said organizer Cajigas, because it invoked a message of denial and rejection.

Heather, meanwhile, was able to intercept the letter before her daughter could read it. ​“It couldn’t have been handled more insensitively if they tried,” she said.

In a follow-up letter sent out to families — addressed this time to both the kids and their parents — Bogue and Heinz apologized for the way the announcement had been mailed out and indicated that patients’ chosen names would be used in future communications.

A sense of security shattered

Heather waited several days before telling her daughter about the contents of the letter. ​“I don’t want her to feel like the rug’s been pulled out from underneath her,” she said. 

When she did sit down to deliver the news — before the family had found an alternative source of gender-affirming care — Heather tried to convey it all in a way that was both honest and age-appropriate. 

She recalled that her daughter was ​“upset and disheartened.” While her daughter had been aware of the possibility that her medication access could fall through, it still came as a shock that it could happen in Connecticut — a place that had once felt distant from the kind of pushback unfolding in red states like Oklahoma, Arkansas, and Tennessee.

Heather reached out to as many medical providers as possible, uncertain if any would be able to take her daughter. ​“This is very specialized medicine,” she said. ​“Many clinics, including several local ones, have long wait lists.” 

Her family is glad to have an option in Boston Medical Center for now. But after two major Connecticut providers of gender-affirming care have closed their programs, Heather worries that any source of health care for her daughter may not be permanently available.

The options that remain available will still face political hostility toward gender-affirming care, especially for youth.

Meanwhile, her daughter is growing up — and the masculine changes she’s dreaded for so long may soon start to take shape. ​“We’re racing against the clock,” said Heather.

“That security and that safety that we thought we had” in Connecticut — ​“that’s very much been shattered,” said Heather. ​“We’re still kind of in this strange space of piecing together a solution, and crossing our fingers to hope that doesn’t fall through.”

The Trans Lifeline operates a peer support phone service run by trans people, for trans and questioning peers. Call 877 – 565‑8860 Monday through Friday, from 1 p.m. – 9 p.m. Eastern time. 

The Trevor Project offers 24/7 crisis support for LGBTQ+ young people via text, chat, or phone. To reach a trained listener, call 1 – 866 – 488‑7386 or text START to 678 – 678.

This story was first published Aug. 18, 2025 by New Haven Independent.