Kow-towing to bullies never works. Many of us learned that lesson in grammar school, and those of us that didn’t would go on to learn the same lesson later in life, perhaps in advanced schooling or the workplace.
So my question is, what kinds of pressure are being brought to bear on Fenway Health to reverse this decision? Can the Massachusetts AG do anything, perhaps by citing the state’s anti-trans-discrimination laws which are some of the strongest in the country?
Erin - is there anything you (or other influential journalists) can do here to call attention to this horrible situation and get Fenway Health to reconsider? As I recall, several trans care hospitals have caved in the past, only to reconsider in the face of public protests and/or pressure.
Thank you for writing this. Fenway has been my gold standard of care for this community and marginalized communities in general my entire life. I could not be more horrified and disillusioned. Of ALL medical institutions, the one founded in response to a plague fueled by a maliciously indifferent federal government chooses cowardly, craven preemptive surrender?! What on earth is WRONG with them??? Larry Kessler would be spitting mad. And fighting. They should be so terribly ashamed of themselves.
It's worth noting that some legal scholars think this kind of preemptive withdrawal of care could be illegal under other laws: https://www.uclalawreview.org/11626-2/
Wonderful article. It's deeply disappointing and a huge betrayal to see Fenway bend the knee. While this isn't the point of the article, and Fenway's own about page is worded unclearly, I do want to point out that it doesn't seem feasible that Fenway originated with HIV/AIDS activism; the virus wasn't identified until 1981. (I don't doubt that they were on the ground when the epidemic struck, but it can't have been part of the founding.) Thank you for your powerful words on this matter.
Correct. The first documented cases were in 1976 or 77. This sentence seems to be based on a misunderstanding of the linked site's sentences:
"Since 1971, Fenway Health has been working to make life healthier for the people in our neighborhood, the LGBTQIA+ community, people living with HIV/AIDS and the broader population. Fenway was founded as part of the free clinic movement by students who believed that “health care should be a right, not a privilege.”"
The free clinic movement far predates HIV/AIDS. It's an easy revision, I'm glad I'm not the only one pointing this out. :)
there was no awareness and no testing for almost a decade but lesbian, gay, and gender expansive people were routinely denied care in the 1960s and 1970s even BEFORE HIV. Or were treated with disrespect and even met with violence. For Fenway to walk away from this legacy is beyond shameful.
Incredibly well written. If it is possible, non-trans patients are the best bet to drawing that line for Fenway Health. Letting them know they will lose their customers because of this decision, and so their direct funding, would certainly be a wake-up call. Also a billboard informing everyone of Fenway Health's cowardice would go a long way toward informing the community.
I am writing to provide the entire Fenway Health community with an update that we recently shared directly with individuals under the age of 19, who receive medical gender-affirming care. Due to a change in federal requirements that took effect on October 1, 2025, Fenway Health will not provide medical gender-affirming care (hormones and puberty blockers) for patients under the age of 19.
We know that many of you have already heard this news and wanted to take the opportunity to share the background behind this difficult decision and the steps we took to support our impacted patients. Before I share more, I want to be clear that as a mission-based entity committed to providing inclusive care to the entire LGBTQIA community, we did not come to this decision lightly.
How did we get here? The US Department of Health and Human Services (HHS) recently issued a revised Grants Policy Statement which allows it to terminate a grant "for convenience" if it “no longer effectuates the program goals or agency priorities.” Health Resources and Services Administration (HRSA) recently released priorities that make clear that providing hormones and puberty blockers for patients under age 19 is no longer an HHS goal or priority.
What would it have meant to continue providing gender-affirming care given this policy change? If we continued the service, our status as a Federally Qualified Health Center (FQHC) would have been at serious risk. Maintaining this designation is essential to our ability to continue providing high-quality, affordable care to more than 30,000 people across New England and beyond. Losing this status would significantly limit our ability to further serve the community we love as we have for decades.
How are we supporting impacted patients? Once it became clear that we would no longer be able to provide gender-affirming care (hormones and puberty blockers) for patients under the age of 19, we focused on a process for engaging directly with impacted patients and their families. We provided details on how they could continue to receive care not provided by Fenway with other entities not impacted by the revised grants policy statement and HRSA's priorities. These conversations were conducted with sensitivity and compassion for the unique challenge created by a change in trusted provider. We are grateful to the team members who led this important work, even as they navigated their own response to this policy change.
We know this news is heartbreaking to our entire community of patients, staff, clinical partners and supporters – we carry that with you. Please know: this change does not reflect our values, our belief that gender-affirming care saves lives, or our unwavering commitment to the transgender and gender-diverse community. It reflects a painful reality that we are working to change. All other services and care for patients of all ages and identities remain fully available and unchanged. We understand, hear, and respect that some in our community disagree with this decision. We reached it based on careful and difficult consideration of what we believe is best for our mission given our current options.
We continue to stand firmly with our transgender and gender-diverse patients, families, and community members. We are doing everything in our power to navigate a fast-moving policy and funding environment in a way that centers passion, respect, and continuity of care for everyone who depends on us. While our primary focus is on the direct care we provide our patients, we will continue our longstanding history of advocating for policies, funding, and access to a wide range of services that support the health and well-being of the LGBTQIA+ population, and all members of the community we serve.
These are unprecedented times. But we remain committed to walking through them together – with you. I acknowledge that our communication about this change fell short and caused confusion and concern. I am committed to improving how we communicate moving forward.
I’m still editing, but I will be sending this letter: To whom it may concern,
My name is Olivia Eason and I have been a patient at Fenway Health for several years. I am a transgender woman, and I came to Fenway years ago because I was struggling to get the medical support I needed in my transition from my then-current doctors. I was so relieved to find Fenway and my doctor —————————-, where I found a welcoming environment dedicated to "provid[ing] and advocat[ing] for compassionate, equitable healthcare, research, and education —empowering people from all walks of life to live, love, and thrive freely."
I don't have to tell you that my gender affirming care is quite literally life-saving. As threats against the queer community at large and trans people in particular have escalated over the past few years, I've looked at my bottles of estradiol and spironolactone compulsively, fearing what would happen if I lost access. I've seen people like me across the nation lose their rights and their medicine, and I've been nervously wondering if I should make black-market or DIY backup plans. But as I've talked to professionals, including people at Fenway, about these fears, I've been reassured that Fenway has the protections and strategies it needs to make sure all its patients get the healthcare they need. Specifically, I've been reassured that rights enshrined in the Massachusetts constitution, the hiring of Dallas Ducar as a new EVP, and the overall mission of Fenway Health means they'd be on the front line of equitable access for everyone.
It hasn't even been a year. For all your talk about "healthcare is a right, not a privilege", I can't help but take the recent decision to end medical affirming care for anyone under the age of 19 as a betrayal. Fenway Health as an institution is supposed to lead the nation in providing healthcare to the queer community. Yet, here you are, complying in advance to unjust policies, long before vague threats become real.
If there’s anything I can empathize with in the letter your CEO sent yesterday, it’s that this has been a year filled with horror and hard decisions. And I don’t want to pretend like this was an easy decision to make - I know it wasn’t. Even so, this was undoubtedly the wrong choice for your patients, for this institution, for Massachusetts.
From what I can tell, your strategy was to sacrifice care for a small portion of your patients so that you could protect the rest of them. That is enough reason to feel angry and hurt - acting like children are somehow more capable of living without their vital care. But even beyond that, it is ignorant at best and negligent at worst to suggest that this sacrifice will protect others. We are dealing with an administration with an explicit goal: "transgenderism must be eradicated from public life entirely". Even if we look just at the last five years, attacks on sports and bathrooms always shift to care for minors, then ID cards, then care for adults, then fundamental identity and the ability to even talk about trans people. This will not be the last threat this administration poses toward Federally Qualified Health Centers, and if you fold now, I have no trust you will protect the queer community when attacks inevitably escalate.
I have had nothing but great experiences with my PCP at Fenway. It would pain me to leave to try and find another provider. But unless this decision is reversed, and unless this institution proves they actually advocate for the community they profess to serve, I will soon have to leave for a health center I can actually trust.
I'm so sorry you are having to consider finding a new provider. A friend of mine who'd been receiving care at Emerson (in Concord) was told a year ago - a couple of months before the election - that Emerson Hospital would no longer provide her with trans health care because "they did not feel they had adequate training" to do so. Hello?! She'd been seeing her endocrinologist there for five years! No referral, no apology - they even had the balls to say "oh, we aren't dropping you as a patient, we just aren't providing trans health care anymore." Um, what?! Another friend's minor child had top surgery there last summer, and I asked about that - I thought they'd stopped providing trans care, I said to the mom. They have, she said grimly. But my son had already been preparing for this surgery and it was already scheduled, and his surgeon told the hospital he insisted on following through with scheduled surgeries despite their cowardice and his revulsion at that cowardice. Emerson's decision to fold before there was even any reason to chilled me to the bone; I thought we were better than that in Massachusetts. I also had always had Fenway in the back of my mind in case my own trans kid, who receives care at MGB, faced similar issues. Never in a million years did it cross my mind that MGB would remain committed to their trans patients of all ages - so far! - while Fenway Health would not.
‘We aren’t dropping you as a patient, we just aren’t providing trans health care anymore’ was basically John Roberts’ whole logic in Skrmetti. It’s infuriating
That's a lot of pretty words for "we know we're supposed to say we care about trans people but we care more about doing the easy thing." Thanks for sharing, what a gut-punch.
"we remain committed to walking through them together - with you. " - well, you know, some of you. Not all of you. Not the ones we threw under the bus.
This letter is disgusting. No, Fenway, you do NOT "continue to stand firmly with our transgender and gender-diverse patients, families, and community members." In fact, dropping your minor trans patients is the very definition of not standing with your transgender patients.
Simply saying something that is an outright lie does not change that it remains an outright lie, despite the Trump administration's insistence to the contrary. This sounds like it was written by a Republican press secretary.
Fenway also just sent this announcement regarding a healthcare continuing education offering -
Course Postponed: Advancing Excellence in Transgender Health: A Core Course for the Whole Care Team
Good Afternoon,
We are writing to notify you that the continuing education course “Advancing Excellence in Transgender Health: A Core Course for the Whole Care Team,” which is offered and developed by the Fenway Institute and accredited by Harvard Medical School, has been postponed and will not be held Oct. 24-26 as planned. The course will be rescheduled for later this academic year, and we will be in touch as soon as the new date is set. In the meantime, we will be refunding your course fees. We apologize for any inconvenience this may cause.
In other words we are no longer educating our providers on Trans care, even adult Trans care, because we're soon going to throw all Trans people over 19 under the bus, too. Why waste money training providers to treat people who soon won't have or need ANY healthcare? Project 2025 is 55% complete and the complete denial of all healthcare to transgender Americans in order to eradicate us is the ultimate goal. It's shameful that the smokescreens of youth bans have been successful in 27 states and at institutions in another 21.
This is a betrayal of the worst kind. I am so disgusted by them. What actions can we take to protest besides contacting the AG? I'm a MA resident. My local PFLAG chapter usually sends out a letter about what we can do to protest issues like this, but I haven't seen anything yet.
I’m a patient and I’m telling them I’m leaving if they don’t change this policy. And I’m already angrily looking for other providers in the area. I can only hope others do the same
This is shameful a once valued institution has again bowed to trump threats. They are failing to sever the community it once served with distinction. I hope that like the reaction of the people on this past Saturday the community will turn out to protest in vast numbers. Don’t they know that other Institutions have stood up to this bully and won
Kow-towing to bullies never works. Many of us learned that lesson in grammar school, and those of us that didn’t would go on to learn the same lesson later in life, perhaps in advanced schooling or the workplace.
So my question is, what kinds of pressure are being brought to bear on Fenway Health to reverse this decision? Can the Massachusetts AG do anything, perhaps by citing the state’s anti-trans-discrimination laws which are some of the strongest in the country?
Erin - is there anything you (or other influential journalists) can do here to call attention to this horrible situation and get Fenway Health to reconsider? As I recall, several trans care hospitals have caved in the past, only to reconsider in the face of public protests and/or pressure.
1000% Medical institutions need to stand up for evidence and the best outcomes they stood by for decades.
Stop abandoning patients to the twin wolves of fear and ignorance.
Thank you for writing this. Fenway has been my gold standard of care for this community and marginalized communities in general my entire life. I could not be more horrified and disillusioned. Of ALL medical institutions, the one founded in response to a plague fueled by a maliciously indifferent federal government chooses cowardly, craven preemptive surrender?! What on earth is WRONG with them??? Larry Kessler would be spitting mad. And fighting. They should be so terribly ashamed of themselves.
It's worth noting that some legal scholars think this kind of preemptive withdrawal of care could be illegal under other laws: https://www.uclalawreview.org/11626-2/
Thanks for this!
Thanks! This will come in handy for our lawsuit against UPMC.
Wonderful article. It's deeply disappointing and a huge betrayal to see Fenway bend the knee. While this isn't the point of the article, and Fenway's own about page is worded unclearly, I do want to point out that it doesn't seem feasible that Fenway originated with HIV/AIDS activism; the virus wasn't identified until 1981. (I don't doubt that they were on the ground when the epidemic struck, but it can't have been part of the founding.) Thank you for your powerful words on this matter.
Correct. The first documented cases were in 1976 or 77. This sentence seems to be based on a misunderstanding of the linked site's sentences:
"Since 1971, Fenway Health has been working to make life healthier for the people in our neighborhood, the LGBTQIA+ community, people living with HIV/AIDS and the broader population. Fenway was founded as part of the free clinic movement by students who believed that “health care should be a right, not a privilege.”"
The free clinic movement far predates HIV/AIDS. It's an easy revision, I'm glad I'm not the only one pointing this out. :)
Spider, thank you for the commentary, I came to do the same. The Fenway free clinic was critically important in 1971, even though HIV cases existed in the United States, (https://www.historyhit.com/first-us-aids-death-who-was-robert-rayford/)
there was no awareness and no testing for almost a decade but lesbian, gay, and gender expansive people were routinely denied care in the 1960s and 1970s even BEFORE HIV. Or were treated with disrespect and even met with violence. For Fenway to walk away from this legacy is beyond shameful.
Incredibly well written. If it is possible, non-trans patients are the best bet to drawing that line for Fenway Health. Letting them know they will lose their customers because of this decision, and so their direct funding, would certainly be a wake-up call. Also a billboard informing everyone of Fenway Health's cowardice would go a long way toward informing the community.
Excellent strategic suggestion, Tammy.
It looks like community is coming together. Let us hope Fenway listens.
The full text of the cowardly letter all us Fenway patients got yesterday:
Dear Community,
I am writing to provide the entire Fenway Health community with an update that we recently shared directly with individuals under the age of 19, who receive medical gender-affirming care. Due to a change in federal requirements that took effect on October 1, 2025, Fenway Health will not provide medical gender-affirming care (hormones and puberty blockers) for patients under the age of 19.
We know that many of you have already heard this news and wanted to take the opportunity to share the background behind this difficult decision and the steps we took to support our impacted patients. Before I share more, I want to be clear that as a mission-based entity committed to providing inclusive care to the entire LGBTQIA community, we did not come to this decision lightly.
How did we get here? The US Department of Health and Human Services (HHS) recently issued a revised Grants Policy Statement which allows it to terminate a grant "for convenience" if it “no longer effectuates the program goals or agency priorities.” Health Resources and Services Administration (HRSA) recently released priorities that make clear that providing hormones and puberty blockers for patients under age 19 is no longer an HHS goal or priority.
What would it have meant to continue providing gender-affirming care given this policy change? If we continued the service, our status as a Federally Qualified Health Center (FQHC) would have been at serious risk. Maintaining this designation is essential to our ability to continue providing high-quality, affordable care to more than 30,000 people across New England and beyond. Losing this status would significantly limit our ability to further serve the community we love as we have for decades.
How are we supporting impacted patients? Once it became clear that we would no longer be able to provide gender-affirming care (hormones and puberty blockers) for patients under the age of 19, we focused on a process for engaging directly with impacted patients and their families. We provided details on how they could continue to receive care not provided by Fenway with other entities not impacted by the revised grants policy statement and HRSA's priorities. These conversations were conducted with sensitivity and compassion for the unique challenge created by a change in trusted provider. We are grateful to the team members who led this important work, even as they navigated their own response to this policy change.
We know this news is heartbreaking to our entire community of patients, staff, clinical partners and supporters – we carry that with you. Please know: this change does not reflect our values, our belief that gender-affirming care saves lives, or our unwavering commitment to the transgender and gender-diverse community. It reflects a painful reality that we are working to change. All other services and care for patients of all ages and identities remain fully available and unchanged. We understand, hear, and respect that some in our community disagree with this decision. We reached it based on careful and difficult consideration of what we believe is best for our mission given our current options.
We continue to stand firmly with our transgender and gender-diverse patients, families, and community members. We are doing everything in our power to navigate a fast-moving policy and funding environment in a way that centers passion, respect, and continuity of care for everyone who depends on us. While our primary focus is on the direct care we provide our patients, we will continue our longstanding history of advocating for policies, funding, and access to a wide range of services that support the health and well-being of the LGBTQIA+ population, and all members of the community we serve.
These are unprecedented times. But we remain committed to walking through them together – with you. I acknowledge that our communication about this change fell short and caused confusion and concern. I am committed to improving how we communicate moving forward.
With care and solidarity,
Jordina Shanks
CEO, Fenway Health
I’m still editing, but I will be sending this letter: To whom it may concern,
My name is Olivia Eason and I have been a patient at Fenway Health for several years. I am a transgender woman, and I came to Fenway years ago because I was struggling to get the medical support I needed in my transition from my then-current doctors. I was so relieved to find Fenway and my doctor —————————-, where I found a welcoming environment dedicated to "provid[ing] and advocat[ing] for compassionate, equitable healthcare, research, and education —empowering people from all walks of life to live, love, and thrive freely."
I don't have to tell you that my gender affirming care is quite literally life-saving. As threats against the queer community at large and trans people in particular have escalated over the past few years, I've looked at my bottles of estradiol and spironolactone compulsively, fearing what would happen if I lost access. I've seen people like me across the nation lose their rights and their medicine, and I've been nervously wondering if I should make black-market or DIY backup plans. But as I've talked to professionals, including people at Fenway, about these fears, I've been reassured that Fenway has the protections and strategies it needs to make sure all its patients get the healthcare they need. Specifically, I've been reassured that rights enshrined in the Massachusetts constitution, the hiring of Dallas Ducar as a new EVP, and the overall mission of Fenway Health means they'd be on the front line of equitable access for everyone.
It hasn't even been a year. For all your talk about "healthcare is a right, not a privilege", I can't help but take the recent decision to end medical affirming care for anyone under the age of 19 as a betrayal. Fenway Health as an institution is supposed to lead the nation in providing healthcare to the queer community. Yet, here you are, complying in advance to unjust policies, long before vague threats become real.
If there’s anything I can empathize with in the letter your CEO sent yesterday, it’s that this has been a year filled with horror and hard decisions. And I don’t want to pretend like this was an easy decision to make - I know it wasn’t. Even so, this was undoubtedly the wrong choice for your patients, for this institution, for Massachusetts.
From what I can tell, your strategy was to sacrifice care for a small portion of your patients so that you could protect the rest of them. That is enough reason to feel angry and hurt - acting like children are somehow more capable of living without their vital care. But even beyond that, it is ignorant at best and negligent at worst to suggest that this sacrifice will protect others. We are dealing with an administration with an explicit goal: "transgenderism must be eradicated from public life entirely". Even if we look just at the last five years, attacks on sports and bathrooms always shift to care for minors, then ID cards, then care for adults, then fundamental identity and the ability to even talk about trans people. This will not be the last threat this administration poses toward Federally Qualified Health Centers, and if you fold now, I have no trust you will protect the queer community when attacks inevitably escalate.
I have had nothing but great experiences with my PCP at Fenway. It would pain me to leave to try and find another provider. But unless this decision is reversed, and unless this institution proves they actually advocate for the community they profess to serve, I will soon have to leave for a health center I can actually trust.
With deep hurt and with a plea for courage,
Olivia Eason
Excellent letter.
I'm so sorry you are having to consider finding a new provider. A friend of mine who'd been receiving care at Emerson (in Concord) was told a year ago - a couple of months before the election - that Emerson Hospital would no longer provide her with trans health care because "they did not feel they had adequate training" to do so. Hello?! She'd been seeing her endocrinologist there for five years! No referral, no apology - they even had the balls to say "oh, we aren't dropping you as a patient, we just aren't providing trans health care anymore." Um, what?! Another friend's minor child had top surgery there last summer, and I asked about that - I thought they'd stopped providing trans care, I said to the mom. They have, she said grimly. But my son had already been preparing for this surgery and it was already scheduled, and his surgeon told the hospital he insisted on following through with scheduled surgeries despite their cowardice and his revulsion at that cowardice. Emerson's decision to fold before there was even any reason to chilled me to the bone; I thought we were better than that in Massachusetts. I also had always had Fenway in the back of my mind in case my own trans kid, who receives care at MGB, faced similar issues. Never in a million years did it cross my mind that MGB would remain committed to their trans patients of all ages - so far! - while Fenway Health would not.
‘We aren’t dropping you as a patient, we just aren’t providing trans health care anymore’ was basically John Roberts’ whole logic in Skrmetti. It’s infuriating
Well written.
Wonderful response, Olivia!😘🥰😍
"How are we supporting impacted patients? "
Not at all, but by telling them without buttermelting in your mouth, they can go hell for all you care.
" It reflects a painful reality that we are working to change."
You mean going along with without evident friction.
"We continue to stand firmly with our transgender and gender-diverse patients, families, and community members."
No you don't, you threw them under Trump!'s bus.
I don't see you keeping or deserving your profession post 2026. You have demonstrated you are not morally fit for it.
That's a lot of pretty words for "we know we're supposed to say we care about trans people but we care more about doing the easy thing." Thanks for sharing, what a gut-punch.
What a pusillanimous, self serving, own hand washing sack of feces.
"we remain committed to walking through them together - with you. " - well, you know, some of you. Not all of you. Not the ones we threw under the bus.
This letter is disgusting. No, Fenway, you do NOT "continue to stand firmly with our transgender and gender-diverse patients, families, and community members." In fact, dropping your minor trans patients is the very definition of not standing with your transgender patients.
Simply saying something that is an outright lie does not change that it remains an outright lie, despite the Trump administration's insistence to the contrary. This sounds like it was written by a Republican press secretary.
Backstabber just wants to save her 600k+ salary, don't listen to her lies.
This is indeed a cowardly letter, you've correctly identified its tone and meaning. This is outrageous.
Fenway also just sent this announcement regarding a healthcare continuing education offering -
Course Postponed: Advancing Excellence in Transgender Health: A Core Course for the Whole Care Team
Good Afternoon,
We are writing to notify you that the continuing education course “Advancing Excellence in Transgender Health: A Core Course for the Whole Care Team,” which is offered and developed by the Fenway Institute and accredited by Harvard Medical School, has been postponed and will not be held Oct. 24-26 as planned. The course will be rescheduled for later this academic year, and we will be in touch as soon as the new date is set. In the meantime, we will be refunding your course fees. We apologize for any inconvenience this may cause.
Thank you
They're scared to face the commnity.
In other words we are no longer educating our providers on Trans care, even adult Trans care, because we're soon going to throw all Trans people over 19 under the bus, too. Why waste money training providers to treat people who soon won't have or need ANY healthcare? Project 2025 is 55% complete and the complete denial of all healthcare to transgender Americans in order to eradicate us is the ultimate goal. It's shameful that the smokescreens of youth bans have been successful in 27 states and at institutions in another 21.
Has anyone got any updates on any legal actions being taken against Fenway health? Any other updates?
This is a betrayal of the worst kind. I am so disgusted by them. What actions can we take to protest besides contacting the AG? I'm a MA resident. My local PFLAG chapter usually sends out a letter about what we can do to protest issues like this, but I haven't seen anything yet.
Agreed, but how do we make them do it?
I’m a patient and I’m telling them I’m leaving if they don’t change this policy. And I’m already angrily looking for other providers in the area. I can only hope others do the same
Erin, what can we dob as allies to amplify your voice in this situation?
This is shameful a once valued institution has again bowed to trump threats. They are failing to sever the community it once served with distinction. I hope that like the reaction of the people on this past Saturday the community will turn out to protest in vast numbers. Don’t they know that other Institutions have stood up to this bully and won
There have been a few protests so far, it's short notice since they kept this so well under wraps. Hopefully the protests keep happening.
They need to be more frequent and larger and people must use the local news to get the message across
They can never regain trust.
617-267-0900 call Fenway and tell them that you do not bow to a despicable dictator.
Plume … online gender affirming care. Affordable. Fenway can go to hell!
this is devastating news! perhaps we need to flood their zone with postcards! Make it a mass effort!