###

Opposition is mounting after Open Door Community Health Centers stopped offering new patients under the age of 19 gender-affirming medication prescriptions.

As reported by Robert Schaulis of the Times-Standard, the change went into effect in July. The health system, the largest provider of primary care in Humboldt County, no longer will accept new patients under the age of 19 for hormone treatments, prescribed to transgender patients to better align with their gender identity.

Open Door CEO Tory Starr said federal funding that Open Door relies on was at risk.

“As a Federally Qualified Health Center (FQHC), Open Door must comply with federal laws, regulations, funding requirements, and contractual obligations,” Starr said in an email.

“Recent changes in the federal environment related to gender-affirming medication treatment for individuals under age 19 have created significant compliance concerns for FQHCs. After careful review, Open Door determined that discontinuing the initiation of new gender-affirming medication treatment for youth is necessary to maintain compliance and protect our ability to continue providing comprehensive healthcare services across our communities,” he said.

This follows a series of efforts by the Trump Administration targeting transgender people. A Jan. 28, 2025 executive order laid the groundwork to significantly limit gender-affirming care for people under age 19.

The administration has taken steps to pressure healthcare organizations to stop offering gender-affirming care for young people through federal agencies, including the Department of Justice. One proposal from the Department of Health and Human Services would withhold Medicaid and Medicare funds from hospitals offering gender-affirming care to youth.

Executive orders and federal directives have caused hospitals and organizations to cut the treatments across the country, even as federal judges blocked enforcement of the order while a lawsuit filed by civil rights groups progresses.

“Our decision was based on a careful review of risks, including new federal contractual language related to gender-affirming care and diversity, equity, and inclusion initiatives,” Starr said.

But an opposition letter, signed by 350 people and sent to Open Door leadership last week, urges the organization to reinstate the care. Signed by employees, patients, parents, medical providers, councilmembers and community members, the letter argues the health center could’ve kept the practice intact.

“Capitulating is a choice. Open Door is among the first health centers in California to abandon care for transgender young people. Clinics across the country are finding ways to continue care despite federal pressures,” the letter said.

Advocates are calling on Open Door to reinstate the care.

“Leadership at Open Door is pushing a disingenuous narrative that the federal government is requiring them to do this. That is not the full truth,” said Lark Doolan, executive director of Queer Humboldt, in an interview with the Outpost.

“There are multiple solutions, identified by members of Open Door’s leadership, that both meet federal requirements and result in not one child losing access to the healthcare that they need,” he said.

Starr emphasized that the change does not affect the care of current patients.

He said Open Door decided to keep treating patients already receiving care after thoughtful consideration. He said Open Door remains committed to supporting youth and their families through a range of services, including primary care, behavioral health, care coordination and referrals for patients experiencing gender dysphoria.

New patients 16 and older can access hormones at Planned Parenthood, and others can be treated online through True U Clinic.

“Our commitment to caring for youth patients and their families has not changed. We will continue to provide compassionate, comprehensive care and will do everything we can to help patients access the services and support they need,” Starr said.

Of over 60,000 patients, approximately 500 receive gender-affirming care services at Open Door, he said. “The number of patients under 19 currently receiving medication management is small, and their care will continue without interruption,” he said.

Doolan said as a result of this policy change, transgender youth in Humboldt County seeking to start hormones will only have the option of telehealth to start care. He said they will lose out on Open Door’s help with taking injections, and won’t be able to get bloodwork done at Open Door health centers.

He said it will be “virtually impossible for youth in rural outlying regions of Humboldt to access the healthcare that they need,” he said, because of a lack of non-Open Door locations to get lab work done, necessary for hormone treatment.

“Some people are able to access prescriptions and services elsewhere, but not every patient that Open Door turns away will overcome the obstacles that are being created in their path,” he said.

Advocates point to research showing the treatment reduces depression and suicide risk among transgender and nonbinary youth.

“All children deserve the medications and care that they need in order to be happy and healthy and thriving. Refusing medical care for a young person just because they’re trans is morally reprehensible. Refusing to run lab work for a child because they’re transgender is ethically and morally reprehensible. Refusing to offer a needed prescription to a young person just because they’re transgender is discriminatory,” said Doolan. 

He said there’s been an outpouring of opposition to the change, which he described as “a calamity” for trans youth.

To read the letter, click here. The Outpost has reviewed signatures attached to the letter, but has published a version excluding individual names as per a request by Queer Humboldt, who said some that signed are afraid of retaliation.

Meanwhile, Starr said those seeking information about gender-affirming care services can contact Open Door’s Member Services Department. He said community members who would like to express concerns regarding this change in services can call a hotline at 844-973-2721.