Cracks are beginning to appear in the landscape of gender-affirming care for trans and gender-diverse youth in Washington state, as the federal government’s efforts to restrict the field have turned more aggressive in recent months.

Since President Donald Trump returned to office, he has intensified his agenda against gender care providers and trans people around the country, leading many hospitals and clinics to face a difficult decision: Continue to treat young patients with health services deemed medically necessary, or actively oppose the federal government and risk funding cuts.

A number of children’s hospitals, including in Democratic-controlled states, have chosen to narrow their gender care services or shutter gender clinics altogether. In Washington, largely considered a welcomi

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