Recent closures of trans surgery programs do not appear coordinated

Both of these closures are tragedies, but they do not appear coordinated, and they do not appear to be the result of the same proximate cause.

By Jane Migliara Brigham

As two healthcare clinics have shut down their programs for trans surgeries in the past month, a wave of apprehension has spread that these closures are the beginning of a wider crackdown.

Earlier this month, UMASS Memorial Hospital in Worcester ended its trans surgery program without providing a clear answer as to why. Last week, Vanderbilt in Nashville followed suit, ending its trans surgery program while citing a lack of staffing as the reason.

This comes around the same time that a number of the last holdouts on trans youth healthcare are finally ending all transition services for them, such as NYU Langone and Mt. Sinai. 

While these developments are concerning, there is no evidence that these closures are part of a wider pattern as of yet. Each hospital gave a separate answer as to why this is happening, and the changes do not appear to be coordinated. 

While there are many within the Republican Party who would love to ban these procedures (along with all trans healthcare), the administration appears focused on suppressing youth care for now.

Take for example the speed and coordination with which trans youth healthcare was shut down by hospitals across the country in regards to the administration’s Executive Order to ban medical transition for those under 19. Within a month, most major hospitals ceased to provide this. All that was mainly accomplished with the bully pulpit, as the administration would not even formally propose financial punishments for those who would not comply with their rules until October.

In this case, there was a coordinated push to ban all such coverage. Hospitals either blamed their closures on the federal government, or stayed silent on the matter. In either case, everyone knew the reason this was happening.

This is not the case with the latest shutdowns. These appear to be caused by different factors, and do not appear to be part of a coordinated plan. 

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In the case of UMASS Memorial, they did not explain their decision, and the main surgeon there declined to go on the record about it.

As for the more recent case at Vanderbilt, their stated reason for the closure is due to “operational limitations and lack of surgical coverage”. In other words, they have lost so much staff that they are unable to provide adequate surgical care. 

This comes after a prolonged legal battle between it and the State’s Attorney General’s office, among the consequences of which are the Skrmetti court case. This has led the hospital to shed staff over the years, as they move to practices in states where they can practice more freely. All of this has been known by locals for years, especially those who rely on Vanderbilt for trans medicine.

In light of this, it makes sense that Vanderbilt would shut down its care, as it can no longer hold on to the staff they would need to provide it.

Both of these closures are tragedies, but they do not appear coordinated, and they do not appear to be the result of the same proximate cause.