Western Massachusetts family navigates healthcare rollback for transgender youth

Blaze Hartley, a 16-year-old in western Massachusetts, came out as transgender at age 11 and spent the next few years navigating his identity before settling on his name. Two years after legally changing his name, he found himself facing a new obstacle: access to gender-affirming medical care.

Hospitals and health centers across New England and the country have discontinued gender-affirming care for minors in recent months, citing pressure from the Trump administration and threats of federal funding cuts. The shift has left families scrambling to find providers willing to continue treatment, and some have resorted to crossing state lines. According to the Williams Institute at UCLA, over half of U.S. states have some form of legislation restricting healthcare for transgender minors, which can include puberty blockers, hormone therapy, and surgery.

Blaze's care was disrupted multiple times. Connecticut Children's Medical Center, where he had been receiving treatment, abruptly ceased gender-affirming services for minors. When his family tried to reach the hospital for explanation, they received little response, according to his mother Stacey. "We felt like we were being treated like shit, like second class citizens," Stacey said. "And it's like, we gave you money to do this. The least you could do was maybe individually call each person."

Even Massachusetts, which has shield laws to protect people seeking gender-affirming care, has seen providers pull back. Fenway Health in Boston, Outer Cape Health Services on Cape Cod, and Baystate Health in western Massachusetts have all stopped providing care to patients under age 19. Though Blaze found a provider at Transhealth, a nonprofit clinic in Northampton, he has been unable to access top surgery, a common shorthand for breast reduction or mastectomy.

Stacey said providers have required Blaze to be on testosterone for a year before beginning the surgery process, a timeline complicated by the Trump administration's regulations restricting access to puberty blockers and hormone therapy. In most cases, minors seeking gender-affirming surgery need thorough documentation of gender dysphoria, parental consent, and letters from both physical and mental health providers.

Blaze has struggled with dysphoria while waiting. He avoids swimming and previously used binding tape to flatten his chest, a method that can cause skin damage and rashes. Testosterone, he said, transformed his life. "The way people interact with me, the way I'm able to connect with people in the world now that they don't see me as a woman, or like weird or different. It makes life so much easier," he said.

But the political climate and restrictions on care have caused some people in Blaze's circle to leave the country, including friends and his therapist. For the first time, the Hartley family obtained passports, though they said they do not want to leave the United States. Stacey, who was raised Jewish and spent years learning about the Holocaust in Hebrew school, said the current atmosphere weighs on her. "It's always in the forefront of my mind," she said.

At school, Blaze has faced harassment from classmates who learned of his transgender identity. One student, previously friendly, began calling him homophobic slurs instead of his name. Though his therapist reported the behavior and an incident report stopped it, Blaze continues to interact with the student. He has also been told by friends' parents that he is "living in sin" and fielded invasive questions tied to misinformation spread about transgender people.