LOS ANGELES — When Children's Hospital Los Angeles first told thousands of patients it was shuttering its pediatric gender clinic last month, Jesse Thorn was distraught but confident he could quickly find a new local care team for his kids.

But by the time the Center for Transyouth Health and Development officially closed its doors on Tuesday, the father of three was making plans to flee the country.

"They're targeting whoever they can," Thorn said. "[I'm afraid] the police will show up at my door because I took my child to see their doctor."

Until this week, Children's was among the largest and oldest pediatric gender clinics in the United States — and one of few providing puberty blockers, hormones and surgical procedures for trans youth on public insurance.

The closure of the renowned program signals a wider unraveling in the availability of care across the country, experts said. That includes in former safe havens such as California, New York and Illinois, where state laws protecting trans-specific healthcare are crumbling under mounting legal pressure and bureaucratic arm-twisting by the Trump administration.

In the last week, University of Chicago Medicine and Children's National in D.C. announced they will end or dramatically scale back services for trans youth, following similar moves by Stanford Medicine, University of Pittsburgh Medical Center and Children's Hospital of Orange County.

"There's a rapid collapse of the provision of this care in blue states," said Alejandra Caraballo, a civil rights attorney and legal instructor at Harvard. "By end of 2025, most care will effectively be banned."

Some parents in L.A. say they fear the Department of Justice will use private medical data subpoenaed from California's largest pediatric safety-net hospital to take their children away from them.

"It's absolutely terrifying," said Maxine, the mother of a Children's Hospital patient, who declined to give her last name for fear of attacks on her son.

"I'm very afraid that the DOJ and this acting Attorney General are going to come after parents and use the female genital mutilation law ... to prosecute parents and separate me from my child," she said.

On July 9, Atty. Gen. Pam Bondi announced the Department of Justice was subpoenaing patient medical records from more than 20 doctors and clinics, the latest in a cavalcade of legal and technical maneuvers against providers who care for trans youth.

"Medical professionals and organizations that mutilated children in the service of a warped ideology will be held accountable by this Department of Justice," Bondi said in a news release announcing the move.

Children's would not say whether it had been subpoenaed or if it had turned over records responsive to the government's demand.

The Justice Department was already investigating pediatric specialists for a litany of alleged crimes, from deceptive trade practices to billing fraud. Federal health agencies have vowed to withhold funding from institutions that continue to provide affirming care.

"These threats are no longer theoretical," Children's Hospital executives wrote to staff in an internal email announcing the closure June 12. "[They are] threatening our ability to serve the hundreds of thousands of patients who depend on CHLA for lifesaving care."

Advocates say gender-affirming care is also lifesaving. They point to statistics — contested by the federal government and some experts — showing high rates of suicide among trans youth.

In June, the decision to shutter the clinic was widely condemned. Advocates said Children's Hospital L.A. had "thrown trans kids under the bus" in disregard of state law.

Few are saying that now.

"You could see kids with leukemia being cut off their chemo therapy unless these hospitals stop provide care to trans people," Caraballo said. "If one of the biggest children's hospitals in the country couldn't shoulder that burden, I don't see many others being able to do so."

Others agreed.

"No matter what California or any other state has done to say, 'We want to protect these kids,' unless they can write checks that equal the amount of money that's being lost, [programs close]," said Dara E. Purvis, a law professor at Temple University.

So far, the Trump administration has painted parents as victims of "radical gender ideology."

Some experts warned that as the government tightens the screws on doctors and hospitals, trans teens and their families are likely to seek hormones outside the medical system, including through gray market channels.

"We've seen this with abortion," Caraballo said. "People are going to go about getting it whichever way they can."

There are fears that families could face prosecution for continuing to seek medications, similar to charges being filed against mothers who have secured abortion pills for their teenagers.

"We're working with Congress on existing criminal laws related to female genital mutilation to more robustly protect children," Justice Department Chief of Staff Chad Mizelle said during a Federal Trade Commission workshop entitled "The Dangers of 'Gender-Affirming Care' for Minors."

"We are using all of the tools at the Department of Justice to address this issue," Mizelle said.

For now, dozens of hospitals across California still provide gender-affirming care, including hormone therapy and surgical procedures.

But the list changes almost day to day.

"Even programs that may have been operating a month ago are not operating now," said Terra Russell-Slavin, chief impact officer at the Los Angeles LGBT Center. "There's a lot of concern about even being public about offering care because those agencies become targets."

With the medical care their children rely on under threat and few promised protections from the state, some families are unsure what the coming months will bring.

For one Orange County father, who asked not to be named for fear of retaliation against his trans son, plans for future travel are suddenly in jeopardy.

He said only about half of his son's identity documents match his gender, and they've been warned not to try to change others.

"He won't be able to leave the country because he can't get a matching passport," the father said.

For Maxine, the L.A. mom, balancing the banal with the existential is a daily strain.

"My kid is just living their life. They want to go to concerts, they want to go shopping for back to school — they don't know any of this is happening," the mother said. "You have to experience this intense fear while maintaining a normal household for everybody else."

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