It has been two years since Ari Cohen, 16, began taking hormone therapy to coax his female body into closer alignment with his long-held masculine sense of self.
During treatment at Children’s Hospital Colorado on the outskirts of Denver, Ari’s voice has deepened, so much that he has been known to laugh out loud at the booming sound. He has gained muscle. His breasts stopped growing. The anxiety of not quite looking or sounding like a boy, even though in his mind he had always been one, lifted.
“I like the way I am now,’’ he said in a recent interview. “It’s nice.’’
It had taken years for Ari to persuade his parents to take him to a gender clinic. But the new year brings a new anxiety for Ari, as well as for thousands of other transgender teenagers in the United States: What if they can no longer receive medical treatment for gender dysphoria in this country?
Over the last year, the Trump administration has moved to upend gender transition treatment for minors. Many families living in Republican-led states had already faced bans on such treatment, but federal agencies in 2025 used an array of pressure tactics to try to end treatments for minors in every state, red and blue.
Ari lives in Colorado, one of the two dozen states where it is legal to provide the care, and received treatment from the increasingly rare hospital still offering it. But over the course of the year, his family, too, was sent scrambling for Plans B, C, and D. And by the beginning of this year, it became clear that those plans might need to be put into effect.
In his 2024 election campaign, President Trump tapped into — and stoked — a broad cultural discomfort with the growing number of young people identifying as transgender, vowing to “stop the transgender lunacy,” especially when it came to medical treatment for minors.
Once in office, he quickly signed an executive order that vowed the government would not “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another.’’
And in February, the Trump administration urged the Supreme Court to uphold a Tennessee law banning transgender medication for minors, and, by extension, other bans in more than 20 states. The court did that in June, prompting many families to move or travel to receive care, including to Ari’s hospital.
Most major U.S. medical groups have endorsed medical treatments as effective in relieving the distress young people can experience when their gender identity conflicts with their sex. That treatment can include puberty blockers, hormone therapies and, in rare cases, mastectomies.
But an influential report commissioned by the British government found that the risks and benefits have not been well studied. And some European countries have restricted gender treatments in recent years.
The Trump administration took its own stance in May, when the Department of Health and Human Services issued a report prioritizing psychotherapy for gender dysphoria treatment.
Other federal agencies also began to act against medical treatment for minors. In June, the F.B.I. called on the public to report hospitals and doctors who are performing mastectomies on minors.
The Federal Trade Commission held a hearing in July on potentially unfair or deceptive trade practices in the field, featuring several young people and parents who say they were misled by the medical establishment into embracing gender treatments, and regretted their decision.
That same month, the Justice Department issued subpoenas to more than 20 doctors and hospitals, including Children’s Hospital Colorado, demanding confidential records of gender treatments that it suggested could be linked to fraud.
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In response, Ari’s hospital, along with several other institutions, sued. But high-profile clinics in Boston, Washington D.C., Los Angeles and Pittsburgh started shutting down, telling patients they were trying to avoid government sanctions.
Then, a week before Christmas, Mr. Trump’s health secretary, Robert F. Kennedy Jr., made it all but impossible for Children’s Hospital Colorado to continue.
Mr. Kennedy announced that the agency would effectively bar all Medicaid and Medicare funding to hospitals that continued to provide gender medicine to minors. Two weeks later, Mr. Kennedy’s agency indicated that it would investigate several hospitals, including Ari’s, for failing to meet the standards of its report recommending psychotherapy. In the first week of January, the hospital informed Ari and his family that it was suspending care for patients under the age of 18 — “beginning today.’’
The risk of losing federal health care funding was too great, the hospital said in a statement: “As a safety net hospital system, nearly half of our patients are covered by Medicaid. This loss of funding would critically impair our ability to provide care for the multitudes of children who depend on us.”
Critics of youth gender medicine — including some health professionals, parents and young people who regret their own treatment — have applauded the closings. They say the shutdowns will protect many children from long-term side effects that can include infertility. About 10,000 minors between age 10 and 17 have been receiving gender treatment, according to a federal government estimate.
The threat to withhold Medicaid and Medicare funds, said Dr. Stanley Goldfarb, chairman of Do No Harm, an anti-transgender advocacy group, “marks a major step toward delivering a crippling blow to the child transgender industry.’’
For his part, Ari has started calculating whether he can adjust his testosterone dosage to make his existing prescriptions last until he turns 18, which is more than a year away. He has worries, especially over the possibility of uneven consequences. Vocal changes are typically permanent. But he might get a period and return to a softer, more feminine physique.
“I’m afraid of basically turning back into a female-presenting person,’’ Ari said. “And I don’t even know what that will look like, so I’m afraid of that too.’’
Ari’s mother, Erin Roosa, is worried about the harassment that can come from “not passing” as male. She is looking into other options, just as she has all year. When Children’s Hospital Colorado suspended care, she already had a backup provider lined up nearby, in Boulder.
But that is no guarantee that Ari’s care will last, since legal experts say that any provider receiving federal funds could be affected by the Trump administration’s new policies.
Ms. Roosa is looking into the legality of purchasing hormones outside the United States. Other parents, especially those with younger children being treated with puberty blockers, are considering leaving the country. Another option, albeit an expensive one, may be providers that take only private insurance or direct payments, and do not accept Medicare and Medicaid.
Ms. Roosa, like many parents of transgender teenagers, feels the Trump administration is attacking her family for political advantage.
“Apparently,” she said, “I can’t be given the responsibility to take care of my own child.’’
Litigation is continuing. Colorado is among 19 states now suing the U.S. Health Department, arguing that Mr. Kennedy does not have the legal authority to declare a new standard of care and punish providers who do not adhere to it. The department has agreed not to take action against any provider as the litigation proceeds.
A hearing is scheduled for March 19.
For Ari, who turns 18 in 2027, that buys him some time.
Amy Harmon covers how shifting conceptions of gender affect everyday life in the United States.
The post In Colorado, the Options for Ari, a Transgender Teen, Begin to Disappear appeared first on New York Times.
