Minnesota clinics look to fill gap in gender-affirming care after Children's Minnesota pause

KELLY GORDON: This is Minnesota Now. I'm Kelly Gordon in for Nina Moini. This month, Children's Minnesota will pause some gender-affirming care. The health system announced yesterday that, starting February 27, it will stop prescribing puberty blockers and hormones to patients under 18. Hospitals and clinics around the country are under pressure from the Trump administration. It's proposed ending Medicaid and Medicare funding for providers that continue these treatments for minors.

One of the providers that will likely take on patients who had gone to Children's Minnesota is Family Tree Clinic, and Family Tree's executive director, Annie Van Avery, joins me now. Hi, Annie.

ANNIE VAN AVERY: Hi, thanks so much for having me.

KELLY GORDON: Yeah, thanks for being here and for talking to us about this issue. So let's just start by setting the stage. How significant is it for Children's Minnesota to stop providing this type of care?

ANNIE VAN AVERY: It's very significant. I think our collective communities and patients and families have faced so much during this administration, and Children's has really been an incredible support network for folks, has been a place where families can find essential care for their youth, for their children. So it's really significant in our community. And in this moment, we're also really standing with the providers at Children's in the heartbreak over having to make this decision.

KELLY GORDON: I saw that your organization posted on social media yesterday that gender-affirming care is still legal in Minnesota for all who seek it out. So I'm curious why you thought it was important to clarify that.

ANNIE VAN AVERY: Absolutely. Well, again, so many of our families have just faced significant threats that are both coming from the chaos and from some of the rhetoric and misinformation that's coming from this administration, but also just the feeling of lack of safety, lack of access, lack of resources. And I think that that's incredibly significant for our families. And so for us, we immediately started getting phone calls from folks around the state. We also have served patients from over 17 states as, in the current moment, 27 states have banned this kind of health care.

So Minnesota has stood as a refuge state, in particular for families seeking care. We have had so many folks move to the state, so many folks really seeking safety. And, again, this essential health care. And so when Children's made their announcement, we immediately started getting calls from concerned parents, from concerned caregivers, from patients, from former patients of Children's to ask, can I still access this care?

I think part of the threat that our communities are facing is this instability of wondering, will I be able to access this health care? And so really giving folks the assurance that we're here, we're here for you, we're Here for our families, we're here for patients of Children's and other systems and clinics that have had to close under the threats of this administration.

KELLY GORDON: So it's still available. There's just a dwindling number of providers to give it in Minnesota. That's kind of what we're facing.

ANNIE VAN AVERY: Correct, yeah. It's still available now, and we're really facing a large looming threat, which is the HHS rule proposal, which would eliminate Medicaid from any hospital system that provides these services. And so we're waiting to see if that passes. But in this moment in time, Family Tree is very committed to this, to not preemptively complying and to providing these essential services as long as we can.

KELLY GORDON: And I want to talk about that in a second. But I also want you just to define the term gender-affirming care. Can you talk about what it includes? Because I feel like a lot of people aren't really sure.

ANNIE VAN AVERY: Absolutely. Yeah, it's such a great question. And actually, it's quite broad. So at Family Tree Clinic, when you are making an appointment for gender-affirming care services, that could look like an intake, that could look a consultation, that could look like your child is approaching puberty and is trans identified or gender expansive, and just wants to have some information about what are the options before, during, and after puberty. It can be hormone care appointments, so very similar to what folks would have for a perimenopause or menopause visit.

It can be just some counsel and support around meeting this moment. And for us, the biggest part of gender-affirming care at Family Tree-- and I think what we're trying to promote in the broader community-- is just being able to provide a welcoming space that really meets, in particular, young people where they are. There is so much stigma and can really be some traumatic consequences of not being well informed in how you can provide a safe space to access any form of health care.

KELLY GORDON: And can you talk a little bit about how important this care is to give to kids under 18? Because I think, sometimes, people will say, well, let's let them become adults, legal adults, and then they can make decisions on their own. But will you address that a little bit?

ANNIE VAN AVERY: Absolutely. I mean, the young people that we see and the young people that have made a determination with their families and their providers that this is the kind of care and services that they would like to move forward with, our families and young people who are very assured in who they are, what their identity is, and what they are seeking from this care. And it is a really important form of care, in particular prior to or at puberty, and so that is when we're thinking about access to this health care and how old a patient is. They are informed and really have just critical, important conversations with their provider that is really led by the patient and by their caregivers.

And what we found is, across the board, first of all, this is proven care. This is care that's been provided for decades and even centuries before that. This is research-based. We are using best practices. And this has shown that it really contributes to reducing health disparities amongst young trans folks. It really supports mental health. It really supports well-being. There are all positive outcomes from this care. And this care can continue to change. So I think we often hear rhetoric about this care being surgical, this care being irreversible. That is absolutely not true. We are participating in essential health care that really moves with the developmental stages of a young person seeking this care.

KELLY GORDON: So with Children's Minnesota stepping back out of providing this kind of care later this month, how much capacity does your organization or organizations like yours have to take on new patients? Will you be able to absorb the people out there who are going to be looking for a new provider?

ANNIE VAN AVERY: I really appreciate that question, and I have to say that this is an area where I am so proud of our community. Your show focuses on Minnesota and Minnesotans and how incredible we can be in meeting this moment for folks that we care about and our neighbors and our community. There is so much incredible collaboration happening to figure out how to support each and every one of these families and these young people, not just with our clinic, but statewide amongst other clinics as well.

So we are all working really closely together to help meet the need, while Children's has this pause in care, and we're working very closely with Children's. We're just so appreciative that just the care and the ability to be working collaboratively and collectively in this moment to meet the need.

I will share that Family Tree really, since the start of this administration, has been doing so much contingency planning and so much work to be able to respond to these different attacks and funding cuts. And our priority is always our patients and our community. So we're finding creative solutions, but we certainly continue to need support from community and from our legislators to make sure that we can continue this care.

KELLY GORDON: I really appreciate you taking the time to talk to us today, Annie.

ANNIE VAN AVERY: Thank you so much.

KELLY GORDON: Yeah, that was Annie Van Avery. She's the executive director of Family Tree Clinic.