The largest pediatric health care system in California will stop providing gender-affirming medical care to transgender youth next month amid increasing pressure from the federal government.

Rady Children's Health, encompasses Children's Hospital of Orange County, Rady Children's Hospital San Diego and Rady Children's in Riverside County, said the organization was recently referred for investigation to the U.S. Department of Health and Human Services Office of Inspector General.

The federal agency, which oversees the Medicare and Medicaid programs, did not comment about the timeline of its investigation or the focus of the probe Friday, saying HHS-OIG's "general policy is to neither confirm nor deny the existence of an investigation."

But patients at Rady Children's and CHOC have been told they will no longer receive gender-affirming care at the facilities, which can include prescriptions for medications like puberty blockers, beginning on Feb. 6, according to advocates. As a result, patients going without medications like puberty blockers will not be able to see a doctor and have the specialized medical professional walk them through the process of going off the medication.

"The environment around gender-affirming care has changed dramatically, with escalating federal actions," Rady Children's Health said in a statement. "These developments affect our role and responsibilities as a provider participating in federal programs such as Medicaid and Medicare, which are essential to caring for all children and families in our communities."

In December, HHS announced that the Centers for Medicare & Medicaid Services were proposing new rules that would ban gender-affirming care by medical providers that participate in its programs.

"Nearly all U.S. hospitals participate in Medicare and Medicaid and this action is designed to ensure that the U.S. government will not be in business with organizations that intentionally or unintentionally inflict permanent harm on children," the department said at the time.

The department said that officials would also propose additional rules to prohibit Medicaid and other funding from being used for gender-affirming care for children or adults under the age of 19.

Rady Children's Health said the decision to stop providing such medical interventions, procedures and prescriptions for patients was "very difficult" and "made to ensure we can continue serving all children and families across the communities we serve."

LGTBQ+ advocacy organizations say the move is another example of continuous efforts by the Trump administration to mischaracterize legitimate care backed by major U.S. medical associations and erode access to services based in part on the false premise that transgender people do not exist.

Many hospitals across the country, including in California, have already pulled back on gender-affirming care or shuttered entire programs amid mounting pressure from the federal government.

In July, Children's Hospital Los Angeles officially closed what had been among the largest and oldest pediatric gender clinics in the United States. For years the clinic had provided puberty blockers, hormones and other procedures for trans youth on public insurance.

This has forced transgender children and their families to relocate — sometimes to other states and out of the country — to seek medical care, said Brit Cervantes, the founder of OCGAPNet, an organization that advocates for trans rights.

"It's a message that's being sent that's very clear: transgender people, and particularly transgender youth, don't have a right to exist, and we don't have a right to have access to health care," Cervantes said. "All of this rhetoric that comes with these hostile policies is really damaging."

OCGAPNet and Pride at the Pier, another Orange County-based organization, are holding a rally outside Children's Hospital of Orange County in Orange at noon on Saturday to call for hospital leadership to resist federal pressure. TransFamily Support Services and the Alliance for TransYouth Rights are also holding a protest at 11 a.m. on Saturday outside the Rady Children's Hospital in San Diego.

"This will not end with transgender kids," said Kanan Durham, director of Pride at the Pier. "The administration is testing how easily they can force a hospital to betray its patients. They're weaponizing their purse strings to tell us who can get care and who can't."

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