An Analysis of Gender-Affirming Care Offerings on United States Pediatric Hospital Websites: Exploring the Impact of State Legislative Bans.

Purpose: This longitudinal study compared the presence of information about gender-affirming care (GAC) on U.S. pediatric hospital websites in March 2022, when bans on the provision of pediatric GAC had been passed in two states, versus in October 2023, when bans had been passed in 22 states and implemented in 15 states without court blockage. Methods: All U.S. pediatric hospitals, sourced from online databases, excluding specialty hospitals (e.g., rehabilitation) were included (n = 149). In March 2022 and October 2023, two independent reviewers systematically reviewed each hospital website for GAC information. The presence of GAC information on websites was analyzed based on: 1) GAC legal status (legal, banned, or proposed ban blocked by court) in the hospital's state, (2) geographic location using the U.S. Census regions (Northeast, Midwest, South, and West), (3) the presence of hospital affiliation with a U.S. medical school, and (4) presence of hospital religious affiliation. Results: A total of 149 pediatric hospital websites were surveyed. In 2022, 105 (70%) hospital websites published content about GAC offerings versus 87 (58%) in 2023 (p = 0.001). This decrease in available information was significant in states where GAC bans had been passed without court blockage (60% vs. 29%, p = 0.001) and in the Southern region (63% vs. 39%, p = 0.004). Academic and secular hospitals were also more likely to include GAC information on websites. Conclusion: Legislation may hinder the ability of transgender youth and/or their parents to access previously available information about GAC and to identify local transgender care providers.