NORTHAMPTON — Concerned that area transgender youth are not continuing to receive gender-affirming care healthcare services, Rep. Mindy Domb is urging Baystate Medical Center to follow through with its promise to limit healthcare interruptions for the 250 patients affected by the hospital’s termination of these pediatric services.
In February, Baystate terminated all gender-affirming services for youth, such as hormone blockers and hormone replacement therapy, other than counseling. At the time, the Trump administration threatened to restrict Medicare and Medicaid funding for all providers offering such treatments. The Springfield hospital announced the change and its partnership with TransHealth, a gender care specialty clinic in Northampton, to refer patients to a new provider.
Eight months after the change, Domb doubts whether Baystate upheld its original promise. TransHealth confirmed to Domb that only 50 of the 250 patients seeking gender-affirming care at Baystate contacted the Northampton provider about services. The Amherst lawmaker tasked Baystate with reaching out to the 200 “lost patients” and assure they have the information and support required to continue their care.
“Baystate described their process as a warm handoff. It’s only a warm handoff if it’s effective. This is not effective,” Domb said. “I feel they have the burden to demonstrate that it hasn’t failed.”
Baystate could not be reached by email and phone for comment on this article.
In an email to Baystate Health CEO and President Peter Banko on Sept. 28, Domb noted that the referral’s success rate was 20%, which “falls below currently acceptable benchmarks for a healthcare referral completion rate.” She requested the institution look into data on patients transferring medical recorders to a new provider — an indication of continued healthcare with a different medical professional.
In a phone interview with the Gazette, Domb acknowledged many reasons for patients to not transfer to TransHealth. Some people age out of the restrictions, return to their pediatrician or a different provider or simply cease all care out of fear. But lack of information from Baystate should not be one of these reasons, Domb said.
In his Oct. 2 response, Banko said he shared Domb’s concerns . He notes the collaboration with TransHealth and movement of some patients into their adult endocrinology program aligns with the medical provider’s commitment to “preserve the integrity and continuity of services for impacted patients and their families.”
However, Baystate is legally prohibited from making referrals or contacting these patients about whether they have received care elsewhere.
“It is important to note that we did not terminate these patients, and, given legal and regulatory constraints, we did not and should not be making referrals,” Banko said. “If the patients are no longer ours, we are not legally permitted to contact former patients to see if, and where, they are getting care.”
Domb told Banko that his response was “disappointing and troubling.”
“Since we know that 200 Baystate patients did not successfully transfer their medical care to TransHealth (Baystate’s “partner”) and you have stated that you have not terminated any of these patients, I believe your ethical responsibility to the 200 remaining Baystate patients to ensure their continuity of care remains unfulfilled.”
Domb told the Gazette that she found Banko’s email contradictory.
“He said they aren’t their patients, but they also are their patients,” Domb said.
If there is a legal concern about contacting patients, then Baystate should consult their lawyers about solutions, Domb said.
In his email, Banko reiterated that “broader implications of federal policy” motivated Baystate’s decision to end gender-affirming care, likely referring to two proposed rules that would withhold federal healthcare funding for gender-affirming care providers. According to its statement at the time, 70% of Baystate patients are enrolled in Medicare and Medicaid.
However, these threats have not yet resulted in tangible consequences. An investigation by National Public Radio found the Trump administration never finalized the two proposed rules that would have implemented these threats.
On April 18, a federal judge struck down a declaration from U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. that gender-affirming care does not meet professional standards and cannot qualify for federal healthcare programs.
Massachusetts Attorney General Andrea Campbell send a legal advisory letter to healthcare providers in May affirming that no law prohibits medical practitioners from offering pediatric gender-affirming care. Failure to offer this care to minors may be considered discrimination on the basis of sex, gender identity or disability under Massachusetts state law, Campbell wrote.
Domb also requested that Baystate detail the conditions required to restart gender-affirming care. She was concerned about the loss of services after the initial announcement, and the low transfer rate has only reignited these worries.
Baystate has faced criticism for halting gender-affirming care since its initial announcement. Protesters have brought a political art installation to Baystate locations in Springfield, Greenfield and Northampton that depicts a blue bus with Baystate’s logo superimposed on stuffed child-sized shirts, jackets and pants. At their demonstrations, organizers have also called attention to the low transfer rate and Baystate’s failure to follow up with families.
