Chicago family seeks asylum in Canada amid federal attacks on gender-affirming treatment
Nicholas Reeve, his wife Amanda Reeve and their transgender son Sam Reeve, who all requested to go by pseudonyms for fear of retaliation, devised an “escape plan” for their family in anticipation of the 2024 presidential election.
Nicholas, a Northwestern University employee, and Amanda worried what another four years under President Donald Trump’s leadership could mean for their preteen transgender son’s access to gender-affirming care. The Reeves said the risk of trauma from potential treatment interruptions was intolerable.
For the Reeves, Election Day concluded with one certainty among a sea of questions: They would move to Canada.
The Trump administration’s attack on gender-affirming healthcare
A week into his second term, Trump signed an executive order to halt federal funding for hospitals that provide gender-affirming care for people under age 19.
Specifically, the order aims to block access to puberty blockers, hormones used to stop the body from producing estrogen and testosterone, as well as surgical procedures that align a person’s appearance with their gender identity. The order characterizes gender-affirming care and surgeries as “mutilation,” a term widely disapproved of by activists and many medical professionals.
Under the executive order, Northwestern Medicine cut care for approximately 35 patients seeking gender-affirming surgery, according to sources within the Feinberg School of Medicine, who all requested anonymity. This group includes patients who recently came under the care of NM after just turning 18.
On the same day Trump signed the initial executive order, he signed another order that removed recognition for transgender, nonbinary and intersex people, directly impacting gender-affirming care from providers like NM and Ann & Robert H. Lurie Children’s Hospital of Chicago.
In response to Trump’s policies, Lurie Children’s released a statement in early February announcing a pause in gender-affirming surgeries for patients under the age of 19 until further notice.
The statement, however, did not disclose any changes to hormone therapy or puberty blocker access.
An NM spokesperson did not immediately respond to a request for comment on Lurie Children’s and NM’s changes to gender-affirming treatment in light of Trump’s executive orders.
Access to gender-affirming care was already a long process
Sam came out as transgender two years ago and started on a puberty blocker in April 2024 under the Biden administration. He plans to begin testosterone hormone therapy in the near future. But to access gender-affirming care, the Reeves said they had to jump through many hoops.
Initially, the Reeves said they encountered long waiting lists to see a social worker and a gender therapist. Then, to get puberty blockers, Sam had to have a primary physician validate his formation of breast buds to get a referral to see a doctor at Lurie Children’s.
Amanda estimated that it took six to eight months to get a foot in the door in the hospital’s gender identity clinic. Sam is still receiving care at Lurie Children’s while the Reeves transition their lives to Canada.
“I feel like in our political climate, people are getting the impression that hormone suppressants are being handed out at public school or that children can just decide these things and that the parents are not involved,” Amanda said. “It’s so frustrating, because I’ll tell you, it was so hard.”
Puberty blockers only delay puberty, which allows patients time to start hormone therapy before puberty begins for the sex they were assigned at birth.
Amanda said Sam’s doctors hope to get him started on testosterone as soon as possible, naming concerns with reduced bone density and muscle growth when on puberty blockers.
“They don’t want to delay puberty too much, because it’s not good for the kids, socially and emotionally,” Amanda said.
Straddling the U.S. and Canada
Sam is finishing the school year in Chicago, spending more time with his biological father, while Amanda lives in the Greater Toronto Area full-time to establish residency. Meanwhile, Nicholas travels frequently to Canada while working full-time in a hybrid position at NU.
Amanda was able to relocate to a Canadian office of the same company she worked for in Chicago, but said she took a pay cut in the process.
Sam’s biological father is also moving to Canada this summer, hopeful to receive a student visa through enrollment in a graduate program.
The Reeves had to sell their dream home in Chicago to afford both residences in Evanston and Toronto.
“As a result of all of this, what I call political persecution of transgender people, we had to sell that house. … That’s the house where we became a family,” Amanda said. “To me, it’s just another symptom of the whole, like, ‘Do they even know what they’re doing, putting families through this kind of stuff?’”
Despite the financial sacrifices and downsizing of their lives, the Reeves said they feel “profoundly privileged” to be able to prioritize the health and wellness of their son.
At a family camp, the Reeves met other families with transgender children and have kept in touch with several families since. The couple said many of the families they met are facing similar predicaments with the future of gender-affirming care in several Midwestern regions, as well as an increasingly transphobic sociopolitical climate.
“How many families can afford to sort of straddle these two countries and make this transition? I mean, so many stars had to align for us to be able to do this,” Amanda said.
The treatment cuts might also affect cisgender people
Although Trump’s executive orders impacted the Reeve family because of Sam’s transgender identity, non-transgender people could be affected as well.
A bilateral mastectomy, which is the procedure used to remove both breasts on an individual, is used in both gender-affirming care and breast cancer treatment. The surgery used to treat gynecomastia, which is the abnormal enlargement of breast tissue, is extremely similar to this procedure. a request from The Daily to discuss
Because of this, an Illinois hospital denied a male teenager from getting his gynecomastia surgery in early February, citing that it could be classified as gender-affirming care.
An NM spokesperson declined to comment on the cancellation and rescheduling of gynecomastia surgeries at NM.
Bilateral mastectomies have been halted for transgender patients under the age of 19 at NM. The Reeve family, however, doesn’t think that the treatment cuts will end there.
“Lurie thinks not doing mastectomies is sufficient, but in another month, (the Trump administration) might decide, ‘Uh oh, we can’t do blockers anymore, either, right?’” Amanda said.
The other parties invested
Patients at NM are not the only people who have taken issue with the hospital’s gender-affirming care cutbacks.
Medical personnel and patients haven’t been informed about the exact care being cut after Trump signed his executive order targeting gender-affirming care for minors.
After NM began cutting care, students at Feinberg shared a petition directed at NM advocating against the care cuts and for increased transparency for both medical personnel and patients.
The petition — which was organized by Adam Davies and Rachel Washart, co-founders of the Gender Affirming Care Interest Group at Feinberg — received over 160 signatures. Signatories were primarily third- and fourth-year medical students, as well as participants in a physician assistant program and clinical psychologists.
“We as students are in the dark. I can’t speak for providers, but it seems like patients are also in the dark,” Davies said. “We don’t know exactly how they’re policing this.”
The petition pointed out an alarming aspect of Lurie Children’s and NM’s compliance with the federal regulations — they’re the only hospitals in the Chicago area doing so.
The petition noted that this goes against NM’s stated commitment to “deliver world-class, culturally competent care regardless of ability to pay, race, age, gender, sexuality or any other social factor, in the communities where our patients live and work.”
Still, gender-affirming procedures are happening in the Chicago area at non-NU institutions, Washart said.
“The fact that Northwestern has paused, and to our knowledge, is one of the only big institutions that really has, speaks to our confusion in this case,” she said.
Equal rights groups have also caught onto NM’s cutbacks on gender-affirming care
Equality Illinois shared a press release on Feb. 6, denouncing both NM’s pausing of certain types of gender-affirming surgery and Lurie Children’s lack of clarity about which procedures are being cut.
What’s in store for the Reeves and transgender Chicagoans
Davies said they feel confident that transgender patients can continue to find gender-affirming care in the Chicago area.
“I think that trans young people, in Chicago specifically, are still going to be able to access care that they need,” Davies said. “It just won’t include Northwestern Medicine (and) Lurie Children’s Hospital for gender-affirming surgeries.”
For the Reeve family, however, the risk of their child losing access to gender-affirming care in the future was enough to spur their move to Canada from Chicago — a city the Reeves were making their permanent home.
“If a miracle occurs, I feel safe, and I think my child is safe, then it would be wonderful to return,” Amanda said. “My expectation and what I’m girding myself for is that we’re going to be here for six years, until (Sam’s) an adult, and then he’ll be going to college, and wherever he goes to college. Do we want to move? We will have to figure out what we want to do at that time. But that’s a 2030 me problem.”
Email: [email protected]
Email: [email protected]
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