Kaiser Permanente, one of the country’s largest healthcare providers, announced this week plans to halt transgender operations on minors, citing a changing regulatory and legal landscape under the Trump administration. 

The California-based healthcare giant will hit pause on what LGBT advocates describe as “gender-affirming” surgeries for patients 18 and younger on Aug. 29. While sex-change operations end, the group said “all other gender-affirming care treatment remains available,” including puberty blockers and cross-sex hormone therapy. 

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“Since January, there has been significant focus by the federal government on gender-affirming care, specifically for patients under the age of 19. This has included executive orders instructing federal agencies to take actions to curtail access and restrict funding for gender-affirming care,” Kaiser said in statement Wednesday that referenced President Donald Trump’s January executive order that targeted medical professionals accused of “maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions.” 

The  Supreme Court’s June United States v. Skrmetti decision also marked a major victory for state-level efforts to restrict transgender procedures, or “gender affirming care,” for minors, in addition to Trump’s executive orders pertaining to restricting transgender operations, as well as the use of puberty blockers, cross-sex hormones, and other transition treatments on minors. 

Those changes have led to a slew of groups and healthcare providers moving to discontinue sex-change operations on children. The Gender Development Program at Children’s National Hospital became one of the latest to do so earlier this month, after the Department of Health and Human Services issued new guidelines to providers prohibiting the use of puberty blockers, cross-sex hormones, and surgeries to treat minors diagnosed with gender dysphoria. Providers were instead ordered by HHS Secretary Robert F. Kennedy Jr. to revert back to traditional therapies for gender dysphoria.

Weeks after Kennedy sent out the guidelines, Trump’s Department of Justice announced it had issued more than 20 subpoenas to doctors and clinics suspected of performing transgender procedures on minors. 

Kaiser also referenced Attorney General Pam Bond’s subpoenas in its announcement restricting trans operations this week, as the DOJ’s ongoing federal investigation seeks to hold medical professionals and organizations performing “gender-affirming care” accountable.

In California, where Kaiser is based and known as the state’s largest health insurer, Democrats condemned the policy change, as Attorney General Rob Bonta has long urged residents and organizations to defy the Trump administration on LGBT policies, arguing that state law preempts federal regulations. 

“It’s important for us not to just cave in to Donald Trump’s bullying,” Democratic State Sen. Scott Wiener told KQED on Wednesday. “It’s hard and it’s scary, but this is how fascists succeed — when institutions start backing down.”

“I don’t want the state to have to fight with Kaiser or with Stanford or with any of our great health systems, but we have to enforce the law,” he continued. “California should be a safe place for trans people and LGBTQ people generally, and this is not what should be happening.”

CONSERVATIVE LEGAL GAINS AGAINST LGBT AGENDA SPUR PRIDE ACTIVISM

While some LGBT activists cried foul, accusing the Trump administration of hurting children who identify as trans and request a sex-change operation, other pride organizations supported Kaiser’s decision. 

LGB Courage Coalition co-executive director Jamie Reed argued that children “cannot consent to something that is as permanent as having healthy body tissues removed,” in comments to ABC News.