In this episode of Civic, reporter Sylvie Sturm examines how federal policy — through executive orders, funding threats and regulatory pressure — is reshaping access to gender-affirming care for transgender youth across the United States.
The debate is unfolding even though no new federal law has passed and no final rules have taken effect. Yet hospitals, clinics and families are already making decisions in response to the possibility of federal penalties.
Through the story of Eric, a 15-year-old high school student in Oakland, we follow how those policy battles land in real life.
The episode also explores the broader policy fight:
• Federal officials who argue the treatments are unsafe and should be restricted
• Medical associations and clinicians who say the care can be life-saving when carefully managed
• Lawyers challenging whether federal agencies even have the authority to impose such limits
We hear from community health leaders, legal experts, and families navigating the uncertainty, including Dr. Tatyana Moaton Santiago of the San Francisco Community Health Center, who warns that policy threats alone can make providers afraid to offer care.

Subscribe to Civic from the San Francisco Public Press for investigative reporting on the policies shaping life in San Francisco and beyond.