care

A BELOVED grandmother choked to death after being fed the wrong food in a care home.

Joan Whitworth died at the Oaks Care Home in Northumberland after staff prepared her meal in a way which “did not comply with her diet plan”.

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An inquest heard the 88-year-old had lived with her daughter Gillian but moved into the facility when her dementia progressed.

When eating a meal on March 3, 2023, Joan began to display signs of choking.

But the inquest heard how a care assistant did not intervene and had to ask another staff member for help to deliver back slaps and abdominal thrusts.

And, CPR was not performed due to the “inaccurate understanding of a registered nurse”.

Following the hearing, Northumberland’s senior coroner Andrew Hetherington has written a “prevention of future deaths” report.

The care home and NHS trust have 56 days to respond.

The coroner concluded Joan died “in a care home as a result of choking”.

And in his written report, he outlined a total of six “matters of concern”.

Of these, one was regarding the NHS trust and five were directed to the care home’s operator Hillcare.

The first issue was found with the speech and language team.

Joan’s assessment had not been written down in a formal report, meaning observations of her eating had only been passed on verbally.

The coroner also concluded that a nurse and care assistant at the home “were not in date with their training in Basic Life Support and First Aid at Work”.

The coroner added: “I am concerned that a chef in evidence at the inquest was not aware that breaded fish was not a suitable food stuff in the diet identified for the deceased.

“I am concerned that other residents could be fed inappropriate food stuffs that are not in line with their identified diet plans.”

Bryan Smith, Joan’s son-in-law, told ChronicleLive: “Right from the start, we knew what had happened – that they hadn’t given her the right food.

“We knew she hadn’t been looked after.

“The reason we have pursued this is that we knew what had happened.”

Bryan added how the family had been “shocked and astounded by the quantity and severity of the mistakes” that were highlighted in the inquest.

He told how many families have shared similar “painful and shocking experiences”.

In a statement on behalf of the family read in court, they paid tribute: “Joan was a well loved character in Blyth. She was manager of Robson’s shoe shop and then moved to the Water Board.

“When we used to go shopping with Joan, it would take you an hour to get past the car park – as she knew everyone in Blyth with a tap or a pair of shoes!”

A Northumbria Healthcare NHS Foundation Trust spokesperson said: “All referrals to our speech and language therapy service are robustly triaged using a risk and evidence-based approach to inform the most appropriate care for that individual. This includes information on the referral form and discussion with the patient and / or those who care for them daily to gather the most up-to-date information.

“We cannot comment further on this case due to patient confidentiality, but would like to offer our sincere condolences to Mrs Whitworth’s family and loved ones.”

A spokesperson for The Oaks Care Home said: “We acknowledge the Coroner’s report relating to the death of Joan Whitworth at our home in March 2023. Our thoughts remain with her family and loved ones.

“Following the incident, we carried out a full review and made all necessary changes to our practices and procedures. These have been in place for some time and will be reflected in our formal response to the Coroner’s report. The safety, dignity, and wellbeing of those in our care remain our highest priorities.”

California and a coalition of other liberal-led states sued the Trump administration Friday over efforts to end gender-affirming care for transgender, intersex and nonbinary children and young adults nationwide — calling them an unconstitutional attack on LGBTQ+ patients, healthcare providers and states’ rights.

The lawsuit was brought by California Atty. Gen. Rob Bonta and officials from 15 other states and the District of Columbia. It challenges a Jan. 28 executive order by President Trump that denounced gender-affirming care as “mutilation” and called on U.S. Justice Department officials to effectively enforce a ban, including by launching investigations into healthcare providers.

The lawsuit notes the Justice Department last month sent more than 20 subpoenas to doctors and clinics that have provided such care nationwide, with justice officials suggesting they may face criminal prosecution.

Bonta’s office, in a statement, said such efforts “have no legal basis and are intended to discourage providers from offering lifesaving healthcare that is lawful under state law.” The lawsuit asks a federal court in Massachusetts to vacate Trump’s order in its entirety for exceeding federal authority and undermining state laws that guarantee equal access to healthcare.

The White House did not immediately respond to a request for comment Friday.

Trump made reining in transgender rights a key promise of his presidential campaign. Upon taking office, he moved swiftly to do so through executive orders, funding cuts and litigation. And in many ways, it has worked — particularly when it comes gender-affirming care for minors.

Clinics across the country that had provided such care have closed their doors in response to the threats and funding cuts. That includes the renowned Center for Transyouth Health and Development at Children’s Hospital Los Angeles, one of the largest and oldest pediatric gender clinics in the U.S.

The clinic told thousands of its patients and their families that it was shuttering last month. Other clinics have similarly closed nationwide, radically reducing the availability of such care in the U.S.

Republicans and other Trump supporters have cheered the closures as a major win, and they praised the president for protecting impressionable and confused children from so-called woke medical professionals pushing what they allege to be dangerous and irreversible treatments.

Bonta said in the Friday statement that Trump and his administration’s “relentless attacks” on such care were “cruel and irresponsible” and endangered “already vulnerable adolescents whose health and well-being are at risk.”

“These actions have created a chilling effect in which providers are pressured to scale back on their care for fear of prosecution, leaving countless individuals without the critical care they need and are entitled to under law,” Bonta said.

Mainstream U.S. medical associations have supported gender-affirming care for minors experiencing gender dysphoria for years. They and LGBTQ+ rights organizations have accused Trump and his supporters of mischaracterizing that care, which includes therapy, counseling and support for social transitioning, and can include puberty blockers, hormone treatment and, in rarer circumstances, mastectomies.

Queer advocates, many patients and their families say such care is life-saving, alleviating intense distress — and suicidal thoughts — in transgender and other gender-nonconforming youth. They and many mainstream medical experts acknowledge that gender-affirming care for young people is still a developing field, but say it is also based on decades of solid research by medical professionals who are far better equipped than politicians to help families make difficult medical decisions.

However, as the number of children who identify as transgender or nonbinary has rapidly increased in recent years, that argument has failed to take hold in many parts of the country. Conservatives and Republican leaders have grown increasingly alarmed by such care, pointing to young people who changed their minds about transitioning and now regret the care they received.

“Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding,” Trump’s executive order stated.

Trump and others have escalated tensions further by spreading misinformation about kids being whisked away from school to have their gentials mutilated without their parents’ knowledge — which is not happening.

The battle has played out in the courts, in part as a state’s rights issue. In June, the Supreme Court ruled that conservative states may ban puberty blockers and hormone treatments for transgender teens, with the court’s conservative majority finding that states are generally free to set their own standards of medical care.

The Trump administration, however, has not taken the same view. Instead, it has aggressively tried to eradicate gender-affirming care nationwide, regardless of state laws — like those in California — that protect it.

Trump’s Jan. 28 executive order, titled “Protecting Children from Chemical and Surgical Mutilation,” claimed that “medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions.”

It defined children as anyone under the age of 19, and said that moving forward, the U.S. wouldn’t “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another,” but would “rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”

The states’ lawsuit focuses on one particular section of that order, which directed Atty. Gen. Pam Bondi to convene state attorneys general and other law enforcement officials nationwide to begin investigating gender-affirming care providers and other groups that “may be misleading the public about long-term side effects of chemical and surgical mutilation.”

The section suggested those investigations could be based on laws against “female genital mutilation,” or even around a 1938 law known as the Food, Drug, and Cosmetic Act, which authorizes the Food and Drug Administration to regulate food, drugs, medical devices and cosmetics.

On July 9, Bondi announced the Justice Department’s subpoenas to healthcare providers, saying doctors and hospitals “that mutilated children in the service of a warped ideology will be held accountable.”

On July 25, The Times reported that Bill Essayli, the Trump administration’s controversial pick for U.S. attorney in L.A., had floated the idea of criminally charging doctors and hospitals for providing gender-affirming care, according to two federal law enforcement sources who spoke on the condition of anonymity for fear of reprisal.

The targeting of gender-affirming care is part of a wider effort by the administration to eliminate transgender rights more broadly, in part on the premise that transgender people do not exist. On his first day in office, Trump issued another executive order declaring there are only two sexes and denouncing what he called the “gender ideology” of the left.

His administration has sought to limit the options transgender people have to get passports that reflect their identities, and the Justice Department has sued California over its policies allowing transgender girls to compete against other girls in youth sports. Many transgender Americans are looking for ways to flee the country.

Still, many in the LGBTQ+ community fear the attacks are only going to get worse. Among those who are most scared are the parents and families of transgender kids — including those who believe their health records may have been collected under the Justice Department’s subpoenas.

One mother of a Children’s Hospital patient told The Times last month that she is terrified the Justice Department is “going to come after parents and use the female genital mutilation law … to prosecute parents and separate me from my child.”

Bonta is leading the lawsuit along with the attorneys general of Connecticut, Illinois, Massachusetts and New York. Joining them are Pennsylvania Gov. Josh Shapiro and the attorneys general of Delaware, the District of Columbia, Hawaii, Maine, Maryland, Michigan, Nevada, New Jersey, New Mexico, Rhode Island and Wisconsin.

Official says ‘contingency plan had flaws’ as torrential rains, floods kill 31 people at senior centre near Beijing.

Torrential rains and flooding across northern China have killed dozens of people, authorities say, including more than 30 elderly residents who were trapped at a care facility in a suburb of the capital Beijing.

Officials said on Thursday that 31 people died at the Taishitun Town Elderly Care Center in the Miyun district, about a 90-minute drive from central Beijing, which was one of the areas hit hardest by this week’s storms.

“For a long time, this senior centre was in the town’s centre and was safe, and such was not included in the preparedness plans,” said Yu Weiguo, the Communist Party secretary for Miyun, expressing his condolences and adding it was a “bitter lesson”.

“This showed that our contingency plan had flaws, and our understanding of extreme weather was inadequate,” Yu said.

The care centre housed 69 residents, including 55 who were disabled in some capacity. The facility sat on low-lying ground near a river that had flooded after the unusually intense rains, local media outlet Caixin reported.

Torrential rains began a week ago and peaked around Beijing and its surrounding provinces on Monday.

In the space of a few days, the hilly Miyun district in the northeast of the capital saw rainfall of up to 573.5mm (22.6 inches). By comparison, the average annual precipitation in Beijing is around 600mm (23.6 inches).

The Miyun Reservoir, the largest in northern China, saw record-breaking water levels during the rains.

The Qingshui River, which runs through Taishitun feeding into the reservoir and is normally a small stream, was flowing at 1,500 times its normal volume on Monday morning when the disaster struck, Yu said.

One Beijing resident’s 87-year-old mother managed to get out of the elder care centre in Miyun, Caixin reported.

“She doesn’t know where she got the strength, but she managed to climb onto the windowsill,” the woman’s daughter said, noting her mother’s roommate was unable to escape and drowned.

Hundreds of thousands affected

At a news conference on Thursday, Beijing’s Deputy Mayor Xia Linmao said at least 44 people died over the past week in the city.

In total, more than 300,000 people have been affected by the rain and flooding in the capital, with more than 24,000 homes, 242 bridges and 756km (470 miles) of roads damaged, said Xia, citing preliminary figures.

In neighbouring Hebei province, authorities announced an additional eight deaths on Thursday and 16 deaths total this week.

At least 31 people were missing in Beijing and Hebei province, authorities said.

Meanwhile, in northern Shanxi province, authorities said on Wednesday evening that 10 people were dead after a minibus carrying farm workers washed away in heavy rain.

Four people were still missing as the rescue continued, according to a city government statement three days after the bus disappeared.

Safety Quentin Lake and running back Kyren Williams are key players for a Rams team with legitimate designs on a Super Bowl title.

Both are in the final years of their rookie contracts.

But while the Rams have been in negotiations with Williams’ agent about a possible extension, Lake will most likely have to play out the season before his future with the Rams is determined.

And history is not on his side.

Consider: Since the Rams returned to Los Angeles from St. Louis in 2016, they have not signed a safety they drafted to an extension.

“I’m just taking it one day at a time,” Lake said Tuesday when asked about the situation, “as long as I take care of myself between these white lines everything will take care of itself.”

Lake, a team captain, is scheduled to earn $3.4 million this season, according to Overthecap.com. The 2022 sixth-round draft pick from UCLA has been a versatile and dependable piece of the defense under second-year coordinator Chris Shula.

Last season, Lake played every defensive snap as a safety, nickel/corner and hybrid linebacker.

The only element missing from Lake’s statistical resume are interceptions: He is still looking for his first.

On Tuesday, Lake picked off a ball that tipped off Williams’ hands.

“If you’re hustling to the ball, or if you’re in the right place at the right time, something good will happen eventually,” Lake said, “and that’s exactly what happened there.”

Lake has been “invaluable” to the Rams, coach Sean McVay said.

“I’ve loved everything that he’s about,” McVay said. “And all you see from Quentin Lake is him just continuing to get better, bringing people with him. He is a Ram and I love Q.”

Lake knows that making plays on the ball will help his case. But he is not stressing about it.

“I’m not worried about stats because value — my value — I think comes in other ways,” he said. “Versatility, being in the right position, being able to communicate, having the ability to be the [defensive signal-caller] if need be.

“So I’m not too worried about stats. But I think at this time, it’s now, how can I take calculated risks? How can I find an uncommon ability to make plays on the ball?”

Etc.

McVay started his post-practice news conference with comments about the shooting on Monday at the New York building that houses NFL headquarters. “Thoughts and prayers are with the people that have been affected by the shooting at NFL headquarters,” McVay said. “It’s just such a terrible thing. And again you just hope for the best for any of the people that are injured, and then the people that did lose loved ones, we’re just thinking about them.”…. Quarterback Matthew Stafford, who remains sidelined because of what McVay has described as a back issue, observed practice. McVay reiterated that “there is a plan in place” for when Stafford might practice, but he said he did not want to set a definitive timetable publicly. “This is the smartest plan for him and we’re confident he’ll be ready,” for the Sept. 7 opener against the Houston Texans, McVay said…. Cornerback Emmanuel Forbes Jr. (hamstring) and safety Kam Curl (ankle) did not finish practice…. After a veteran rest day on Monday, receiver Davante Adams participated in the second practice in pads and he made several impressive catches…. Quarterback Stetson Bennett connected with tight end Davis Allen for a touchdown pass…. Inside linebacker Nathan Landman and nose tackle Poona Ford continue to stand out.

The United Kingdom says it is working with Jordan on “forward plans” to airdrop aid into besieged Gaza and evacuate children needing medical care as Israel’s forced starvation and bombardment of Palestinians fuel global outrage.

Two infants on Saturday became the latest Palestinian children to die from malnutrition. Hospitals in Gaza have now recorded five new deaths due to famine and malnutrition in the past 24 hours. The total number of starvation deaths in the territory has risen to 127, including 85 children.

British Prime Minister Keir Starmer confirmed the proposal on Saturday in an emergency call with French President Emmanuel Macron and German Chancellor Friedrich Merz.

In a readout of the call, the UK government said the leaders had
agreed “it would be vital to ensure robust plans are in place to turn an urgently needed ceasefire into lasting peace,” according to Britain’s Press Association.

“The prime minister set out how the UK will also be taking forward plans to work with partners such as Jordan to airdrop aid and evacuate children requiring medical assistance,” the readout said.

Starmer’s Labour government has been roundly accused at home of doing too little too late to alleviate the intense suffering of Palestinians in Gaza.

Hundreds of thousands of people in the UK have been protesting weekly against Israel’s genocidal war since October 2023, making it clear they feel their voices aren’t being heard.

Public anger has been further stoked as police in the UK arrested more than 100 people at peaceful protests across the country last weekend that called for a ban on the campaign group Palestine Action to be reversed.

Demonstrations took place on Saturday in Manchester, Edinburgh, Bristol, Truro and London as part of a campaign coordinated by Defend Our Juries.

Starmer is also facing mounting pressure to recognise a Palestinian state as France has said it will do at the United Nations General Assembly meeting in September. More than 200 British parliamentarians urged the prime minister to take this course of action this week.

There has been further controversy over accusations the UK government has continued with arms sales to Israel despite stating it had scaled back weapons sales.

A report in May found that UK firms have continued to export military items to Israel despite a government suspension in September amid allegations that the UK Parliament has been deliberately “misled”.

The report by the Palestinian Youth Movement, Progressive International and Workers for a Free Palestine revealed that the UK sent “8,630 separate munitions since the suspensions took effect, all in the category ‘Bombs, Grenades, Torpedoes, Mines, Missiles And Similar Munitions Of War And Parts Thereof-Other’.

‘Waiting for the green light to get into Gaza’

In the meantime, Philippe Lazzarini, head of the UN Palestinian refugee agency (UNRWA), said proposed airdrops of aid would be an expensive, inefficient “distraction” that could kill starving Palestinians.

Israel said on Friday that it will allow airdrops of food and supplies from foreign countries into Gaza in the coming days in response to critical food shortages caused by its punishing months-long blockade.

But in a social media post, Lazzarini said the airdrops would “not reverse the deepening starvation” and called instead for Israel to “lift the siege, open the gates [and] guarantee safe movements [and] dignified access to people in need.”

Airdrops, he said, are “expensive, inefficient [and] can even kill starving civilians”. “A manmade hunger can only be addressed by political will,” he said, calling on Israel to allow the UN and its partners to operate at scale in Gaza “without bureaucratic or political hurdles”.

He said UNRWA has the equivalent of 6,000 trucks in Jordan and Egypt “waiting for the green light to get into Gaza”. “Driving aid through is much easier, more effective, faster, cheaper and safer” than airdrops, he said, adding that it is also more dignified for the people of Gaza.

More than 100 aid and human rights groups this week called on governments to take urgent action as a hunger crisis engulfs Gaza, including by demanding an immediate and permanent ceasefire and the lifting of all restrictions on humanitarian aid.

In a statement signed and released on Wednesday by 109 organisations, including Mercy Corps, the Norwegian Refugee Council and Doctors Without Borders (also known as MSF), the groups warned that deepening starvation of the population was spreading across the besieged enclave.

When Children’s Hospital Los Angeles first told thousands of patients it was shuttering its pediatric gender clinic last month, Jesse Thorn was distraught but confident he could quickly find a new local care team for his kids.

But by the time the Center for Transyouth Health and Development officially closed its doors on Tuesday, the father of three was making plans to flee the country.

“They’re targeting whoever they can,” Thorn said. “[I’m afraid] the police will show up at my door because I took my child to see their doctor.”

Until this week, Children’s was among the largest and oldest pediatric gender clinics in the United States — and one of few providing puberty blockers, hormones and surgical procedures for trans youth on public insurance.

The closure of the renowned program signals a wider unraveling in the availability of care across the country, experts said. That includes in former safe havens such as California, New York and Illinois, where state laws protecting trans-specific healthcare are crumbling under mounting legal pressure and bureaucratic arm-twisting by the Trump administration.

In the last week, University of Chicago Medicine and Children’s National in D.C. announced they will end or dramatically scale back services for trans youth, following similar moves by Stanford Medicine, University of Pittsburgh Medical Center and Children’s Hospital of Orange County.

“There’s a rapid collapse of the provision of this care in blue states,” said Alejandra Caraballo, a civil rights attorney and legal instructor at Harvard. “By end of 2025, most care will effectively be banned.”

Some parents in L.A. say they fear the Department of Justice will use private medical data subpoenaed from California’s largest pediatric safety-net hospital to take their children away from them.

“It’s absolutely terrifying,” said Maxine, the mother of a Children’s Hospital patient, who declined to give her last name for fear of attacks on her son.

“I’m very afraid that the DOJ and this acting Attorney General are going to come after parents and use the female genital mutilation law … to prosecute parents and separate me from my child,” she said.

On July 9, Atty. Gen. Pam Bondi announced the Department of Justice was subpoenaing patient medical records from more than 20 doctors and clinics, the latest in a cavalcade of legal and technical maneuvers against providers who care for trans youth.

“Medical professionals and organizations that mutilated children in the service of a warped ideology will be held accountable by this Department of Justice,” Bondi said in a news release announcing the move.

Children’s would not say whether it had been subpoenaed or if it had turned over records responsive to the government’s demand.

The Justice Department was already investigating pediatric specialists for a litany of alleged crimes, from deceptive trade practices to billing fraud. Federal health agencies have vowed to withhold funding from institutions that continue to provide affirming care.

“These threats are no longer theoretical,” Children’s Hospital executives wrote to staff in an internal email announcing the closure June 12. “[They are] threatening our ability to serve the hundreds of thousands of patients who depend on CHLA for lifesaving care.”

Advocates say gender-affirming care is also lifesaving. They point to statistics — contested by the federal government and some experts — showing high rates of suicide among trans youth.

In June, the decision to shutter the clinic was widely condemned. Advocates said Children’s Hospital L.A. had “thrown trans kids under the bus” in disregard of state law.

Few are saying that now.

“You could see kids with leukemia being cut off their chemo therapy unless these hospitals stop provide care to trans people,” Caraballo said. “If one of the biggest children’s hospitals in the country couldn’t shoulder that burden, I don’t see many others being able to do so.”

Others agreed.

“No matter what California or any other state has done to say, ‘We want to protect these kids,’ unless they can write checks that equal the amount of money that’s being lost, [programs close],” said Dara E. Purvis, a law professor at Temple University.

So far, the Trump administration has painted parents as victims of “radical gender ideology.”

Some experts warned that as the government tightens the screws on doctors and hospitals, trans teens and their families are likely to seek hormones outside the medical system, including through gray market channels.

“We’ve seen this with abortion,” Caraballo said. “People are going to go about getting it whichever way they can.”

There are fears that families could face prosecution for continuing to seek medications, similar to charges being filed against mothers who have secured abortion pills for their teenagers.

“We’re working with Congress on existing criminal laws related to female genital mutilation to more robustly protect children,” Justice Department Chief of Staff Chad Mizelle said during a Federal Trade Commission workshop entitled “The Dangers of ‘Gender-Affirming Care’ for Minors.”

“We are using all of the tools at the Department of Justice to address this issue,” Mizelle said.

For now, dozens of hospitals across California still provide gender-affirming care, including hormone therapy and surgical procedures.

But the list changes almost day to day.

“Even programs that may have been operating a month ago are not operating now,” said Terra Russell-Slavin, chief impact officer at the Los Angeles LGBT Center. “There’s a lot of concern about even being public about offering care because those agencies become targets.”

With the medical care their children rely on under threat and few promised protections from the state, some families are unsure what the coming months will bring.

For one Orange County father, who asked not to be named for fear of retaliation against his trans son, plans for future travel are suddenly in jeopardy.

He said only about half of his son’s identity documents match his gender, and they’ve been warned not to try to change others.

“He won’t be able to leave the country because he can’t get a matching passport,” the father said.

For Maxine, the L.A. mom, balancing the banal with the existential is a daily strain.

“My kid is just living their life. They want to go to concerts, they want to go shopping for back to school — they don’t know any of this is happening,” the mother said. “You have to experience this intense fear while maintaining a normal household for everybody else.”

Information, in the second Trump administration, is a currency of power and fear. Last week, Atty. Gen. Pam Bondi announced sweeping subpoenas targeting physicians and medical providers who offer care for transgender youth. The aim is not to initiate prosecutions: Indeed, the legal theories upon which such prosecutions might rest are tenuous at best.

By filing these investigative demands, the government plainly hopes to chill medical providers from offering expert care. This strategy can work even if, at the end of the day, the government’s threats are hollow as a matter of law. The White House’s plainly unconstitutional attacks on law firms, for example, have substantially worked — even though the minority of firms to challenge the orders rapidly won relief.

Fortunately, the legal system is not powerless in the face of such overreaching: Federal district courts have the authority, and the obligation, to recognize that patient-physician dealings are akin to attorney-client and spousal discussions. Both of the latter benefit from judicially created privileges — or legal shields that individuals can invoke against the state’s probing. At a moment when not just gender medicine but also reproductive care more generally is in peril, federal courts can and should step in and shield intimately private medical data as well.

We suspect that many people believe that what they tell their doctors is already private. They’re right, but only sort of. There’s a federal law called HIPAA that limits what your doctor can do with the information. It says that your doctor can’t, for instance, sell your medical records to the newspaper. In 2024, the Department of Health and Human Services also issued a HIPAA “privacy rule” that heightened protections for reproductive healthcare information. (Last month, a federal district court in Texas declared the rule unconstitutional — so its future is uncertain.)

Even with the privacy rule, however, HIPAA hides a gaping hole: It allows disclosures “required by law.” And the law explicitly permits disclosures pursuant to subpoenas of all kinds — judicial, grand jury or administrative — including those issued by Bondi. So if the Justice Department subpoenas your intimate and sensitive healthcare information, HIPAA won’t stop that.

In previous academic work, we’ve urged Congress and state legislatures to fill this gap. Blue states have acted to curtail cooperation with other states — but there’s a limit to what states can do when the federal government demands information.

Yet there remains one entity that can, and should, act immediately to shield reproductive healthcare information: the same federal district courts that have been at the forefront of pushing back on the Trump administration’s many illegal and constitutional actions. We think federal courts should extend existing “privileges,” as evidentiary shields are called, to encompass both records of gender-affirming and transgender medical care, and also records of reproductive care more generally.

A privilege not only bars protected information from being admitted into evidence at trial, but also blocks subpoenas, warrants and other court orders.

Federal district courts have a general power to create privileges, and they often do so when people already have a reasonable expectation that their conversations will not be disclosed. Most people have heard of the attorney-client privilege, which means that you can confide in your lawyer without worrying that what you say will end up being used in court. But privileges can apply to all sorts of other information as well: what you tell your spouse, what you tell your spiritual advisor and even highway safety data that your state reports to the feds in exchange for funding. Existing court-created privileges protect not only attorney-client but also executive-branch communications.

Federal courts should recognize a privilege for doctor-patient communications in gender and reproductive medicine. They could do so if one of the physicians subpoenaed recently goes to court. The protection they seek is simply an extension of widely recognized legal principles and expectations of privacy. Federal courts already have recognized a privilege for patient communications with psychotherapists, and many state courts also offer privilege protections for broader doctor-patient communications.

Importantly, it is the job of federal district courts to craft evidence-related rules. After all, these are the judges who are closest to litigants and the mechanics of evidence protection. District courts don’t need to wait around for the Supreme Court to act on this, because the Federal Rules of Evidence left privileges to common law development in the district courts. And under the well-established balancing test that lower federal courts should follow when they create new privileges, we think our proposed privilege is an easy case: It serves a public purpose and protects what should be recognized as a valued interest of “transcendent importance” — privacy for our most intimate medical care.

The case for recognizing the privilege in respect to the recent subpoenas is especially strong: The attorney general is seeking to chill physicians from providing advice that is protected by the 1st Amendment and care that is guaranteed by federal statutes. Such subpoenas are directly at odds with the rule of law.

Today, it is trans kids; tomorrow, it will be people seeking an abortion or contraception. We should not have to wait for the federal government to go this far before our privacy gets the shield that it deserves.

Aziz Huq and Rebecca Wexler are professors of law at the University of Chicago Law School and Columbia Law School, respectively.

July 22 (UPI) — The Justice Department has dismissed a Biden-era lawsuit challenging Tennessee’s law banning gender-affirming care for minors, as the Trump administration continues to attack the rights and medical care of transgender Americans.

Attorney General Pam Bondi announced that her department’s Civil Rights Division dismissed the lawsuit in a statement Monday that said the Justice Department “does not believe challenging Tennessee’s law serves the public interest.”

Gender-affirming care includes a range of therapies, including psychological, behavioral and medical interventions, with surgeries for minors being exceedingly rare. According to a recent Harvard study, cisgender minors and adults were far more likely to undergo analogous gender-affirming surgeries than their transgender counterparts.

Every major American medical association supports gender-affirming care for both adults and minors, including the American Academy of Pediatrics and the American Medical Association, the largest national medical association.

Despite the support of the medical community and evidence of its efficacy, gender-affirming care and this marginalized community continue to be targeted by conservatives and Republicans with legislation.

Tennessee enacted Senate Bill 1 in March 2023 to prohibit healthcare professionals from prescribing puberty blockers or hormones to minors to treat gender dysphoria, which attracted a lawsuit from the Justice Department under President Joe Biden, arguing the law violated the 14th Amendment’s Equal Protection Clause, as all other minors continued to have access to the same procedures and treatments.

The conservative movement targeting the healthcare of transgender minors has since gained a supporter in the White House with the re-election of President Donald Trump.

Since returning to power, Trump has implemented an agenda targeting transgender Americans, including directing the federal government to recognize only two sexes determined at “conception,” restricting gender-affirming care for youth and banning transgender Americans from the military.

Last month, the conservative-leaning Supreme Court ruled 6-3 against the Biden administration’s complaint to overturn the Tennessee law. The ruling fell along ideological lines, with the conservative justices voting for the law to stand. The liberal justices dissented.

“By retreating from meaningful review exactly where it matters most, the Court abandons transgender children and their families to political whims,” Justice Sonia Sotomayor said in her dissent.

“Tennessee’s ban applies no matter what a minor’s parents and doctors think, with no regard for the severity of the minor’s mental health conditions or the extent to which treatment is medically necessary for an individual child.”

Bondi on Monday said the Supreme Court made “the right decision.” Assistant Attorney General Harmeet Dhillon of the Justice Department’s Civil Rights Division said that by dismissing the lawsuit, they “undid one of the injustices the Biden administration inflicted upon the country.”

WESLACO, Texas — These days, Juanita says a prayer every time she steps off the driveway of her modest rural home.

The 41-year-old mother, who crossed into the United States from Mexico more than two decades ago and married an American carpenter, fears federal agents may be on the hunt for her.

As she was about to leave for the pharmacy late last month, her husband called with a frantic warning: Immigration enforcement officers were swarming the store’s parking lot. Juanita, who is prediabetic, skipped filling medications that treat her nutrient deficiencies. She also couldn’t risk being detained because she has to care for her 17-year-old daughter, who has Down syndrome.

“If I am caught, who’s going to help my daughter?” Juanita asks in Spanish, through an interpreter. Some people quoted in this story insisted that the Associated Press publish only their first names because of concerns over their immigration status.

As the Trump administration intensifies deportation activity around the country, some immigrants — including many who have lived in Texas’s southern tip for decades — are unwilling to leave their homes, even for necessary medical care.

Tucked behind the freeway strip malls, roadside taquerias and vast citrus groves that span this 160-mile stretch of the Rio Grande Valley are people like Juanita, who need critical medical care in one of the nation’s poorest and unhealthiest regions. For generations, Mexican families have harmoniously settled — some legally, some not — in this predominately Latino community where immigration status was once hardly top of mind.

A ‘very dangerous situation’

White House officials have directed federal agents to leave no location unchecked, including hospitals and churches, in their drive to remove 1 million immigrants by year’s end. Those agents are even combing through the federal government’s largest medical record databases to search for immigrants who may be in the United States illegally.

Deportations and tougher restrictions will come with consequences, says Mark Krikorian, the director of the Center for Immigration Studies, a think tank that favors restrictive immigration policies.

“We shouldn’t have let it get out of hand the way we did,” Krikorian says of the previous administration’s immigration policies. “Some businesses are going to have difficulties. Some communities are going to face difficulties.”

Federal agents’ raids began reaching deeper into everyday life across the Rio Grande Valley in June, just as the area’s 1.4 million residents began their summer ritual of enduring the suffocating heat.

This working-class stretch of Texas solidly backed Trump in the 2024 election, despite campaign promises to ruthlessly pursue mass deportations. People here, who once moved regularly from the U.S. to Mexico to visit relatives or get cheap dental care, say they didn’t realize his deportation campaign would focus on their neighbors.

But in recent weeks, restaurant workers have been escorted out mid-shift and farmers have suddenly lost field workers. Schoolchildren talk openly about friends who lost a parent in raids. More than a dozen were arrested last month at local flea markets, according to local news reports and Border Patrol officials.

Immigrants are staying shut inside their mobiles homes and shacks that make up the “colonias,” zoning-free neighborhoods that sometimes don’t have access to running water or electricity, says Sandra de la Cruz-Yarrison, who runs the Holy Family Services, Inc. clinic in Weslaco, Texas.

“People are not going to risk it,” de la Cruz-Yarrison says. “People are being stripped from their families.”

Yet people here are among the most medically needy in the country.

Nearly half the population is obese. Women are more likely to be diagnosed with cervical cancer and elderly people are more likely to develop dementia. Bladder cancers can be more aggressive. One out of every four people lives with diabetes.

As much as a third of the population doesn’t have health insurance to cover those ailments. And a quarter of people live in poverty, more than double the national average.

Now, many in this region are on a path to develop worse health outcomes as they skip doctor appointments out of fear, says Dr. Stanley Fisch, a pediatrician who helped open Driscoll Children’s Hospital in the region last year.

“We’ve always had, unfortunately, people who have gone with untreated diabetes for a long time and now it’s compounded with these other issues at the moment,” Fisch says. “This is a very dangerous situation for people. The population is suffering accordingly.”

Trepidations about going to clinics are spreading

Elvia was the unlucky — and unsuspecting — patient who sat down for the finger prick the clinic offers everyone during its monthly educational meeting for community members. As blood oozed out of her finger, the monitor registered a 194 glucose level, indicating she is prediabetic.

She balked at the idea of writing down her address for regular care at Holy Family Services’ clinic. Nor did she want to enroll in Medicaid, the federal and state funded program that provides health care coverage to the poorest Americans. Although she is a legal resident, some people living in her house do not have legal status.

Fewer people have come to Holy Family Services’ clinic with coverage in recent months, says billing coordinator Elizabeth Reta. Over decades, the clinic’s midwifery staff has helped birth thousands of babies in bathtubs or on cozy beds in birthing houses situated throughout the campus. But now, Reta says, some parents are too scared to sign those children up for health insurance because they do not want to share too much information with the government.

“Even people I personally know that used to have Medicaid for their children that were born here — that are legally here, but the parents are not — they stopped requesting Medicaid,” Reta says.

Their worry is well-founded.

An Associated Press investigation last week revealed that U.S. Immigration and Customs Enforcement officials have gained access to personal health data — including addresses — of the nation’s 79 million Medicaid and Children’s Health Insurance Program enrollees. The disclosure will allow ICE officials to receive “identity and location information of aliens,” documents obtained by the AP say.

In Texas, the governor started requiring emergency room staff to ask patients about their legal status, a move that doctors have argued will dissuade immigrants from seeking needed care. State officials have said the data will show how much money is spent on care for immigrants who may not be here legally. Federal law requires emergency rooms to treat any patients who come to the doors.

Visits to Holy Family Services’ mobile clinic have stopped altogether since Trump took office. The van, which once offered checkups at the doorsteps in the colonias, now sits running on idle. Its constant hum is heard throughout the clinic’s campus, to keep medical supplies fresh in the 100-degree temperatures.

“These were hard-hit communities that really needed the services,” de la Cruz-Yarrison says. “People were just not coming after the administration changed.”

A mother almost loses a son. A daughter is too scared to visit the doctor

Immigrants were less likely to seek medical care during Trump’s first term, multiple studies concluded. A 2023 study of well-child visits in Boston, Minneapolis and Little Rock, Arkansas, noted a 5% drop for children who were born to immigrant mothers after Trump was elected in 2016. The study also noted declines in visits when news about Trump’s plans to tighten immigration rules broke throughout his first term.

“It’s a really high-anxiety environment where they’re afraid to talk to the pediatrician, go to school or bring their kids to child care,” says Stephanie Ettinger de Cuba, a Boston University researcher who oversaw the study.

A delayed trip to the doctor almost cost 82-year-old Maria Isabel de Perez her son this spring. He refused to seek help for his intense and constant stomach pains for weeks, instead popping Tylenol daily so he could still labor in the farm fields of Arkansas, she says. He put off going to the hospital as rumors swirled that immigration enforcement officials were outside of the hospital.

“He waited and waited because he felt the pain but was too scared to go to the hospital,” she explains in Spanish through an interpreter. “He couldn’t go until the appendix exploded.”

Her son is still recovering after surgery and has not been able to return to work, she says.

Perez is a permanent resident who has lived in the United States for 40 years. But all of her children were born in Mexico, and, because she is a green card holder, she cannot sponsor them for citizenship.

Maria, meanwhile, only leaves her house to volunteer at a local food bank. She’s skipped work on nearby farms. And after last month’s arrests, she won’t sell clothes for money at the flea market anymore.

So she stuffs cardboard boxes with loaves of bread, potatoes, peppers and beans that will be handed out to the hungry. Before the raids began, about 130 people would drive up to collect a box of food from Maria. But on this sweltering June day, only 68 people show up for food.

She brings home a box weekly to her children, ages 16, 11 and 4, who are spending the summer shut inside. Her 16-year-old daughter has skipped the checkup she needs to refill her depression medication. The teenager, who checks in on friends whose parents have been arrested in immigration raids through a text group chat, insists she is “doing OK.”

Maria left Mexico years ago because dangerous gangs rule her hometown, she explains. She’s married now to an American truck driver.

“We’re not bad people,” Maria says from her dining room table, where her 4-year-old son happily eats a lime green popsicle. “We just want to have a better future for our children.”

Juanita, the prediabetic mother who hasn’t filled her prescriptions out of fear, was not sure when she would brave the pharmacy again. But with a cross hanging around her neck, the devout Catholic says she will say three invocations before she does.

Explains her 15-year-old son, Jose: “We always pray before we leave.”

Seitz and Martin write for the Associated Press.

WASHINGTON, July 14 (UPI) — Despite an apparent reversal on mass layoffs, the Department of Veterans Affairs is still planning a workforce reduction, prompting legal challenges, staff unrest and warnings from frontline nurses who say the cuts will harm the very veterans the VA is meant to serve.

The VA has signaled it would not move forward with mass layoffs initially envisioned, but recent developments show the agency is still on track to eliminate tens of thousands of jobs by the end of 2025.

Internal contracts and legal challenges suggest broader restructuring efforts are underway, yet the scope and restructuring framework is unclear, raising concerns among lawmakers, unions and frontline workers about their potential impact on veteran care and employee rights.

In a VA press release last week, the agency secretary, Doug Collins said the “VA is headed in the right direction,” thanks to departmental reviews conducted since March.

“A department-wide [reduction in force] is off the table, but that doesn’t mean we’re done improving VA. Our review has resulted in a host of new ideas for better serving veterans that we will continue to pursue,” Collins said.

30,000 employees to be cut

The VA, which employs over 467,000 medical professionals, administrative staff and others, also announced the press release that it’s on track to reduce its workforce by nearly 30,000 employees by the end of fiscal year 2025 through retirements, resignations and attrition.

The department says this voluntary path eliminates the need for a formal reduction in force.

However, that conflicts with a $726,000 contract signed in May by the VA and the U.S. Office of Personnel Management to prepare for a mass layoff. The contract was prepared because the VA said it lacks the internal expertise for such a wide-scale restructuring and requires OPM to supply seasoned human relations specialists to guide layoffs.

Neither the VA nor OPM responded to multiple phone and email requests for comment on the status of the contract. And, so, the VA’s actual plan remains mired in lack of information and confusion for employees, veterans and congressional representatives.

A VA spokesman said Monday that the department is “in the process of winding down that contract with OPM.”

Of the 83,000 VA positions Collins previously set as a goal to cut, according to the department’s latest update, the agency had shed nearly 17,000 positions as of June 1, with another 12,000 departures expected by Sept. 30.

“Nobody in their right mind thinks you can cut 80,000 workers and not cut resources to the veteran,” said Irma Westmoreland, chair of the Veterans Affairs division of National Nurses United, who was reacting to the original plan.

Nurses skeptical

VA nurses on the front lines remain skeptical that reduced staffing can be carried out without affecting patient care, one of their union representatives said. The VA is the largest integrated health care system in the United States, providing services at 1,380 facilities to more than 9.1 million enrolled veterans each year, according to the agency.

“The VA says nurses and doctors won’t be affected, but that just means they’re cutting all the support staff,” Westmoreland said. “That’s still going to impact patient care.”

Westmoreland said the VA has failed to include frontline staff in restructuring discussions, and that the resulting fear and confusion already have caused widespread staffing shortages. That’s because many have decided to retire or switching to another health care system.

The remaining staff is facing burnout by being assigned additional tasks outside of their role to fill the staffing gaps, Westmoreland said.

“People who can retire are retiring. People just hired are leaving. And the rest of us are being stretched thin to do non-nursing work like cleaning, delivering trays, even transporting patients,” she said.

Although the VA plans the staffing cutbacks, the department is requesting $441.3 billion in fiscal year 2026, according to its budget request released in May. Paradoxically, that is a 10% increase from the 2025 fiscal year budget.

Budget approved in House

House Republicans approved a $435.3 billion budget on June 25, but the Senate must prepare its version of the spending plan. The Military Times noted that “the plan is unlikely to pass as its own standalone measure, but instead is expected to be approved sometime this fall as part of an all-of-government spending package.”

The VA said the funding increase, if it happens, would be prioritized toward health care, benefits and national cemeteries.

Much of what is coming has not been shared with Congress, and congressional staffers who work for the House Veterans Affairs Committee say they are in the dark about the agency’s plan.

“VA indicated to the committee in June that they are ‘allowed to do planning, but no execution’ of a reduction in force,” a committee statement said. “They have developed recommendations for an RIF for VA Central Office positions, but that plan has not been signed off on.”

Requests ignored

Staffers also noted that repeated requests for documentation by Democrats on the House Veterans Affairs Committee have been ignored, raising questions of whether veterans will be negatively impacted by the proposed changes.

“We continue to have serious concerns about the effects of VA’s plan because details remain so limited,” said a Democratic staffer who asked that his name not be used because he was not authorized to speak for the committee. “We are conducting an ongoing investigation into VA’s workforce reduction efforts.”

Meanwhile, legal challenges to President Donald Trump‘s March 2025 executive order to mandate sweeping federal workforce reductions had complicated VA’s path forward.

The order was initially blocked by a federal court, but the Supreme Court lifted that injunction Tuesday, allowing agencies like VA to resume planning for workforce cuts while the legality of the order is still under review.

In a separate lawsuit, a federal judge in California issued a preliminary injunction in June against the Trump administration for stripping federal workers of their union rights.

Unions file suit

Six major unions — National Nurses United; American Federation of Government Employees; American Federation of State, County, and Municipal Employees; National Association of Government Employees; National Federation of Federal Employees; and Service Employees International Union — filed that suit.

In a June press release from National Nurses United, the unions argued that Trump’s order violated the First and Fifth amendments by taking away collective bargaining rights without due process from nearly 1 million federal employees. Westmoreland said the case is critical for protecting care quality and the rights of VA staff.

“Collective bargaining rights are critical for union nurses so we can advocate for our veterans and ensure they get the care they deserve,” National Nurses United’s Westmoreland said. “We will fight for our veterans who put their lives on the line for us.”

The court has temporarily stopped the administration from stripping federal workers of their union rights. The injunction is still in place while the lawsuit plays out.

Representing veterans as president of the American Federation of Government Employees Local 2092, Robert Malosh said the administration’s actions have created a culture of fear and uncertainty among staff.

Life-threatening gaps

Malosh, a veteran, recounted the union’s role in addressing life-threatening gaps in emergency care at the main VA hospital in Ann Arbor, Mich.

“For almost 30 years, [certified registered nurse anesthetists] were expected to respond to emergency airway calls from home. We identified that risk and bargained for 24-hour on-site coverage,” he said. “Just last month, a CRNA told me they saved a life. If they weren’t already in the building, that veteran would have died.”

Malosh said that cases like this spotlight the value of unions in identifying blind spots and advocating for both staff and veterans. He described a troubling case involving podiatric surgeries being delayed due to administrative interpretation of care eligibility rules, potentially placing diabetic veterans at risk of amputation or worse.

He also pushed back against a VA back-to-office mandate, calling it a disruptive change that was poorly planned and worsened care delivery.

Back to the office

According to the VA, it announced its back-to-office mandate Feb. 3, ordering all employees, except those with approved arrangements, to work full-time at their assigned duty stations.

The announcement followed Trump’s presidential memorandum Jan. 20 for a back-to-office mandate across all agencies and departments in the executive branch, according to the White House.

Malosh said a number of issues arose with that mandate: For one, employees struggled with Wi-Fi issues due to the influx of people connecting, causing disruptions for telehealth medical appointments.

Also , mental health professionals who had been working privately from home were moved to shared offices and cubicles, causing veterans to feel uncomfortable due to lack of privacy. Malosh said some veterans saw people in the background of a private call.

As the VA moves forward with plans to reduce its workforce, questions remain about the long-term effects on veteran care and employee stability.

With ongoing legal challenges, congressional scrutiny and staff uncertainty, the future of the agency’s restructuring efforts and their consequences for the nation’s largest health care system remain unresolved.

July 9 (UPI) — The Justice Department on Wednesday announced that it had sent more than 20 subpoenas to doctors and clinics performing gender-affirming care for minors, as the Trump administration ramps up its attacks on this marginalized community.

No information about the doctors and clinics subpoenaed was provided by the Justice Department, though it suggested the subpoenas were part of investigations into “healthcare fraud, false statements and more.”

“Medical professionals and organizations that mutilate children in the service of a warped ideology will be held accountable by this Department of Justice,” Attorney General Pam Bondi said in a statement.

On June 18, the Supreme Court upheld a Tennessee law restricting access to gender-affirming care for minors.

The subpoenas come despite every major American medical association supporting gender-affirming care for both adults and youth, including the American Academy of Pediatrics.

Gender-affirming care includes a range of therapies, from psychological, behavioral and medical interventions, with surgeries for minors being exceedingly rare. According to a recent Harvard study, cisgender minors and adults were far more likely to undergo analogous gender-affirming surgeries than their transgender counterparts.

Despite the support of the medical community and the evidence, conservatives, Republicans and the Trump administration have continued to target this community with legislation affecting their medical care and rights.

The subpoenas were announced the same day that the Federal Trade Commission hosted a day-long workshop titled “The Dangers of Gender-Affirming Care for Minors,” during which Melissa Holyoak, an FTC commissioner, said that while they cannot make policy decisions limiting gender-affirming care, they can target the medical practice for deceptive statements.

“The FTC has previously enforced — and will continue to enforce — against deceptive representations made by medical practitioners, including claims in connection with treatments for transgender children,” she said, according to a copy of her remarks.

Also on Wednesday, the Department of Justice sued California over alleged Title IX violations concerning transgender athletes competing in women’s and girls’ sports.

The Democratic-led state has refused to comply with the Trump administration’s ban on transgender women and girls competing in sports that align with their gender identity.

Since returning to the White House in January, President Donald Trump has signed several executive orders targeting transgender Americans, including one directing the federal government to recognize only two sexes determined at “conception,” another restricting gender-affirming care for youth and a third banning transgender Americans from the military.

Children’s Hospital Los Angeles is the preeminent center for pediatric medicine in Southern California. For three decades, it’s also been one of the world’s leading destinations for trans care for minors. Don’t take my word for it: CHLA boasts about its record of providing “high-quality, evidence-based, medically essential care for transgender and gender-diverse youth, young adults, and their families.”

Earlier this month, it abruptly ended all that, telling its staff in a meeting that the Center for Transyouth Health and Development would be shutting down. (My daughter was, until this announcement, a patient at the center.)

Did some new medical breakthrough, some unexpected research drive the decision to cut off care for roughly 2,500 patients with no warning? No. It came, the hospital said, after “a thorough legal and financial assessment of the increasingly severe impacts of recent administrative actions and proposed policies.”

In other words, the hospital caved. In advance.

CHLA made the move a week before the Supreme Court’s 6-3 decision in the United States vs. Skrmetti, which upheld a Tennessee law that bans most gender-affirming care for minors. More than 20 states have passed similar laws that prevent trans minors from accessing many different forms of medical care. The decision essentially shields those laws from future legal challenges.

But the Supreme Court ruling had nothing to do with CHLA’s decision. There is no such law in California.

Why, then, without any court order or law, did the center suddenly close, leaving so many young patients in need of doctors, medications and procedures? You can probably guess the answer.

Pressure from the Trump administration threatened the hospital with severe repercussions if it continued to serve these patients. One form of pressure arrived in a May 28 letter from the Centers for Medicare and Medicaid Services, signed by its administrator, the former TV host Dr. Mehmet Oz. He announced that his agency would seek financial records on a range of gender-affirming care procedures from several dozen hospitals.

Being faced with the choice of discontinuing care for an entire class of patients or battling the administration over access to financial records is not a dilemma any doctor wants to face. To be clear, this is not a debate over medical science or proper care for trans youth. CHLA followed the science — until it didn’t. This is a debate over ideology about who is deserving of medical care.

In the past few months, we have seen powerful law firms, large corporations and universities forced to contend with difficult bargains. Settle with an administration that has singled you out? Or take the battle to court?

In February, when Children’s Hospital announced that it would stop taking on new patients in its Transyouth Center, California Atty. Gen. Rob Bonta sternly reminded them that they had a legal obligation to continue to provide this care. The hospital quickly reversed course.

That’s why the recent choice of the CHLA board marks a huge shift that could potentially affect care for not just trans youth patients but so many others as well.

Because what the board of CHLA did was, in fact, a choice. Moreover, CHLA’s choice went against its own medical advice about the urgent need for such care. On its website, the hospital claims it was “immensely proud of this legacy of caring for young people on the path to achieving their authentic selves.”

When confronted with threats, the board chose to sacrifice the care of one group of patients in the hope that it could continue to care for others. Perhaps the board concluded that it was following a crude, utilitarian logic: denying the medical needs of some would allow it to provide for many more.

That’s not how I see it. In caving to blackmail, they have endorsed the administration’s bigotry. They have demonstrated that trans youth are expendable. The board has made it clear that this group of patients is not as deserving of care as others. When CHLA faced actual pressure, its own record of providing “high-quality, evidence-based, medically essential care” simply became too inconvenient.

This time, it was trans youth. Who will it be next time? Disabled children? Children born outside the U.S.? CHLA agreed to play the game rather than call it out for what it is.

As a journalist, I occasionally grant anonymity to a source. It’s not an action I take lightly. The decision means that if pressured, even when threatened with contempt of court, I will not reveal their identity. Thankfully, it’s never come to that for me, although other journalists have gone to jail to protect sources. If I were to break that pledge once, I could never in good conscience grant it again.

I now wonder how doctors at CHLA can ever look their young patients in the eye again and promise that, no matter what, they will fight for their care.

Gabriel Kahn is a professor of professional practice at the USC Annenberg School for Communication and Journalism.

A WOMAN has revealed that she is in an age gap relationship with a man who is 27 years older than her.

Sass, 27, from London, is dating her 54-year-old boyfriend, who she calls her “silver fox.”

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The self-proclaimed “spoiled girlfriend” lives a luxury lifestyle with skiing trips to Vail Village, Colorado, designer bags, posh hotel stays and delicious meals out.

But now, the content creator has found herself on the receiving end of a barrage of abuse from mean trolls who have criticised her relationship dynamic.

Not only were keyboard warriors “disgusted” by the age gap, but others told her to choose “self-respect over money.” 

It came after Sass took to social media to show off her age gap relationship, leaving many open-mouthed.

Alongside a gorgeous picture of Sass and her partner before an evening out, she confirmed that while she was born in 1997, her man was welcomed into the world much earlier, in 1970. 

But Sass, who “doesn’t date younger”, was eager to set the record straight on her relationship, as she wrote: “If you know us as individuals, us as a couple makes sense. 

“Those we know in real life understand, are supportive and happy for us.”

Not only this, but she claimed that her man is “highly educated, emotionally intelligent, financially secure”, has “a great personality and is hot.”

As a result, she confirmed: “I’m happy as Larry.”

The TikTok clip, which was posted under the username @sweetheartsass, has clearly left many open-mouthed, as it has quickly racked up 136,800 views, 4,372 likes and 391 comments. 

But social media users were totally divided by Sass’ relationship – while some accused her of doing “anything for money”, others were supportive. 

One person said: “Lol my dad was born in 1977 and me in 1994. If they’re old enough to be your parent, it’s not right, sorry.” 

Anything for money and a lifestyle I guess

TikTok user

But to this, Sass eagerly clapped back and snapped: “I literally do not care about you and your dad. Go away.” 

Another slammed: “Self respect over money!” 

A-list age gap relationships that have stood the test of time

1. Kris Jenner & Corey Gamble – 25 years
   The Kardashian matriarch, 69, met her younger man, 44, at a mutual friend’s 40th birthday party in Ibiza. They’ve been together since August 2014.
2. Sam & Aaron Taylor-Johnson – 23 years
   The director, 57, and actor, 34, reportedly met at a film audition in 2009, and were married by 2012. The pair share two daughters and Sam has two children from a previous marriage.
3. Rosie-Huntington-Whiteley & Jason Statham – 20 years
   The model, 37, started dating actor Jason, 57, in 2010. They were wed in 2016 and have since welcomed a son and a daughter together.
4. Catherine Zeta-Jones & Michael Douglas – 25 years
   Catherine, 55, was introduced to Michael, 80, a film festival in 1996 and engaged three years later. Shortly after their engagement, the couple welcomed a son and married in 2000.

And a third commented: “Anything for money and a lifestyle I guess.” 

But at the same time, one user said: “Why are people disgusted with this? It’s not for them so why is it your issue? Not every relationship is a design to fit the usual expectations.” 

According to the comments I’ve committed a crime

Sass

A second chimed in: “I love this! She’s well looked after and if you look at their videos they look really happy. As women all we want is security and love and that’s what she’s getting regardless of the age gap!” 

Meanwhile, someone else gushed: “As long as you’re happy, it doesn’t matter what the person looks like, how old they are or who they are. Love is Love.” 

In response to the rude remarks, clearly unbothered, Sass later laughed: “According to the comments I’ve committed a crime.”

Unlock even more award-winning articles as The Sun launches brand new membership programme – Sun Club

NASHVILLE, Tenn. — A U.S. Supreme Court decision upholding Tennessee’s ban on gender-affirming care for minors is leaving transgender children and their parents uncertain and anxious about the future.

The court on Wednesday handed President Trump’s administration and Republican-led states a significant victory by effectively protecting them from at least some of the legal challenges against many efforts to repeal safeguards for transgender people.

The case stems from a Tennessee law banning puberty blockers and hormone treatments for transgender minors. Opponents of gender-affirming care say people who transition when they’re young could later regret it.

Families of transgender children argue the ban amounts to unlawful sex discrimination and violates the constitutional rights of vulnerable Americans.

Student says ruling creates an unwelcome world

Eli Givens, who is transgender and testified against Tennessee’s gender-affirming care bill in 2023, said it’s devastating that lawmakers “who have called us degenerates, have told us that we’re living in fiction” are celebrating the court’s ruling.

The nonbinary college student from Spring Hill received mastectomy surgery in 2022 at age 17. They said the legislation inspired their advocacy, and they attended the Supreme Court arguments in the case last December, on their 20th birthday.

“We’re not making a world that trans youth are welcomed or allowed to be a part of,” Givens said. “And so, it’s just a really scary kind of future we might have.”

Jennifer Solomon, who supports parents and families at the LGBTQ+ rights group Equality Florida, called the ruling a decision “that one day will embarrass the courts.”

“This is a decision that every parent should be concerned about,” she said. “When politicians are able to make a decision that overrides your ability to medically make decisions for your children, every family should worry.”

Conservative activists take credit

Chloe Cole, a conservative activist known for speaking about her gender-transition reversal, posted on social media after the court’s decision that “every child in America is now safer.”

Cole was cited as an example by Tennessee Republicans as one of the reasons the law was needed.

Matt Walsh, an activist who was one of the early backers of Tennessee’s law, applauded the high court. Three years ago, Walsh shared videos on social media of a doctor saying gender-affirming procedures are “huge moneymakers” for hospitals and a staffer saying anyone with a religious objection should quit.

“This is a truly historic victory and I’m grateful to be a part of it, along with so many others who have fought relentlessly for years,” Walsh posted on social media.

Fears of what’s next after Supreme Court decision

Rosie Emrich is worried the court decision will embolden legislators in New Hampshire, where legislation banning hormone treatments and puberty blockers for children is expected to reach the governor’s desk.

Lawmakers are weighing whether to block the treatments from minors already receiving them, like Emrich’s 9-year-old child.

“It’s definitely disappointing, and I’m trying to figure out how I’m going to talk to my kid about it,” Emrich said.

Emrich said she and her husband have considered moving from New Hampshire and are waiting to see what will happen.

“The hard part is, like, I’ve grown up here, my husband has grown up here, we very much want to raise our family here,” she said. “And we don’t want to leave if we don t have to.”

A move across the country and other hurdles

Erica Barker and her family moved from Jackson, Mississippi, to North Las Vegas, Nevada, a little over two years ago so one of her children could start receiving gender-affirming care.

Barker’s transgender daughter, then 12, had been in therapy for three years, and the family agreed it was time for medical treatments.

Mississippi passed a ban on gender-affirming care for minors the next year, which Barker said she saw coming.

Barker said the move was complicated, involving a new job for her husband and two mortgages when their Mississippi home was slow to sell, but it also brought access to care for her daughter, now 14.

“Our hearts are hurting for folks who are not having the same experience,” Barker said.

In another state with a ban on gender-affirming care for minors, Oklahoma resident Erika Dubose said finding care for her 17-year-old nonbinary child, Sydney Gebhardt, involves a four-hour drive to Kansas and getting prescriptions filled in Oregon and mailed to their home.

“I just wish the younger folks wouldn’t have to go through this,” Gebhardt said. “These folks deserve to be focusing on their academics and hanging out with their friends and making memories with their families and planning out a safe and happy future.”

Mother says gender-affirming care saves lives

Sarah Moskanos, who lives near Milwaukee, said her 14-year-old transgender daughter went through nearly a decade of counseling before she started medical gender-affirming care but has been sure since the age of 4 that she identified as a girl.

“I would say that there is decades of research on this very thing,” she said. “And we know what works and we know what will save trans kids’ lives is gender-affirming care.”

Wisconsin doesn’t have a gender-affirming care ban, but Moskanos said getting her daughter that care has not been easy. She now worries about what the future holds.

“We are but one election cycle away from disaster for my kid,” she said.

Vowing not to disappear

Mo Jenkins, a 26-year-old transgender Texas native and legislative staffer at the state Capitol, said she began taking hormone therapy at 16 years old and has been on and off treatment since then.

“My transition was out of survival,” Jenkins said.

Texas outlawed gender-affirming care for minors two years ago, and in May, the Legislature passed a bill tightly defining a man and a woman by their sex characteristics.

“I’m not surprised at the ruling. I am disheartened,” Jenkins said. “Trans people are not going to disappear.”

Mattise, Mulvihill and Seewer write for the Associated Press. Mulvihill reported from Cherry Hill, N.J., and Seewer reported from Toledo, Ohio. AP journalists Susan Haigh in Hartford, Conn.; Kenya Hunter in Atlanta; Laura Bargfeld in Chicago; Nadia Lathan in Austin, Texas; and Daniel Kozin in Pinecrest, Fla., contributed to this report.

WASHINGTON — The go-broke dates for Medicare and Social Security trust funds have moved up as rising health care costs and new legislation affecting Social Security benefits have contributed to earlier projected depletion dates, according to an annual report released Wednesday.

The go-broke date — or the date at which the programs will no longer have enough funds to pay full benefits — was pushed up to 2033 for Medicare’s hospital insurance trust fund, according to the new report from the programs’ trustees. Last year’s report put the go-broke date at 2036.

Meanwhile, Social Security’s trust funds — which cover old age and disability recipients — will be unable to pay full benefits beginning in 2034, instead of last year’s estimate of 2035. After that point, Social Security would only be able to pay 81% of benefits.

The trustees say the latest findings show the urgency of needed changes to the programs, which have faced dire financial projections for decades. But making changes to the programs has long been politically unpopular, and lawmakers have repeatedly kicked Social Security and Medicare’s troubling math to the next generation.

President Trump and other Republicans have vowed not to make any cuts to Medicare or Social Security, even as they seek to shrink the federal government’s expenditures.

Social Security Administration Commissioner Frank Bisignano, sworn into his role in May, said in a statement that “the financial status of the trust funds remains a top priority for the Trump Administration.”

“Current-law projections indicate that Medicare still faces a substantial financial shortfall that needs to be addressed with further legislation. Such legislation should be enacted sooner rather than later to minimize the impact on beneficiaries, providers, and taxpayers,” the trustees state in the report.

The trustees are made up of six people — the Treasury Secretary serves as managing trustee, alongside the secretaries of Labor, Health and Human Services, and the commissioner of Social Security. Two other presidentially-appointed and Senate-confirmed trustees serve as public representatives, however those roles have been vacant since July 2015.

About 68 million people are enrolled in Medicare, the federal government’s health insurance that covers those 65 and older, as well as people with severe disabilities or illnesses.

Wednesday’s report shows a worsening situation for the Medicare hospital insurance trust fund compared to last year. But the forecasted go-broke date of 2033 is still later than the dates of 2031, 2028 and 2026 predicted just a few years ago.

Once the fund’s reserves become depleted, Medicare would be able to cover only 89% of costs for patients’ hospital visits, hospice care and nursing home stays or home health care that follow hospital visits.

The report said expenses last year for Medicare’s hospital insurance trust fund came in higher than expected.

Income exceeded expenditures by nearly $29 billion last year for the hospital insurance trust fund, the report stated. Trustees expect that surplus to continue through 2027. Deficits then will follow until the fund becomes depleted in 2033.

The report states that the Social Security Social Security Fairness Act, enacted in January, which repealed the Windfall Elimination and Government Pension Offset provisions of the Social Security Act and increased Social Security benefit levels for some workers, had an impact on the depletion date of SSA’s trust funds.

Romina Boccia, a director of Budget and Entitlement Policy at the libertarian CATO Institute called the repeal of the provisions “a political giveaway masquerading as reform. Instead of tackling Social Security’s structural imbalances, Congress chose to increase benefits for a vocal minority—accelerating trust fund insolvency.”

“It’s a clear sign that populist pressure now outweighs fiscal responsibility and economic sanity on both sides of the aisle,” She said.

Pair that with a Republican reconciliation bill that increases tax giveaways while refusing to rein in even the most dubious Medicaid expansions, and the message is unmistakable: Washington is still in giveaway mode.

AARP CEO Myechia Minter-Jordan said “Congress must act to protect and strengthen the Social Security that Americans have earned and paid into throughout their working lives.” “More than 69 million Americans rely on Social Security today and as America’s population ages, the stability of this vital program only becomes more important.”

Social Security benefits were last reformed roughly 40 years ago, when the federal government raised the eligibility age for the program from 65 to 67. The eligibility age has never changed for Medicare, with people eligible for the medical coverage when they turn 65.

Nancy Altman, president of Social Security Works, an advocacy group for the popular public benefit program said in a statement that “there are two options for action: Bringing more money into Social Security, or reducing benefits. Any politician who doesn’t support increasing Social Security’s revenue is, by default, supporting benefit cuts.”

Congressional Budget Office reporting has stated that the biggest drivers of debt rising in relation to GDP are increasing interest costs and spending for Medicare and Social Security. An aging population drives those numbers.

Several legislative proposals have been put forward to address Social Security’s impending insolvency.

Hussein writes for the Associated Press. AP reporters Amanda Seitz and Tom Murphy in Indianapolis contributed to this report.