A lot is changing in U.S. health policy, and New York is feeling the ripple effects. Changes are showing up in New Yorkers’ appointments, prescriptions, and prevention tools.

This week’s Dose covers disruptions to youth gender-affirming care in NYC, a vaccine access package moving through the state legislature, and an update on measles cases in Rockland County.

Gender-affirming care disrupted at NYC’s major hospitals: what the whole community should know

NYU Langone has closed its gender-affirming care program for trans youth, and Mount Sinai has reduced or cut some services, leaving families scrambling for alternatives.

For a lot of families, gender-affirming care isn’t an abstract policy, it’s part of daily life. It’s a standing appointment. A prescription refill that keeps things steady. A clinician who knows their child, their history, what’s worked, what hasn’t.

So when that care changes suddenly, it can be destabilizing, with families describing abrupt changes and referrals to private clinics.

And this isn’t a small slice of NYC. While we don’t have data available on the number of trans youth in NYC, we do have an estimate for adults. Based on NYC survey data, about 0.6% of NYC adults identify as transgender—roughly 50,000 people. If kids make up about 20% of NYC’s population, the back-of-the-envelope math suggests there may be at least 10,000 transgender youth in NYC, too.

Why are there disruptions?

These stories are unfolding because federal funding cuts and regulatory pressure are disrupting gender-affirming care for minors across the country, including in New York.

The Trump administration has threatened to pull funding from hospitals and practices associated with hospitals that provide these services. They are also trying to end Medicaid coverage for gender-affirming care, which would mean that even if a family can find non-hospital-based care, they wouldn’t be able to access it if their insurance is through Medicaid.

I also want to call out some of the fear-based language in these federal documents.

Phrases like “sex-rejecting procedures” and “chemical and surgical mutilation” are meant to alarm and make people think of non-reversible treatments or “removing body parts.”

But that’s not what most families are facing right now. Most of the access being cut off is for puberty blockers—medication which pauses puberty and is reversible (when stopped, puberty resumes). Puberty blockers actually give families, children, and their clinical teams more time to make longer-term decisions. For a more detailed explanation, Those Nerdy Girls has a helpful post on puberty blockers.

It’s also worth putting surgery in context: a 2024 analysis of insurance data found that among minors aged 15–17, gender-affirming surgeries were rare—for every 100,000 minors, there were only ~2.1 surgeries.

The ray of light is that New York is pushing back.

The attorney general’s office told NYU Langone to resume care, noting the federal funding threats they cited aren’t currently in effect, and raising concerns the pause could violate state anti-discrimination law.

There is also a bill going through NY state legislature that would ensure that Medicaid covers gender affirming care in the absence of federal funding.

What this means: continuity of care is a health issue

For many families, “just go somewhere else” isn’t a real option—it’s waitlists, insurance challenges, travel across the city (or out of state), and clinical disruption piled onto a situation that can be stressful and sensitive. And when care gets interrupted, the ripple effects aren’t just medical, they also affect mental health, school, stability, and trust.

What to do: practical steps for families and caregivers

If your child is currently receiving care:

• Ask for a written transition plan that includes a timeline, prescription guidance, referral list, a record transfer process, and any important points of contact.

• Request copies of records now (visit notes, medication history, labs, etc.) and keep them for your records and for finding new care.
• Ask for prescriptions with plenty of refills if they are at a stable point in their care.
• Read this amazing piece by my friend MK that describes how to help kids feel emotionally safe during these uncertain times.
• Know these resources are available:
  • Trevor Project hotline for LGBTQ+ young people
  • Trevor Project’s Finding Support & Building Community Amid Political Uncertainty guide
  • Trans Lifeline
  • LGBT National Help Center
  • Organizations hosting in-person support spaces, including HMI, The Center, and The Black Trans Liberation Kitchen, among others
• Encourage hope. Here are some success stories you can share:
  • Society for Research on Adolescence: Trans Stories
  • Human Rights Campaign: Trans Stories are Everyone’s Stories: Daniel
  • The Trevor Project: Stories of Pride: Sophia

If you’re searching for care:

• The NYCHealthMap lists clinicians offering gender-affirming care for adults and youth (select LGBTQ Health Services > Gender Affirming Care >Youth).
• Connect with trusted local advocacy groups that often keep updated provider lists. Community Support Resources are listed on this NYC DOH Transgender Health page.
• When you call practices, ask directly: Are you accepting new adolescent/minor patients? What’s the wait? Do you take my insurance? What documentation do you need?

If you’re a clinician or educator:

• This is a moment to tighten safety nets: proactive check-ins, mental health supports, and warm handoffs are important.
• Don’t assume families have a backup plan. Encourage or help them set one up if possible.

At the end of the day, the most important things for kids affected right now are making them feel safe and maintaining access and continuity of care. This means steady and coordinated, not abrupt and fragmented.

Something to watch: a vaccine package going through the NY Senate

In response to the rapidly shifting federal vaccine landscape, New York State Senate Democrats are moving a package of vaccine-access bills through the state legislature this week.

Together, these seven bills would protect insurance coverage for vaccines regardless of changes in federal recommendations, expand who can vaccinate (like pharmacy techs, nursing students, and medical assistants), and ensure clinicians are reimbursed for the full cost of vaccination.

These bills still need to pass through the state assembly and be signed by Governor Hochul to become law, and the package could reach the Assembly as early as next week.

This isn’t about changing the science, it’s about protecting the infrastructure that helps maintain vaccine access in New York—insurance coverage, staffing, reimbursement—when federal guidance is actively damaging those systems.

Infectious disease “weather report”

Measles: Three measles cases were just reported in Rockland County, all international tourists visiting the county. Residents who were exposed to these measles cases have been notified and are being closely monitored.

Rockland County has had large outbreaks of measles previously—last year there were more than 20 cases, and in 2019 there were more than 300. The county has some pockets vulnerable to measles—in some zip codes, fewer than 50% of eligible infants are vaccinated, far below the 95% needed for community protection.

The best thing to do right now is check the vaccination status of everyone in your family, and get up to date if needed. If you’re unsure whether you or your child is immune, talk to your healthcare provider.

RSV: For the tenth week in a row, RSV remains quite high.

Who should pay extra attention right now because of RSV risks:

• Older adults
• People with chronic conditions
• Pregnant people (to protect newborns)
• Families with young infants

What to do:

• Same as last week—if you’re eligible and haven’t gotten protected yet this season, it’s still worth doing because we have weeks ahead of us of elevated activity.
• Layer in protections when you can: avoid visiting newborns or older people when sick, mask in crowded indoor spaces, and keep an eye on breathing symptoms in little kids (fast breathing, retractions—when the skin sucks in around the ribs, collarbone, or stomach with each breath—or dehydration).

Flu: Across New York state and in NYC, flu cases have increased slightly. Flu is still relatively low compared to the season so far, but it’s something to keep an eye on.

Covid: Covid cases are holding steady, while ED visits are going down. Overall, Covid remains low compared to previous winters.

Bottom line

If you or your loved ones are affected by disruptions to gender affirming care, prioritize continuity (records, refills, and a written transition plan) and supporting mental health. For other community members, now’s the time to support the kids and families navigating these disruptions.

Love,

Your NY Epi

Dr. Marisa Donnelly, PhD, is an epidemiologist, science communicator, and public health expert. This newsletter exists to translate complex public health data into actionable insights, empowering New Yorkers to make informed and evidence-based health decisions.