Dear Community,
I am writing to provide the entire Fenway Health community with an update that we recently shared directly with individuals under the age of 19, who receive medical gender-affirming care. Due to a change in federal requirements that took effect on October 1, 2025, Fenway Health will not provide hormones and puberty blockers for patients under the age of 19.
We know that many of you have already heard this news and wanted to take the opportunity to share the background behind this difficult decision and the steps we took to support our impacted patients. Before I share more, I want to be clear that as a mission-based entity committed to providing inclusive care to the entire LGBTQIA community, we did not come to this decision lightly.
How did we get here? The US Department of Health and Human Services (HHS) recently issued a revised Grants Policy Statement which allows it to terminate a grant “for convenience” if it “no longer effectuates the program goals or agency priorities.” Health Resources and Services Administration (HRSA) recently released priorities that make clear that providing hormones and puberty blockers for patients under age 19 is no longer an HHS goal or priority.
What would it have meant to continue providing gender-affirming care given this policy change? If we continued the service, our status as a Federally Qualified Health Center (FQHC) would have been at serious risk. Maintaining this designation is essential to our ability to continue providing high-quality, affordable care to more than 30,000 people across New England and beyond. Losing this status would significantly limit our ability to further serve the community we love as we have for decades.
How are we supporting impacted patients? Once it became clear that we would no longer be able to provide hormones and puberty blockers for patients under the age of 19, we focused on a process for engaging directly with impacted patients and their families. We provided details on how they could continue to receive care not provided by Fenway with other entities not impacted by the revised grants policy statement and HRSA’s priorities. These conversations were conducted with sensitivity and compassion for the unique challenge created by a change in trusted provider. We are grateful to the team members who led this important work, even as they navigated their own response to this policy change.
We know this news is heartbreaking to our entire community of patients, staff, clinical partners and supporters – we carry that with you. Please know: this change does not reflect our values, our belief that gender-affirming care saves lives, or our unwavering commitment to the transgender and gender-diverse community. It reflects a painful reality that we are working to change. All other services and care for patients of all ages and identities remain fully available and unchanged. We understand, hear, and respect that some in our community disagree with this decision. We reached it based on careful and difficult consideration of what we believe is best for our mission given our current options.
We continue to stand firmly with our transgender and gender-diverse patients, families, and community members. We are doing everything in our power to navigate a fast-moving policy and funding environment in a way that centers compassion, respect, and continuity of care for everyone who depends on us. While our primary focus is on the direct care we provide our patients, we will continue our longstanding history of advocating for policies, funding, and access to a wide range of services that support the health and well-being of the LGBTQIA+ population, and all members of the community we serve.
These are unprecedented times. But we remain committed to walking through them together – with you. I acknowledge that our communication about this change fell short and caused confusion and concern. I am committed to improving how we communicate moving forward.
With care and solidarity,
Jordina Shanks
CEO, Fenway Health