Trans youth react to Nationwide Children’s Hospital ending gender-affirming care

When Colleen Sheridan went searching for gender-affirming care for her teenage daughter, Corinne Embi, she remembers finding just one option, the THRIVE program at Nationwide Children’s Hospital in Columbus. “I feel so fortunate Corinne was able to receive such comprehensive and kind care during her high school years,” Sheridan said. “The care for her and me was superb.” 

But last month, in the wake of the hospital’s decision to end the THRIVE program and cease providing gender-affirming care, Embi, who has been a patient at the hospital for two and a half years, went in for her last appointment.

The decision comes as both the Trump administration and Ohio’s Republican-controlled legislature seek to restrict healthcare for trans youth. As advocates criticize those measures, providers face complicated legal and financial challenges to gender-affirming care. Their reactions in the face of those challenges are having a major impact on how trans people access healthcare in central Ohio, limiting options and even pushing some toward community-based alternatives.

When she first decided to seek gender-affirming care, Embi said, “it took a few months for me to actually get an appointment. But basically, the moment I turned 16, I started talking with them about starting HRT (Hormone Replacement Therapy).” She appreciated that her care team was deliberate, talking about the side effects and what to expect, as well as answering questions and correcting misinformation. In February 2023, Embi started taking spironolactone, a hormone blocker. “Then I started actual estrogen in May.”

In addition to the medication, Embi said Nationwide Children’s Hospital and the THRIVE program offered a range of services for trans youth. “There’s voice-training therapy, there’s normal therapy,” all from specialists with years or decades of experience working with trans youth.

However, in April 2024, House Bill 68 came into effect after the Ohio legislature overrode a veto by Gov. Mike DeWine. This bill prohibits physicians from providing HRT and other forms of gender-affirming care to minors and includes a number of other provisions targeting trans youth with respect to access to mental health care, custody disputes, Medicaid coverage, and school and collegiate sports. The ACLU of Ohio challenged the law, resulting in multiple rounds of court decisions and appeals. Most recently, in March 2025, an Ohio appellate court ruled the law unconstitutional before the state appealed again to the Republican-controlled Ohio Supreme Court, which agreed to allow the restrictions to go into effect as it takes up the case.

Additionally, in January 2025, the Trump administration issued an executive order directing the executive branch to work to prohibit access to gender-affirming care for trans youth under the age of 19. Though this executive order cannot outlaw gender-affirming care outright and faces its own legal challenges, it nevertheless led a number of hospitals across the country to suspend the provision of gender-affirming care to youth.

In this context, Nationwide Children’s Hospital announced in early September that it would stop providing gender-affirming care as of Sept. 26, 2025, not only to minors or those under the age of 19, but to all patients. The hospital generally provides primary care for youth up to age 21, though in special circumstances it sometimes treats adults up to age 25. “I was not surprised, honestly,” Embi said. “The writing has been on the wall for like months, years.” Since the passage of HB 68, Embi said, THRIVE hasn’t taken in new minors for HRT. “But there was a grandfather clause, so I was still able to get it,” she said. (Multiple current and former healthcare providers in the THRIVE program declined requests for interviews.)

In a statement, a Nationwide Children’s spokesperson said the hospital chose to end gender-affirming care “in order to proactively plan and support our providers and patients in a rapidly changing regulatory environment.” “The hospital is working with affected patients to end their prescriptions, always with patient safety as a top priority,” the statement continued. “Nationwide Children’s will continue to support these patients and families through the provision of behavioral health services, and any other needed healthcare.”

Now 18 years old, Embi said her doctor prescribed her enough estradiol and progesterone to last until she turns 19 and is no longer affected by either HB 68 or the Trump executive order. “I’ve been looking at alternatives already,” she said with respect to how she will access care, naming Equitas and Planned Parenthood as potential options.

Providers like Equitas Health have taken a strong position. “Our position on efforts to limit healthcare access for gender-expansive folx is simple: No one should have to worry that the government will block their access to medically necessary care,” a spokesperson wrote in a statement to Matter News. However, the organization still serves only adult patients.

Embi said based on her discussions with her doctor at Nationwide, “there aren’t a lot of legal alternatives for minors who need HRT [or] even just hormone blockers.” She also lamented the loss of access to therapy and mental health support in the absence of THRIVE. “It’s going to be a huge loss for a lot of trans youth across Central Ohio.”

HB 68 also targets physicians who help patients go to another state or country for gender-affirming care. This may mean that one of the only options left for trans youth, especially those with limited financial means, will be DIY HRT. “If worse comes to worst,” Embi said, “I might have to do that.”

Estelle, a pseudonym, is a young central Ohio trans woman who volunteers her time and money to help others access DIY HRT. In her own journey, she found that even as a well-informed 21-year-old adult, her primary care doctor was uncomfortable providing gender-affirming care, describing such attitudes as common among medical professionals. “Despite the standards of practice around providing HRT, let alone providing HRT for a minor which has very strict standards of practice, they’re worried that they’re going to mess it up and damage people,” Estelle said.

This reluctance has traditionally left few options for trans youth. When Estelle was a minor with trans friends seeking HRT, most went to Nationwide Children’s Hospital, which she said, “was really the only available resource that [we] were aware of to get this type of gender-affirming care.”

But for those without access to gender-affirming care through the medical system owing to financial, family, or now legal reasons, Estelle works to provide DIY HRT via a community health approach. She described her work as multi-faceted, starting with compiling resources about ways to access HRT in the area and correcting misconceptions.

Much of the work, though, is “the actual production of these hormones, of testosterone, of estrogen, and working with doctors, with pharm techs, with HRT researchers to figure out how to safely compound formulas at home,” she said. In a laboratory stocked with professional equipment including Still Air Boxes and other sterilization tools, she helps synthesize injectable testosterone and estrogen. “A vial that will last someone about nine months costs maybe 2 or 3 dollars to make per bottle,” she said. “So, once you get over that initial hurdle, it becomes a very accessible thing.”

When it comes to distributing these DIY hormones within networks of trans youth, Estelle follows a philosophy of informed consent. This means, she said, “I get them blood testing … and I work with my friends who are doctors to interpret this blood testing to see, do we have things we need to worry about? We work on monitoring people’s vitals, and we work on conversations with them, very open conversations, again like doctors do, especially specialists in HRT, about what are their goals? What do they want? What is safe?”

Still, Estelle recognized that DIY HRT is not for all. “With Nationwide and Equitas, not only do they provide you with the HRT, but they provide that in a space where you also have someone as your primary care doctor. You have someone as your therapist. You have someone as a dentist,” she said. “You have someone doing all of these things that we would never financially be able to provide those resources in any community health setting.”

Estelle described the decision to end gender-affirming care at Nationwide Children’s as “devastating,” adding that “it’s bullshit to be complying in advance” with HB 68, which has yet to receive a final court ruling and would not in any case ban gender-affirming care for those 18 and older. “If we have somewhere like Nationwide Children’s, which is considered the top tier for children’s healthcare within the United States, if we have powerful institutions like this pushing back, saying ‘no,’ this is people’s right, this is what people need, then it sets such a powerful precedent that we can hope that other smaller groups won’t also comply in advance.”

Corinne Embi empathized with that perspective but said she understands the decision that is cutting her own care. “They are a hospital serving a bunch of people, and trans people are just a subsection of that. So if they got their Medicare or Medicaid funding cut because they were standing up for trans people, then a bunch of other people they serve might be in trouble,” she said. “I don’t necessarily blame them.”

Other top Ohio pediatric hospitals, however, have been slower to take such drastic action. Top-ranked Cincinnati Children’s Hospital did not respond to multiple requests for comment, but the website for its Transgender Health Center implies only minors are prevented from receiving puberty blockers and hormones. A spokesperson for Akron Children’s Hospital meanwhile confirmed that it “is continuing to provide gender affirming care in compliance with applicable state and federal laws.”

Trans advocates have criticized the decision by Nationwide Children’s to end gender-affirming care. In a statement, Minna Zelch from Trans Allies of Ohio called it “an egregious overstep that is actively harming patients and is not in line with any Ohio or federal laws.” “Forcibly detransitioning patients can be traumatic and dangerous and it is unconscionable that this administration has placed our hospital systems in this position,” Zelch added. 

Jennifer Kuhn from Kaleidoscope Youth Center, meanwhile, expressed the organization’s disappointment in the decision. “Service providers in our community should be finding ways to proactively support transgender individuals, rather than proactively discriminating against them,” she said.

Despite the end of gender-affirming care at Nationwide Children’s and the broader crackdown on trans youth healthcare, Estelle said she will continue providing DIY care to her community. 

“I’m extraordinarily happy where I am in my transition,” said Estelle, who didn’t start HRT until she turned 19. “And even if you can’t get access to HRT until you’re older … it will still change you in the ways that you want. You will still go through a beautiful transformation.”