This story has been updated.

Yale New Haven Health will no longer provide medication treatment as part of its gender-affirming care services for patients 19 and under, a spokesperson confirmed Thursday morning.

The announcement comes one day after Connecticut Children’s Medical Center publicly announced that it would be “winding down” its gender-affirming care program for children. The two facilities were the most prominent providers of youth gender-affirming care in the state.

Both will continue to provide behavioral health services. While there are other providers of medication treatment for children in the state, the cancellation of these programs at the two largest pediatric hospitals in Connecticut is sure to have an impact on the availability of services for the populations they serve.

The Yale health system made the decision after “carefully monitoring federal executive orders and administrative actions” relating to gender-affirming care for children, wrote the spokesperson in a statement provided to The Connecticut Mirror.

“This decision was not made lightly. We are aware of the profound impact that this decision will have on the patients treated in this program, as well as their families. We are committed to offering transitional support as the medication treatment component of the pediatric gender-affirming care program winds down, and our providers will continue to provide mental health and other health care services to these patients in a compassionate care environment,” the statement reads.

Yale New Haven Health is the state’s largest health system by net patient revenue.

Melissa Combs, a Farmington resident whose 16-year-old son receives gender-affirming care at Yale, received a letter from the health system by mail on Thursday morning informing patients of the hospital’s decision and committing to working with them to develop a transition plan for care.

Combs’s son, whom she declined to name, began seeing a Yale provider for gender-affirming care in October 2023, after waiting more than a year for an appointment. For about six months, she said, her son received only behavioral health services. Then, after meetings with “numerous medical professionals,” including a therapist and endocrinologist, he began receiving hormone therapy.

Combs said she will find another provider that can get her son access to medication, but that he will continue to see physicians at Yale for behavioral health.

“They are his doctors and he trusts them. And that’s important,” Combs said.

On Wednesday, in response to the news about Connecticut Children’s, Gov. Ned Lamont issued a statement lamenting the decision and standing with trans youth and their families in Connecticut.

“It’s disappointing for hospitals in Connecticut to be forced to make the difficult decision to end gender-affirming care for minors in response to the federal executive order. These decisions are not based on Connecticut values or Connecticut law—they part of a series of relentless federal demands that have created fear, confusion, and legal uncertainty for our healthcare providers,” Lamont said.

“To transgender youth and their families in Connecticut: you are not alone. We see you, we support you, and we are working closely with the Attorney General and hospital leaders to understand the full impact,” the statement continued. “In Connecticut, we do not turn our backs on kids in need.”

On Thursday, a spokesperson for the governor’s office added that the administration is evaluating what the state can do in response to this and other “recent impactful changes from the federal government.”

“Given that Yale serves a larger population, we will also want to meet with them to better understand the impact on services and those they serve. As for what the state can do, as with any of the recent impactful changes or cuts from the federal government, we’ll evaluate what we’re able to do,” the spokesperson added.

Since President Donald J. Trump took office, his administration has targeted gender-affirming care for children.

In January, Trump signed an executive order aimed at withholding federal funding from institutions, including medical schools and hospitals, that provide gender-affirming care to kids.

The directive also sought to restrict coverage of those services from federally-run insurance programs, like Medicaid. A federal judge temporarily blocked the order the following month.

Earlier this month, the Department of Justice issued more than 20 subpoenas to providers of youth gender-affirming care in connection with investigations related to “healthcare fraud, false statements, and more.”

Connecticut Republican Chairman Ben Proto released a statement Thursday saying Connecticut Children’s decision marks a “responsible and prudent course” and also “raises important questions.”

“In announcing they are “reviewing the long-term sustainability of our gender care program,” one must ask whether the program was implemented to address actual medical needs or to fulfill a political agenda,” Proto’s statement read.

In a statement on Thursday, Sen. Ceci Maher, D-Wilton, noted that the changes come on the heels of the shuttering of the national Suicide and Crisis Hotline’s specialized services for LGBTQ+ youth.

“Amid unprecedented attacks on trans and queer people in the United States, our youngest Connecticut residents losing access to vital resources is unnecessarily cruel,” stated Maher.

Gender-affirming care for children can involve counseling, hormone therapy and puberty blockers. Current medical protocols do not recommend medication or hormones for children who haven’t yet gone through puberty, according to the Yale School of Medicine, but those patients can receive counseling.

Surgery is rarely used as treatment for transgender and gender-diverse children in the U.S., a 2024 Harvard study found. A study published in 2023 found that, out of a total 48,000 gender-affirming surgeries performed in the U.S. between 2016 and 2020, 7.7% were performed on children between the ages of 12 and 18. The vast majority of the procedures performed on children were breast and chest surgeries.

Correction: Melissa Combs’ name was wrong in the original version of this story. It is Combs, not Soto.