Massachusetts is supposed to be one of the safer states for trans people, but hospitals there have been withdrawing gender-affirming care for minors under federal pressure. Activists are fighting back, families are fleeing, and the story makes clear that a protected state on paper does not guarantee that care is actually available when someone needs it.
A bus, a banner, and a message to hospital leadership
Earlier this spring, outside Baystate Medical Center in Springfield, protesters placed a large banner on the grass near the hospital entrance. It showed a bus with the Baystate logo, with the words "Baystate Bows To Trump" painted across it. Fabric legs poked out from underneath. Signs around it carried speech bubbles: "Gender affirming care gave me my life back." And, heartbreakingly: "I don't want to live if I can't live as myself."
When I read that, I had to pause. That second sign was not a slogan, it was a young person's reality, put into words and carried to the doors of a building that had just decided it would no longer help them.
Baystate Health had made the decision to stop providing gender-affirming care to patients under 19, a category that includes puberty blockers, hormone therapy, and psychology appointments. The hospital's leadership connected that decision to threats from Donald Trump's administration to cut federal reimbursement to institutions providing gender-affirming care to minors. Baystate was not alone: Fenway Health in Boston and Outer Cape Health Services on Cape Cod did the same.
Baystate's president and CEO, Peter Banko, released a statement saying that "inclusion is a core expression" of Baystate's mission, and that the hospital's values are not political. He called for celebrating LGBTQ+ staff members and learning from others' stories. What he did not do was commit to restoring the care.
I find that particular combination difficult. You can celebrate Pride and withdraw life-saving treatment in the same breath, and the celebration does not cancel out the withdrawal.
A safe haven that is no longer safe enough
Massachusetts was the first US state to legalise same-sex marriage. It has been a destination for trans people seeking care, safety, and community for years. People have moved there precisely because they believed it offered something more solid than other states could.
Madison, a mother to two children including a trans son, and partner to a trans person, moved her family back to Massachusetts partly because of that belief. She thought the threat level had dropped after 2020. By November 2024, she told The Shoestring, she knew it was time to leave again. Her family now plans to leave the country entirely. Her biggest fear is that the government will find her an unfit parent simply because she supports her son's access to gender-affirming care. That is not a paranoid reading of the situation. It is a rational response to what is actually happening.
What strikes me most about Madison's story is that her family has already done the exhausting work of leaving once, returning once, and now faces doing it all again. That is an enormous cost to place on a family for the act of supporting their child.
The people organising the fight
The protest outside Baystate grew from community conversations, shaped by people like Ali Wicks-Lim, a non-binary western Massachusetts resident who has been part of the organising effort. Wicks-Lim was clear about what they wanted from the demonstration: not comfort, but confrontation with reality.
"We actually want people to have to struggle with how uncomfortable it is," they said, "because it's what's happening."
That is the right instinct. The temptation in advocacy is always to make things easier to hear. But some things should not be made comfortable. When young people are being turned away from medical care that research consistently links to better mental health outcomes, including lower rates of depression and suicidal ideation, making that feel acceptable would be a failure.
The organising has not been without pushback. When protesters gathered outside Baystate Franklin Medical Center in Greenfield, the hospital called the police to disperse them. Organisers have also challenged Baystate's presence at Springfield Pride, arguing that a hospital cannot celebrate the community at a pride event while simultaneously refusing to provide care to trans youth.
In Boston, Protect Trans Futures formed after Fenway Health began contacting patients about its decision to end gender-affirming care for minors. Teddy Walker, a 21-year-old organiser who moved from Texas to Massachusetts as a teenager, explained what motivated him.
"It felt like a moral imperative," he said. "It felt like something we had to do, not just to stand up for and protect the trans kids and youth that we so recently have been, but also knowing that our care is next."
Walker knows people who have had to wait until they were 18 to access care because their parents refused consent. He said plainly that some of those people do not live long enough to reach 18. That is the real-world cost of delay. Delay is not neutral, and it never has been.
What Fenway Health's own history tells us
Fenway Health emerged in 1971 from the context of the HIV epidemic, when queer people were being systematically denied care and dying as a result. It began as a volunteer drop-in centre in the basement of a church. Its entire reason for existing was that mainstream medicine had abandoned a community.
The irony of Fenway now withdrawing care from trans youth is not a small thing. The institution was built in direct response to the harm that happens when healthcare providers capitulate to political pressure rather than standing with their patients. The people who built it knew exactly what that capitulation costs. Protesters and organisers in Boston know that history too, and it is part of why the disappointment runs so deep.
Protected on paper is not the same as cared for in practice
This is what the Massachusetts story makes visible, and why it matters beyond its state borders. A place can have strong legal protections, a history of progressive legislation, and genuine community support, and trans young people can still find themselves without access to the care they need when a hospital decides that federal funding matters more than its patients.
Geography should never determine whether someone gets healthcare. A young trans person in Springfield deserves the same quality of care as someone in a city with more options. A family in Massachusetts should not have to calculate whether they need to leave the country to keep their child safe.
The people organising in western Massachusetts and in Boston are not asking for anything extraordinary. They are asking for the restoration of standard medical care, supported by international professional guidelines, that was working for the people who needed it. The hospitals that withdrew it made a choice. That choice can be reversed.
If there is a news story you would like me to cover then just let Sammy know.
Dr Helen Webberley is a gender specialist, medical educator, and advocate, and the founder of GenderGP. She writes about gender diversity, trans healthcare, and the lives at the centre of both.
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