MaineHealth, the state’s largest hospital network, said this week that it would work to find ways to connect minors to gender-affirming care, even if proposed federal rules take effect that would effectively prohibit hospitals from offering those services.

Robert F. Kennedy Jr., the Trump administration’s Health and Human Services secretary, announced on Thursday that, under the proposed rules, hospitals would be prohibited from participating in the Medicare and Medicaid program if they provided gender-affirming care.

Dr. Andy Mueller, CEO of MaineHealth, the parent organization of Maine Medical Center in Portland and seven other hospitals in the state, said in a statement on Thursday that “for transgender youth, these medical treatments can be lifesaving.”

“We are determined to do everything in our power to ensure that our patients get the best, evidence-based care,” Mueller said.

Gia Drew, executive director of EqualityMaine, a nonprofit that advocates on behalf of the LGBTQ+ community, said regardless of what workarounds hospitals come up with, the rules would make it more difficult to access gender-affirming care.

“A lot of folks won’t get the care they need and that’s terrifying,” Drew said. “It’s going to leave lasting scars.”

The rule-making process takes at least 60 days and, in the interim, the federal government will accept public comments.

“So-called gender affirming care has inflicted lasting physical and psychological damage on vulnerable young people,” Kennedy said at a news conference in Washington on Thursday, according to media reports. “This is not medicine. It is malpractice.”

The American Academy of Pediatrics, a trade group representing pediatricians across the country, has said that gender-affirming care is the standard medical care for people who need such services.

“These rules are a baseless intrusion into the patient-physician relationship,” AAP President Dr. Susan Kressly said in an interview with National Public Radio on Thursday.

MaineHealth, according to its statement, is examining ways to refer patients to clinics that do not participate in Medicaid or Medicare, so that gender-affirming care provided by the hospital system, consisting of puberty blockers and hormone replacement therapy, could continue for those patients.

“We are disappointed that the federal government has taken steps to interfere with our ability to offer evidence-based care to our patients,” Mueller said in the statement.

MaineHealth, according to the statement, would continue to provide behavioral health treatment for transgender youth that does not include puberty blockers and hormone therapies, as the federal rules would only apply to those medications or surgeries. John Porter, a spokesperson for MaineHealth, said the hospital system does not perform gender surgeries for minors.

Suzanne Spruce, a spokesperson for Northern Light Health — which is the second-largest hospital network in Maine and operates Mercy Hospital in Portland and Eastern Maine Medical Center in Bangor — said in a statement that the health system will review “proposed rules that affect health care and will submit comment to the federal government.”

Drew, at EqualityMaine, said even though hospitals may find ways to bypass the rules, it would still result in reduced access for several reasons, including that many minors have Medicaid insurance. If a clinic outside of the Medicaid system offers gender-affirming care, the cost to the patient would be out-of-pocket, Drew said.

“We don’t want to have to go to the black or gray markets to get health care,” Drew said. “This is an attempt to use transgender kids as a political pawn and it could have devastating impacts.”

About 1% of those age 13 and older identify as transgender, according to a 2025 report by the UCLA Williams Institute. Less than 0.1% of youth ages 8 to 17 use puberty blockers or hormone replacement therapy, according to a 2025 Harvard University study.

Groups that support transgender youth, including the American Civil Liberties Union, have said they will fight the proposed rules in court. The ACLU said it planned to file a lawsuit against the Trump administration if the rules are approved.

In August, Maine joined 14 other states, including Massachusetts, New York, Connecticut and California, in suing the Trump administration over “threats of civil and criminal prosecution” of health care providers that offer gender-affirming care. That lawsuit is pending in U.S. District Court in Massachusetts.

Twenty-seven states have laws that prohibit gender-affirming care for minors, and the U.S. Supreme Court ruled in June that states can institute such bans.