Nikolai Mather: Thank you Molly for joining us. Okay, so walk us through some of the current federal challenges to trans healthcare that we're facing right now. What all has the President done these past 10 days?
Molly Rivera: A couple days ago, President Trump issued an executive order that specifically threatens access to gender affirming care for folks under the age of 19.
NM: He also issued some orders on reproductive healthcare, right?
MR: Yes. The Hyde Amendment is often implemented under Presidents who are Republican or conservative. It is essentially a measure that bans federal funding for abortion.
This is actually not new, and not specifically a product of the Trump administration, unfortunately. But the important pattern here is that the Trump administration are taking the playbook that they've used to restrict and ban access to abortion… They are copy pasting that now over to gender affirming care. So for example, in the latest executive order affecting trans folks from a couple days ago, that order is seeking to block Medicaid funding for gender affirming care, just similar to how the Hyde Amendment does that for abortion care.
NM: What legal challenges have you seen so far to these orders?
MR: So far, I don't believe we have seen a legal challenge to the one specific to gender-affirming care. But we, you know, may. We may in the coming days.
Another important thing for people to know about the gender-affirming care executive order is that it does not take immediate effect.
NM: Really — when does it go into effect?
MR: The executive order stated that it's giving federal agencies 60 days. Now… unclear what they will be doing in those 60 days, though, is it 60 days to come up with a plan to do something or...? You know, it's very vague, so, but it could happen sooner. And we could see, for example, the public funding, Medicaid funding, for example, restricted, maybe in another way. But we are here to assure everyone that nothing has changed at this time.
NM: So I understand that Planned Parenthood receives a portion of its budget from federal reimbursements and grants. How do these bans impact y'all?
MR: Yes, you know, we have survived bans on Medicaid funding before. The Trump administration last time blocked Medicaid funding for services from Planned Parenthood. So we have been in this situation before. TBD on how it affects us this time around. There are certainly things that the administration is doing differently than they did last time.
NM: Speaking more broadly – how might these orders impact healthcare as a whole? Could this potentially lead to shortages of estradiol or testosterone? Fewer doctors? What might happen?
MR: You know, anything is possible in this reality. Healthcare is an ecosystem, and if you block or restrict healthcare over here, it affects the rest of the ecosystem.
There are not that many providers to begin with, so even if you lose just one in the Wilmington area, then that only leaves one other provider to serve that entire region and to serve neighboring states.
NM: How have y'all been preparing for future challenges to gender-affirming care?
MR: We are learning as much as we can about how policies might affect our operations, and making adjustments where we can. If we need to move providers from South Carolina up to North Carolina, because that's where we can provide this care, great, let's do that. If there are more ways we can use telehealth to help increase access to care, great, let's do that.
One of our focuses that our health centers have been really working on too is, how do we make sure people can get their meds? How do we work with pharmacies to make sure that they are not unnecessarily keeping people from their medications? Because we know these orders cause a lot of confusion for the pharmacies, even.
Si, we've been working really hard to increase access where we can, while keeping an eye on contingency plans if the worst of the worst happens. But again, that's not the moment that we're in quite yet. Our doors are open. Our operations are the same. Providers like Planned Parenthood and our patients have learned how to live in environments like this.
NM: That was Molly Rivera from Planned Parenthood South Atlantic breaking down the federal trans healthcare ban. Molly, thanks for your time.
MR: You're welcome.