Dear Ann & Robert H Lurie Children’s Hospital Executive Board and Gender Development Program Leaders, 

After reading several news articles and your press release, it has come to our attention that you have suspended gender-affirming surgeries for clients under age 19. We are writing to ask you to reconsider your position and step forward with a spirit of nonmaleficence, beneficence, justice and fidelity. We urge you to adhere to the professional standards promulgated by the American Medical Association’s code of medical ethics. Alignment with the forementioned values and the code of ethics are essential to preserving the lives of transgender youth. 

We understand that this decision was made with careful consideration, but we believe it may have been premature. We feel that the ethical responsibilities owed to transgender youth and the role Lurie plays in setting precedents for medical care in this field may not have been fully explored. Additionally, we recognize that this decision follows the executive order issued on January 28, which aims to eliminate federal funding for gender-affirming procedures. While this order clearly presents a challenge, it is important to note that it is not a law, and its implications exceed the President’s executive authority, raising concerns about potential violations of constitutional protections, including equal protection and state sovereignty. 

This executive order, along with Lurie’s subsequent decision to suspend gender affirming surgeries, appears to conflict with key principles of medical ethics as defined by the AMA: 

·       A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.   

·       A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.  

·       A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.  

·       A physician shall, while caring for a patient, regard responsibility to the patient as paramount.  

·       A physician shall support access to medical care for all people. 

Illinois Attorney General Kwame Raoul has pledged Illinois will protect gender-affirming care along with 14 other states. Attorney General Raoul has reminded healthcare providers that Illinois law requires all residents, regardless of gender identity, to be provided with access to care and prohibits unlawful discrimination on the basis of gender identity. We also wish to highlight that three fellow Democratic-led states – Washington, Oregon, and Minnesota – and three medical doctors have filed a lawsuit challenging the executive order. This legal action is one of several efforts to oppose the order. Recently, seven Maryland families with transgender children, along with two advocacy groups, PFLAG National and GLMA, filed a separate lawsuit arguing that the order is unconstitutional. These actions are paving the way for institutions like Lurie’s to stand firmly for justice and ensure that the responsibility for harm is placed on those who create it, rather than removing essential care from those who need it most. 

We are living through a period that is seeing profound, unjust inequity. While this has been the case throughout almost every period of history, the divisiveness around the idea of justice in today’s sociopolitical climate has created an ambiguous experience of loss and the outcome of this has been traumatic, particularly for those who have marginalized identities. 

As evidenced by Lurie’s own study on the effects of gender affirming care on depression and anxiety in youth with gender dysphoria, this work is critical to supporting transgender youth experiencing decreased mental health symptoms and risk for suicide. The Trevor Project conducted a 2024 U.S. national survey on the mental health of LGBTQIA+ young people ages 13-24. This study shows the experiences of more than 18,000 LGBTQIA+ youth in the U.S. A staggering 39% of LGBTQIA+ young people seriously considered attempting suicide in the past year with transgender and non-binary youth of color reporting higher rates than their white peers. More than 1 in 10 (12%) of LGBTQIA+ young people attempted suicide in the past year. LGBTQIA+ young people who live in accepting communities attempted suicide at less than half the rate of those who reported living in very unaccepting communities. When we look specifically at the surveyed age group that have been impacted by Lurie’s recent decision to suspend gender affirming surgeries, ages 13-17, the statistics jump to 46% considering suicide and 16% actually attempting suicide in the past year. The study also illustrates the various identities within the LGBTQIA+ community, along with racially intersectional identities, impacted by suicide considerations and attempts. The Trevor Project also asked each surveyed youth the top ten actions allies can take to best show their support and acceptance. The top three answers included: 88% said, “Trust that I know who I am.” 81% said, “Standing up for me.” 77% said, “Not supporting politicians that advocate for anti-LGBTQ+ legislation.” Our country’s transgender and non-binary youth have made their needs clear, and they need institutions like Lurie’s to stand up and stand with them against the transphobia and continue to provide lifesaving surgeries for those who are most at risk of dying by suicide. 

You have power in providing these critical procedures and a duty to serve those with medically necessary conditions. Again, we urge you to reconsider your position on this issue and continue to provide gender affirming surgery and care to those under 19 who seek it.  As mental health professionals we have seen both the devasting and the humanizing effects institutions like yours can have within marginalized communities. We know that for many transgender youth, this is literally a matter of life and death. Lurie’s has long been a trusted provider of transgender care, offering hope and the possibility of living an authentic life. To see that light dim would only reinforce the hopelessness that so many transgender youth are experiencing currently. Please, fight for the values you built this program upon and fight for justice for those whom this program was made to serve. We sincerely hope you will continue to champion these values and stand firm in your commitment to justice for those who rely on your services.