Growing up, Sage Sol Pitchenik wanted to hide.
"I hated my body," the nonbinary 16-year-old said. "I hated looking at it."
When therapy didn't help, Pitchenik, who uses the pronoun they, started going to the Center for Transyouth Health and Development at Children's Hospital Los Angeles, the country's biggest public provider of gender-related care for children and teens. It changed their life.
But in response to the Trump administration's threat to cut federal funds to places that offer gender care to minors, the center will be closing its doors July 22. Pitchenik has been among the scores of protesters who have demonstrated regularly outside the hospital to keep it open.
"Trans kids are done being quiet. Trans kids are done being polite, and trans kids are done begging for the bare minimum, begging for the chance to grow up, to have a future, to be loved by others when sometimes we can't even love ourselves," Pitchenik said, prompting cheers from dozens of protesters during a recent demonstration.
They went to the center for six years.
"There's a lot of bigotry and just hate all around, and having somebody who is trained specifically to speak with you, because there's not a lot of people that know what it's like, it meant the world," they told The Associated Press.
The center's legacy
In operation for three decades, the facility is among the longest-running trans youth centers in the country and has served thousands of young people on public insurance.
Patients who haven't gone through puberty yet receive counseling, which continues throughout the care process. For some patients, the next step is puberty blockers; for others, it's also hormone replacement therapy. Surgeries are rarely offered to minors.
"I'm one of the lucky ones," said Pitchenik, who received hormone blockers after a lengthy process. "I learned how to not only survive but how to thrive in my own body because of the lifesaving health care provided to me right here at Children's Hospital Los Angeles."
Many families are now scrambling to find care among a patchwork of private and public providers that are already stretched thin. It's not just patient care, but research development that's ending.
"It is a disappointment to see this abrupt closure disrupting the care that trans youth receive. But it's also a stain on their legacy," said Maria Do, community mobilization manager at the Los Angeles LGBT Center. "I think it showcases that they're quick to abandon our most vulnerable members."
The closure comes weeks after the Supreme Court upheld Tennessee's ban on gender care for minors, amid other efforts by the federal government to regulate the lives of transgender people.
The hospital initially backed off its plans to close after announcing them in February, spurring demonstrations, but later doubled back.
The center said in a statement that "despite this deeply held commitment to supporting LA's gender-diverse community, the hospital has been left with no viable path forward" to stay open.
"Center team members were heartbroken to learn of the decision from hospital leaders, who emphasized that it was not made lightly, but followed a thorough legal and financial assessment of the increasingly severe impacts of recent administrative actions and proposed policies," the statement said.
California Attorney General Rob Bonta has warned that by closing the center, the hospital is violating state antidiscrimination laws, but his office hasn't taken any further action. Bonta and attorneys general from 22 other states sued President Donald Trump's administration over the executive order in February.
"The Trump administration's relentless assault on transgender adolescents is nothing short of an all-out war to strip away LGBTQ+ rights," Bonta told the AP in an email. "The Administration's harmful attacks are hurting California's transgender community by seeking to scare doctors and hospitals from providing nondiscriminatory healthcare. The bottom line is: This care remains legal in California."
LGBTQ+ protesters and health care workers offer visibility
Still wearing scrubs, Jack Brenner joined protesters after a long shift as a nurse in the hospital's emergency room, addressing the crowd with a megaphone while choking back tears.
"Our visibility is so important for our youth," Brenner said, looking out at a cluster of protesters raising signs and waving trans pride flags. "To see that there is a future, and that there is a way to grow up and to be your authentic self."
Brenner, who uses the pronoun they, didn't see people who looked like them growing up or come to understand what being trans meant until their mid-20s.
"It's something I definitely didn't have a language for when I was a kid, and I didn't know what the source of my pain and suffering was, and now looking back, so many things are sliding into place," Brenner said. "I'm realizing how much gender dysphoria was a source of my pain."
Trans children and teens are at increased risk of suicidal thoughts and behaviors, according to a 2024 study from the Centers for Disease Control and Prevention.
Brenner described encountering young patients in the emergency room who are trans or otherwise on the gender-nonconforming spectrum and "at the peak of a mental health crisis." Brenner wears a lanyard teeming with colorful pins emblazoned with the words "they/them" to signal their gender identity.
"I see the change in kids' eyes, little glints of recognition, that I am a trans adult and that there is a future," Brenner said. "I've seen kids light up when they recognize something of themselves in me. And that is so meaningful that I can provide that."
Beth Hossfeld, a marriage and family therapist and a grandmother to an 11- and 13-year-old who received care at the center, called the closure "patient abandonment."
"It's a political decision, not a medical one, and that's disturbing to me," she said.