Millions for gender-affirming care nixed from New York state budget after months of reassurances, advocates say

During the recent New York state budget negotiations, Lorelei Crean, a lead organizer of the nonprofit NYC Youth 4 Trans Rights, received assurances from state senators and Assembly members that gender-affirming care would receive funding. 

But on the morning of May 28, Crean awoke to the news that the money was not in the final $268.5 billion budget, a decision that has outraged trans New Yorkers and advocates amid the Trump administration’s mounting attacks against gender-affirming care access nationwide. From the start of the legislative session in January, trans healthcare advocacy groups, reproductive rights organizations, and LGBTQIA+ groups pushed for the creation of an $8 million fund to shore up gender-affirming care from threats to strip federal funding from hospitals that provide such care for youth.

One state legislator and three advocates with close ties to the capitol in Albany told Prism that they had been optimistic that the fund would be included in the budget; it was written into both the Senate and Assembly draft budgets and had broad support among the Democratic rank and file. But ultimately, the fund did not end up in the approved budget. 

Due to the notoriously opaque and undemocratic nature of New York’s budget process, it’s unclear when the decision was made to cut the funding and who was present at the closed-door meetings where the budget is typically finalized.

New York Assembly Speaker Carl Heastie and President Pro Tempore and Majority Leader Senator Andrea Stewart-Cousins did not respond to requests for comment.

In a statement, New York Gov. Kathy Hochul’s office defended her record on trans rights. “Since taking office, Governor Hochul has been a strong advocate for the LGBTQ+ community, investing $15M in funding for transgender and non-binary wellness and equity,” said Deputy Press Secretary Nicolette Simmonds.

Amanda Babine is the executive director of Equality New York, a group that advocated for the fund to protect gender-affirming care in Albany. She said the proposal offered elected officials an opportunity to stand up for a community they claim to champion. 

“They left transgender people hanging,” she told Prism. “We’re absolutely furious about that.”

New York is known as a safe haven for queer and trans communities, and the birthplace of the LGBTQIA+ rights movement in the U.S. In 2023, Hochul signed a law to protect trans youth, their parents, and their healthcare providers. But as threats begin to materialize, some advocates question whether lawmakers will remain committed to the community.

“New York is supposed to be a sanctuary city for transgender people. Then the highest members of state government suddenly ripped [out] the funding that had been widely agreed upon and advocated for by both elected officials in Albany and advocates across the city and state,” Crean said. “That is a real gigantic betrayal.”

Attacks on gender-affirming care

Since taking office for the second time last year, President Donald Trump’s cruel and consistent attacks on gender-affirming care have had a grievous impact on trans people across the country, including in New York. 

After Trump issued executive orders threatening federal funding for hospitals that provide youth gender-affirming care, some New York hospitals, including NYU Langone and Mount Sinai, opted to cease taking on new patients who are minors. In February, after the federal government proposed rule changes to strip Medicaid funding from hospitals that treat trans children, Langone and Sinai completely shuttered their transgender youth healthcare programs. In recent weeks, both NYU Langone and Mount Sinai revealed that they received federal grand jury subpoenas for patient and personnel records related to their youth gender-affirming care programs. Mount Sinai reportedly told families that they plan to comply with the subpoena.

State Sen. Kristen Gonzalez represents the 59th District that covers Queens, Brooklyn, and Manhattan, where many medical institutions are located, including NYU Langone. She said the shuttering of these hospital programs sparked an immense amount of organizing in her district. In addition to speaking at rallies and helping organize a letter campaign to push NYU Langone to restore care, Gonzalez asserted it was important to create the fund so immediately impacted families could continue seeking care, even if it meant transitioning to a less affordable provider.

“It’s been part of a broader fight, but this year it was more important than ever to have a gender-affirming care fund,” she told Prism.

The proposed fund sought to support both providers and patients in the form of grants. Hospitals and clinics would have been paid for uncompensated care and gotten assistance to pay staff, buy equipment, or otherwise absorb patients who had been displaced from other providers. The funds would also have been made available to patients and their families, if, for example, they needed to travel to obtain care. 

When state budget negotiations began in March, Democratic legislators in both chambers agreed that the Trump administration’s targeting of trans people was an existential crisis, said Gonzalez. Both the Assembly and the Senate included the fund in their budgets, with the Assembly allocating the full $8 million and the Senate allocating $4 million, she explained to Prism.

The broad support gave advocates and legislators hope that the money would be incorporated into the executive budget. “We were confident,” said Kei Williams, executive director of the New Pride Agenda.

That excitement dissipated in the last few days of the session, as Assembly and Senate leaders met with the governor’s office in closed-door meetings to hash out the final budget, advocates familiar with the discussions told Prism. On May 27, when the budget was released, advocates and trans New Yorkers were devastated to learn the money wasn’t there. 

When asked what role legislative leadership played, Gonzalez said both chambers were supportive of gender-affirming care. “It was always the Senate and Assembly vision to want to get this done,” she said.

“The budget is called the executive budget for a reason,” she added. “If the governor wanted there to be money for it, there certainly would be.”

A budget is a moral document. It’s a document that shows your values. At the end of the day, [the funding] is not there.

Kei williams, executive director of the New Pride Agenda

For Williams, the question of who’s to blame may be beside the point, given that lawmakers and the governor ultimately approved the budget. “A budget is a moral document. It’s a document that shows your values,” they said. “At the end of the day, [the funding] is not there. That’s the baseline impact.”

Meanwhile, New York City Mayor Zohran Mamdani appears to have pulled back on a promise made during his campaign to fund gender-affirming care at the city level. Mamdani shared in an interview with WNYC earlier this month that only $15 million over two years has been earmarked in the city’s budget for gender-affirming care—a far cry from the $65 million he proposed during the election. 

The city’s Department of Health and Hygiene announced last week that a new city-run clinic would provide gender-affirming care to trans and nonbinary residents—but not to anyone under 19.

The mayor’s office did not respond to a request for comment.

Falling short on healthcare and LGBTQIA+ programs

The nixed gender-affirming care fund is among several decisions at the state level that fail to adequately provide for healthcare and LGBTQIA+ programs.

Elected officials failed to help avert a healthcare crisis looming this summer, as 450,000 New Yorkers impacted by federal cuts are set to lose coverage on the state’s Medicaid Essential Plan, which provides free or low-cost coverage to residents ineligible for Medicaid.  

While the state budget does set aside $1.8 million for LGBTQ+ youth crisis services, there was no movement on a bill to ensure continued state Medicaid and private coverage for gender-affirming care.

After the budget was finalized, Hochul said she would allocate $500,000 to the Lorena Borjas Transgender Wellness and Equity Fund, which provides critical support to trans-led organizations working to enable community health and employment. However, it remains unclear where the money would come from. 

“The winners in this budget saw funding cuts,” said Allie Bohm, senior policy counsel at the New York Civil Liberties Union. “The losers saw no funding at all.” 

Cuts were also made to the Runaway and Homeless Youth Fund, said Nadia Swanson, the director of advocacy and global programs at the Ali Forney Center, a group that supports unhoused LGBTQ+ and at-risk youth.

Trans people from around the world come to New York to access legally protected healthcare services. That spike has led to a growing need for Ali Forney’s emergency housing and support programs. Swanson said the center’s waiting list is about 400, compared with about 300 last year. But those individuals can’t be housed without sufficient funding, they said, especially given federal cuts to homelessness assistance.

The issues in the state budget go well beyond the failure to fund gender-affirming care, said Ceyenne Doroshow, the founder and executive director of GLITS, a Black-led, trans advocacy organization. 

There’s so much that needs to go along with gender-affirming care, like safety, like safe, affordable housing, like person-to-person care with mental health providers.

Ceyenne Doroshow, executive director of GLITS

“There’s so much that needs to go along with gender-affirming care, like safety, like safe, affordable housing, like person-to-person care with mental health providers,” she told Prism. “We’re thinking more about the aesthetic than the real-life situation, which is—after you get all this care, where are you working? What are you doing with your life?”

As lieutenant governor, Hochul invested significant time on trans-led initiatives, including by calling for the repeal of the “walking while trans” anti-loitering law. But according to advocates, her support for the LGBTQIA+ community has waned since becoming governor. 

“There was clearly a time not that long ago where she was very vocal about trans issues,” said Babine of Equality New York. “And so it’s very disappointing to see now that that isn’t the case.”

According to Bohm, in the last legislative session, Hochul vetoed three out of four LGBTQIA+-related bills. She signed an updated shield law to protect people who provide or receive abortions or gender-affirming care.

Meanwhile, trans New Yorkers continue to struggle to get the healthcare they need. Asked how state residents will be impacted by the lack of funding for gender-affirming care, Williams of New Pride Agenda told Prism, “We’re already living in it, which is why this fund was so necessary.”

“Transgender healthcare may have not always existed at the institutional level, but trans folks have always found a way to be affirmed in their bodies and their existence,” Williams said. “So regardless if it’s coming out of a regulated clinic or a regulated hospital, transgender [and] gender-nonconforming people will continue to access care.”

Editorial Team:
Rashmee Kumar, Lead Editor
Tina Vasquez, Top Editor
Stephanie Harris, Copy Editor