When a health system pauses care for children because of political pressure, and then a county board of elected representatives steps in to say that is not good enough, something important has happened. The Dane County Board of Supervisors has passed a resolution calling on UW Health and Children's Wisconsin to resume prescribing puberty blockers and hormone therapy for transgender young people, after UW Health suspended those services in January citing federal threats to Medicaid and Medicare funding. The board's message is straightforward: health care decisions should be guided by medical evidence, clinical judgement, and established standards of care, not by political enforcement.
What actually happened to these young people
Before we get to the politics, it is worth sitting with what the pause meant in practice. Young people who had been receiving care, who had a trusted clinical relationship, who had probably waited months to access that care in the first place, were told it was stopping. Families have since been forced to travel out of Wisconsin, some at considerable personal cost, to find providers willing to continue treatment. Others are simply left in uncertainty, without the continuity of care that any young person receiving ongoing treatment deserves.
That is not an abstraction. A teenager partway through puberty suppression, suddenly without access to medication or to the clinician who knows their history, is experiencing something genuinely destabilising. The Dane County resolution names this directly, and the board is right to do so.
The legal picture shifted, and UW Health knows it
UW Health's January decision to pause care cited a specific federal directive and the risk of enforcement affecting Medicare and Medicaid reimbursement. The Dane County resolution notes, correctly, that the legal landscape has since changed. Subsequent federal litigation produced a court order vacating the prior federal statements that were used to justify the restrictions on this care. The legal basis UW Health cited for stopping treatment has, at least in part, been removed.
UW Health's response to the county is telling. They say they "continue to believe this is evidence-based care" but that "the current risk is too great to resume." That is an honest statement, and I have some sympathy for any institution trying to navigate a federal government that has made clear it is willing to use funding levers as a weapon. But the consequence of that caution falls entirely on the young people who need care, not on the institution weighing its options. That is an uncomfortable asymmetry, and the county board has named it.
Where the moral authority actually sits
What strikes me most about this story is the source of the pushback. This is not a trans advocacy organisation, not a legal challenge, not a clinician speaking out individually. It is an elected county board, representing ordinary constituents, telling a major health system that it should follow the evidence and resume care. The American Academy of Pediatrics, the Endocrine Society, WPATH, the American Medical Association, and the American Academy of Child and Adolescent Psychiatry, which reaffirmed its support for gender-affirming care in 2025 in direct response to federal pressure, all support access to puberty blockers and hormone therapy for trans adolescents when clinically indicated. The Dane County Board is not making a fringe argument. It is reflecting the settled position of the international medical community.
The federal government has tried to reframe the withdrawal of this care as protective. What the county board is doing, clearly and on the record, is refusing to accept that framing. Delay is not neutral. Withholding care is a decision, with consequences, and those consequences land on real children and their families.
What I hope happens next
I hope UW Health finds a way to resume care. I understand the funding threat is real, and I am not dismissing the institutional difficulty. But the young people who were mid-treatment when care was paused are not mid-difficulty in an institutional sense. They are living in their bodies, going through adolescence, and trying to hold on to some continuity in their lives. The county board has given UW Health political cover and moral backing to act. A court has removed part of the legal basis for the pause. The evidence for the care was never in doubt.
The families who have been travelling out of state, the young people managing the uncertainty, deserve better than an institution waiting for the perfect legal moment. Sometimes the moment has to be made.