Dear Community,

We know that many members of our community are experiencing concern, disappointment, and uncertainty following recent changes to gender-affirming care services at Open Door. We understand how deeply personal this issue is for many patients, families, staff, and community members, and we want to share clear information about what is changing, why this decision was made, and how we are supporting those affected.

In recent months, federal agencies have issued new guidance indicating that certain gender-affirming treatments for patients under age 19 are no longer aligned with current federal priorities, specifically related to gender affirming medications and surgery. These developments have created significant uncertainty regarding funding and regulatory oversight for healthcare organizations that provide these services. After extensive review and consultation, we concluded that continuing to initiate these treatments could jeopardize resources that support essential healthcare services for more than 60,000 patients throughout Humboldt and Del Norte counties who depend on us for their care.

Open Door will no longer initiate hormone therapy or prescribe puberty blockers for patients under age 19. Importantly, patients who are currently receiving these treatments through Open Door will continue their existing care and treatment plans without interruption.

This was an extremely difficult decision, and one that weighs heavily on us. We understand that this news may be mentally, physically, and/or spiritually painful for many members of our community, particularly transgender and gender-diverse youth and their families. We carefully explored every available option before reaching this conclusion and did not make this decision lightly.

Why did this change occur?

The U.S. Department of Health and Human Services (HHS) recently revised its Grants Policy Statement to allow grant funding to be terminated if a program no longer aligns with federal goals or agency priorities. This means they can terminate a grant “for convenience” if it no longer effectuates the program goals or agency priorities.

Termination of our federal grant funding would place our Federally Qualified Health Center (FQHC) status at risk, which is essential to our ability to provide comprehensive, affordable care to our community.

How are we supporting affected patients?

We are committed to ensuring that no patient faces this transition alone.

Our care teams are reaching out to affected patients and families individually to discuss their options, facilitate referrals, and help connect them with alternative providers whenever possible, working to support the unique needs of each patient in accessing safe, high-quality care. We recognize that transitions in care can be stressful and emotional, and our goal is to provide support, accurate information, and compassion throughout the process.

We are also deeply appreciative of our staff members, who continue to show extraordinary care and professionalism while supporting patients and families through this challenging transition. We are also aware of efforts by community partners to preserve local access to gender-affirming care for people of all ages, and we look forward to offering our support in any way we can.

Our commitment remains unchanged

We want to be unequivocally clear: this decision does not reflect a change in Open Door’s values, nor does it diminish our commitment to transgender and gender-diverse patients.

The decision was driven by changes in the federal funding and policy environment, not by a change in our belief that every person deserves dignity, respect, compassionate care, and a sense of belonging within our healthcare system. If the policy regarding GAC services is reversed, we will resume medication management services to our patients under 19 years old.

All other Open Door services remain available and unchanged for patients of all ages, identities, and backgrounds. We understand that some members of our community may disagree with this decision, and we respect those perspectives. We reached this conclusion only after careful consideration of how best to preserve healthcare access for the communities we serve.

Open Door remains committed to supporting transgender and gender-diverse patients, families, and community members. We will continue to advocate for policies, funding, and healthcare access that promote the health and well-being of LGBTQIA+ individuals and all members of our community.

Sincerely,

Tory Starr, MSN, PHN, RN
Chief Executive Officer, Open Door Community Health Centers