Local opinion: El Rio abruptly ends access to minors' gender-affirming care

My ask is seemingly simple: El Rio Health: Reverse the preemptive decision to abruptly abandon gender-affirming care for your minor patients.

My name is Dr. Russell Toomey, and I am a Professor of Human Development and Family Science at the University of Arizona. I have been a Tucson resident for nearly two decades, an El Rio patient, and am a parent to El Rio patients. My research since 2005 has focused on the experiences of sexual and gender expansive youth in their families, schools, and communities, and how these experiences are associated with health and well-being. In contrast to the recent HHS report on gender-affirming care, which has been deeply critiqued and debunked by the scientific community, decades of research has shown that access to gender-affirming care, when indicated, is associated with a myriad of optimal health outcomes, and that denying access to necessary care is associated with compromised health.

Without any doubt, as a researcher in this field, I know that the youth (and their parents; my recent study documents how barriers to health care also impact trans youths’ parents) will suffer tremendously as a result of El Rio’s unconscionable decision to abruptly and preemptively end gender-affirming care.

El Rio Health’s decision to end care was preemptive, unjust, and unethical. Patients and the families that care for them were abandoned by El Rio Health and left without care or alternatives for care for treatments that are life-saving. The decision, as I understand it, was made in caution due to Trump’s executive order that threatens federal funding for providers that offer gender-affirming care to minors. However, this executive order is currently stayed by two judges, and several legal experts believe that the order will be found to be unlawful. Preemptive compliance is harmful and unnecessary, and providing less than 48 hours’ notice to patients of termination of care appears to violate the AMA Principles of Medical Ethics, which require notification to the patient with enough time to secure another provider and facilitate the transfer of care.

I am truly devastated by the decision that El Rio Health made to abruptly end care. Since I began my tenure at the University of Arizona, I have had the opportunity to work collaboratively with El Rio Health several times. For example, I collaborated on grant proposals with El Rio medical providers, spoke at El Rio Health events focused on transgender health (including an LGBTQ+ youth day-long event in 2018), and I was a keynote speaker as part of an El Rio-hosted symposium on the ethics of providing medical care to transgender youth in 2018. El Rio’s recent decision to end care has disrupted my trust in the organization, and has disrupted the trust of many of their transgender and allied patients who have brought El Rio thousands if not millions of dollars from LGBTQ+ culturally competent care over the past few decades given that El Rio proudly advertised itself as one of the only transgender health providers in the area.

I urge El Rio Health to reverse the decision to abandon these patients. The situation for the patients whose care has been abruptly terminated is dire.