What It’s Actually Been Like as a Trans Person Working in Gender Affirming Care at a Major Pediatric Hospital in Trump’s America

My five-and-a-half year journey to get...here

Sporting my “Tranpa” hat at the Pride Festival, when attending Pride was still allowed by my organization

I am writing this from my dark bedroom on a Saturday night. I had several plans today with friends, all of which I cancelled because even the thought of another human interaction today seemed insurmountable.

I spent yesterday discussing an idea for a new series I wanted to start at my job at a major pediatric hospital, “LGBTQ+ Office Hours.” As the Outlook invite clearly stated, “This is not a committee or program, but rather a place for employees to gather and discuss all things LGBTQ+.”

This simple idea for a virtual gathering space was rated between an 8 and 9 on the risk scale to send out by a trusted colleague, which has me time traveling to the days surrounding the Stonewall movement in 1969 where it was illegal for “homosexuals” and people wearing clothes of the “opposite sex” to gather. But let’s understand how we got here in 2026.

I once held two titles at my current institution, one of which doesn’t exist at all anymore and one that only exists in title. The former was Co-Chair of LGBTQ+ DEI Subcommittee, which won the Excellence in DEI Award in 2024, and the latter being “Program Manager for Gender Care Services,” a role which landed me one of my institution’s most prestigious employee awards and a feature on their LinkedIn.

I say this one exists only in title now because there is effectively no “Gender Care Services” anymore. Despite being located in a state where there are no care bans, my institution decided to cease “prescribing gender affirming medications”—not to be confused with “stopping care for transgender patients” —a distinction which was very important to our legal team.

I was hired at the hospital in 2020, first as a Patient Navigator, then promoted to Program Coordinator, and now as Program Manager. When they hired me there were five distinct departments providing care to transgender youth, and they asked me to make them one cohesive program. I had ten years of lived trans experience at that point, but no professional experience in a hospital setting, so I spent a lot of time learning about departments, divisions, medications, insurance, and appointment types. But a majority of my day was spent doing intakes, which meant meeting with every new family and referring them to the services that best fit their needs. I was often the first person parents were talking to about their child’s experience and counseled many of them through the broad range of emotions that comes with a child transitioning. Together we navigated their grief, confusion, frustration, and fear. I also joined all their new patient visits and got to meet the incredible young people the parents had talked about. We maintained our relationship throughout their journey, following some patients for years of their transition.

I came into the navigator role with extensive community experience, previous professional roles at some of the highest profile LGBTQ+ organizations, and two masters degrees from an Ivy-League institution where I am currently working on my doctoral degree. For the first three years in my role, I was the only trans-identified staff member working in the gender care space. I gained a reputation early and quickly as knowing my stuff despite being the only non-clinical member (although if I had taken my licensure exam I could have been, as my master’s degrees are in Counseling).

But I served an important role at my institution outside of the gender care space as well, which was to be the general go-to person for any trans related query, whether employee or patient facing. I have gotten calls from about everything ranging from “We have a new employee coming on that needs their name updated in our systems” to “I have a family friend who has a trans kid. Do you have research I can send them?”

I have done presentations and trainings for almost every department of the hospital, spanning the in-patient unit to the call center. Was this written in my job description? No. But I did it because I had expertise and people wanted knowledge. And honestly, if people genuinely want to learn, I’m always happy to share information and resources. I have the utmost respect for the people at my institution who knew what they didn’t know, and asked someone who did. About three years in it became a running joke among my team and supervisors that I could have a full-time position with just the training I was doing. Any within-hospital trainings were unpaid, although I would occasionally get an honorarium for the external trainings with outside organizations, local pediatricians, or community mental health providers.

It was ultimately my “extra curricular” work that led to me becoming a co-chair for the LGBTQ+ DEI Subcommittee. It got to a point where people were asking the DEI committee to complete tasks, which would forward the request to me, so we decided to take out the middle piece and just have requests come directly to me as co-chair.

There was always a trickle-down effect, though. When the political climate grew too tumultuous for gender care or DEI, senior leadership (C-suite) would meet to make decisions, and then our designated C-suite member would meet with me to share what the decisions were so that I could tell my team.

Here’s the part where I’m going to comb very carefully through my brain to remember what exactly and precisely said “Privileged and Confidential”, and what was more of an unspoken “This stays between us” as I never signed a NDA.

When senior leadership realized they were now not only making decisions about a community they were not informed about, but the sheer number of patients this would involve, they finally acquiesced in meeting with me directly. Those months I was in constant meetings with my Leadership, Risk, Legal, and Communications teams. There were times during those months where every one of us in the circle cracked under the pressure and sheer exhaustion. But I only joined the highest management meeting once.

I remember where I was the day in July of 2025 that I had my regular Friday call with our C-suite member and they said to me: “We’ve decided to close the clinic.” What happened to me at that point in time was akin to the moments you see in movies where someone receives devastating news and time slows as the character hears no sound other than a loud ringing despite the other character’s lips continuing to move as they speak.

I was then afforded one gender care team member to work with in the next six weeks that the wheels spun into motion, and was forbidden from telling anyone outside of that. The people in my life saw that I was always working, that I was always exhausted, that I was always stressed, that I was being completely consumed by what was happening at work. They also noticed that whenever they asked me what was going on, I would simply say that I couldn’t say.

Three months after the “ordeal” of the closure had passed, my institution gave me the award. It felt cheapened for so many reasons, and every congratulations felt more like an insult. Some of the reasons were:

1. I knew that I had received a cascade of nominations (around 20 employees), eight months prior. They didn’t know that I knew, but I told the one person who did, “That’s very kind but they’ll never pick me. It’s too public.” The fact that they waited until after the “threat of featuring me” was gone made it feel more like a PR recovery strategy than actual achievement. “See, we support trans people!”

2. The very work I received the award for was no longer in existence. Even during my recording of a video feature, I had to record two different openings. The first with my title, and another that answered the prompt “How you would you describe your role if you didn’t say the words ‘gender care?’” (Do you want to guess which one they picked?) It was also very interestingly edited to remove any mention of what my “community” was, despite me intentionally saying that I was trans and mentioning my “trans community” about 100 times during the interview.

3. The initial “announcement” email they sent out wasn’t an announcement at all. It was a feature about one of our community partners whose sports event I had received tickets and took my dad to because he had been a longtime fan. The feature was entirely about the partnership (including the “Click here to learn more” button) with the words “Award Winner Attends Game” thrown at the top. It was only after carefully reminding them that I was asking to be treated like every other employee who wins this award that they sent out an additional email and posted me on their LinkedIn.

Only the consistent and caring reminders from colleagues and loved ones that I had given everything to my professional role and deserved the award allowed me to finally feel okay even putting it on my résumé or socials. Whenever I was tempted to hide it, I would go back and read the nominations they included that were written by those that truly knew me and my work.

I now exist in this liminal space where I’m employed still, but my role is a mere shadow of what it once was, an empty title with little to no power to effect change and help the people I’m supposed to be helping. All of the joy has been removed. Employees that were part of either the former DEI committee or gender care team are distraught, mistrusting, anxious, and feel unsupported. The happy days of watching a young person cry tears of joy when they get their first gender affirming medication are long gone, and I’m only called on now to address the constant influx of transgender youth who are showing up to the emergency room in crisis. While my heart absolutely breaks for these young people that think they are better off dead than here right now, I get it. What I want to tell them is: You are needed. You are loved. Please stay.

Standing in front my “Trans Kids Are Loved” poster featuring art by Transpainter that once hung in my office

Speaking of staying, people have asked me for almost two years, “Why do you stay there?” My answer has always been and will always stay the same: “I will stay as long as I feel like I can still help.” But the decision was made for me. A month ago, I was informed that my last day as an employee at my institution will be June 30th, 2026. For trans people, it’s not always a loud exile. Sometimes it’s slow, painstaking removal, with trophies and awards as a consolation prize.

As a trans person working in advocacy spaces for over 15 years, Friendly Neighborhood Tranpa has had the opportunity to share his experience on local, national, and international platforms. He has been featured in Emmy-winning documentaries and was the first out trans man featured in a major fashion ad campaign. His work spans across multiple industries, including academia, research, media, and healthcare. *The views and opinions expressed are solely those of the author and do not necessarily reflect the views of the author’s employer or any affiliated organizations.*