Two Wisconsin hospitals, Madison’s University of Wisconsin Health and Milwaukee’s Children’s Wisconsin, have paused gender affirming care for minors despite having no legal obligation to do so.

UW Health runs the Pediatric and Adolescent Transgender Health clinic and Children’s Wisconsin houses a Gender Health Clinic. Both have confirmed the pause of care amidst controversy, taking seemingly preventative measures, according to The Cap Times.

As two of the largest hospitals in the state, they likely influence other health systems in Wisconsin. These hospitals are not responding to legal necessity, rather political pressure, and by doing so are leaving transgender youth without essential care.

The Kaiser Family Foundation describes gender-affirming care as a spectrum of medical and mental health services for nonbinary and transgender people that aims to affirm a person’s gender identity. This type of care is highly individualized as not all transgender people will seek the same treatment, some choosing to not use medical services as a part of their transition at all.

At the beginning of his second term, President Trump came in ready to take action against transgender youth. Some examples of his actions include declaring there are only two sexes, male and female, enforcing prohibition of transgender girls participating in female sports and now aiming to shut down gender-affirming care, according to The White House Presidential Actions.

A legal challenge is now moving through the federal courts, making the status of gender-affirming care across the country unknown. Any hospitals that provide gender-affirming care will be blocked from collecting all Medicaid and Medicare reimbursements, according to The Cap Times.

While not criminalizing the services themselves, hospitals are scared out of providing care as they do not want to face the financial consequences. But, hospitals are complying before they have to. The Cap Times estimates the courts are not expected to reach a decision until at least April. There is no risk in providing care until the court ruling has been made.

Wisconsin Public Radio released statements from both UW Health and Children’s Wisconsin. UW Health states they remain committed to providing their LGBTQ+ patients with high quality care despite current instability. Children’s Wisconsin makes a similar statement pledging to continue offering mental health services for LGBTQ+ patients and honoring the fact that they deserve to be treated with respect and empathy.

All of this comes amongst a bill introduced by U.S. Rep. Marjorie Taylor Greene, R-Ga. The bill moves to criminalize providing gender-affirming care to transgender minors. Any health care providers involved in doing so face a punishment of a fine and prison time up to 10 years. This bill has officially passed, according to The National Public Radio.

The Trump administration has made their stance on the issue of access to gender-affirming care incredibly clear. According to the U.S. Department of Health and Human Services, HHS Secretary Robert F. Kennedy Jr. states he will comply with President Trump’s call to halt what he describes as unsafe and irreversible health practices. He goes on to describe gender-affirming healthcare as malpractice, according to NPR, mislabeling important care as harmful.

Strategically, the administration focuses on transgender youth, because they can label the discrimination as child safety or medical caution, rather than the stripping of legal rights. If you look between the lines, it is obvious that targeting gender affirming care for minors is not about care. Instead, it is about control and long-time erasure.

Since his first day in office, Trump has slowly but surely been restricting care and support of transgender youth. The suicide prevention lifeline created in particular for transgender youth was canceled and hundreds of millions of dollars dedicated toward scientific research funding related to LGBTQ+ health has been reallocated, according to NPR.

Healthcare providers have also been threatened with prosecution if they provide gender-affirming care to LGBTQ+ patients. These measures create a chilling effect and systematically dismantle the medical, mental health and institutional supports that transgender youth rely on.

The effects of this isolation are not unknown. They are well researched. If an individual stops hormone therapy amidst care, the body can change and revert back to a state that does not align with their gender identity.

Being able to express themselves in a physical manner is vital to a person’s wellbeing. Just as concerning comes the issue of mental health. According to The Trevor Project, 39% of LGBTQ+ young people seriously considered attempting suicide in the past year — 47% were transgender women 52% were transgender men considered attempting suicide.

One proven way to uplift mental health is gender-affirming hormone therapy The Trevor Project also reports. Stanford Medicine finds teens who receive gender-affirming care have better mental health than those who wait until adulthood or those who never receive care.

The reality we live in is unfortunate. 27 states have enacted laws limiting youth access to gender-affirming care and 50% of transgender youth live in states with limited access to care, according to the KFF. This report does not yet include Wisconsin. Transgender youth are in a vulnerable state. There is growing fear, a lack of safety and an increase in violence. 90% of LGBTQ+ young people said their well-being was negatively impacted due to recent politics, according to The Trevor Project.

Conversations and actions surrounding gender-affirming care for transgender youth raise many concerns, but one rises above the rest: the systematic invalidation of their identities and existence. The LGBTQ+ community is increasingly silenced.

The bans we see in health care and restrictions in schools function as tools of censorship. Policies continuously reinforce the message that these identities are not legitimate. They indicate that transgender and queer lives are something to be debated rather than affirmed and protected.

In the end, this moment forces us to decide whether we value political ideology over medical ethics. Will we protect transgender youth through evidence-based care? Or will we continue to let ideology dictate whose lives are worthy of support?