This story about gender-affirming care was written by Three-Sixty Journalism students Wendy Xiong, Johnson Senior High School, Juan Miguel Adams, St. Paul Academy and Summit School and Laney Burns, Breck School.

Leah Burns has begun to carefully monitor her supply of estrogen patches.  

Burns, a transgender teenager who receives gender-affirming care at Children’s Hospital in Minnesota, says she is worried about the future of teens in her community. 

Gender-affirming care includes a range of services for transgender and gender diverse individuals. These services can be social, medical, surgical, and psychological support that aligns with a person’s gender identity. 

Recent federal legislation has brought new attention to the issue. 

President Trump’s “One Big Beautiful Bill Act,” signed last year includes provisions that reduce federal spending on programs such as Medicaid over an estimated 10-year period. Section 44125 of the law prohibits federal funding for “specified gender transition procedures” for minors. Individuals under the age of 19 are the targets.  

Minnesota officials have responded to these federal actions through legal challenges. 

On Dec. 23, 2025 Attorney General Keith Ellison joined a coalition of 20 states in filing a lawsuit against the U.S. Department of Health and Human Services, arguing the agency is “unlawfully” limiting access to gender-affirming care for youth.  

Then, on Jan. 16, Ellison joined another coalition of 12 attorneys general in a separate lawsuit challenging federal policies that they say discriminate against transgender individuals by restricting funding.  

Hospitals have also begun responding to the new pressures from the federal government. 

As of Feb. 27, Children’s Minnesota has temporarily paused certain gender-affirming services for minors including prescribing puberty blockers and hormones.  The restriction is in response to legal pressure from the Trump administration, which has threatened to revoke funding from hospitals that provide gender-affirming care for minors. 

Nationally an estimated 270,000 transgender youth rely on Medicaid or the Children’s Health Insurance Program, also known as CHIP. 

“I believe without gender affirming care, there’s going to be an increased suicide rate among people who are younger than me,” Burns said. “I believe trans healthcare should be a human right, and the Trump administration is violating that [right].” 

Medical professionals have also expressed concern about the potential effects of these changes. 

Dr. Kade Goepferd, a pediatrician at Children’s Minnesota, expressed concern about the policy changes.  

“My biggest concern is that the cuts are getting in the way of kids being able to access their health care,” Goepferd said.  

Goepferd  said young people who receive gender-affirming care often show improvements in mental health and well-being.  

Some Minnesota DFL lawmakers and the legislature’s Queer Caucus are advocating for maintaining access to gender-affirming health care.  

Rep. Brion Curran, a DFL lawmaker and vice chair of the Queer Caucus said restricting care would have long term consequences.  

“If trans kids aren’t provided with the sort of gender-affirming care that they need, we will see a reduction in trans adults,” Curran said. 

Some advocates warn that restrictions on gender-affirming could lead to a 72% increase in suicide attempts for trangender youth in states with such restrictions.   

For some lawmakers, the issue is also personal. 

Rep. Leigh Finke, a DFL lawmaker and member of the Queer Caucus who is transgender, said the issue affects many people in Minnesota’s LGBTQ+ community. 

“It affects me. It affects everyone I know in the community very deeply,” Finke said. 

Beyond politics, these restrictions also affect families differently depending on financial circumstances. Low-income families may struggle to access services they cannot afford. 

Burns said she feels fortunate that her family can still afford her medication.  

“However, for people who might not be as well financially, and who are younger than me, this can be very detrimental,” Burns said.  

As access becomes more uncertain, many LGBTQ+ youth turn to support organizations. 

 One resource many young people rely on is The Trevor Project a nonprofit that provides mental health support and suicide prevention services for LGBTQ+ youth.  

According to the organization a nationwide survey found that more than 90% of LGBTQ+ youth believe political bans on gender-affirming care negatively affect their mental and physical health. 

“Personal medical decisions ought to be made between patients, their doctors and their families not through a one-size-fits-all mandate from the federal government,” said Rodrigo Heng-Lehtinen, senior vice president of public engagement at The Trevor Project.   

The Trevor Project remains a major resource for transgender youth, but other support services have faced changes in recent times. 

In July 2025, the Trump administration announced the termination of several specialized suicide prevention lines for LGBTQ+ youth. 

Advocates say the future of gender-affirming care remains uncertain under the current administration as federal funding continues to be used as leverage. Many people in the LGBTQ+ community are unsure what their future coverage will look like. 

“Everyone who is trans has their own mental health struggles, and people should not demonize those struggles,” Burns said. 

This story was produced as part of ThreeSixty Journalism’s 2026 Capitol Reporting Workshop for Minnesota youth, with financial support from the Saint Paul & Minnesota Foundation. 

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