While much of the transgender debate has surrounded restricting so-called gender affirming care to minors, most acknowledge that legal adults can make the decisions to undergo hormone treatments and consent to such surgeries. However, with the federal government and certain states restricting taxpayer dollars from funding youth transgender surgeries, hospitals that offered this service are closing their doors in order to protect their Medicare and Medicaid funding. This has also produced a chilling effect on the less lucrative adult-end of transgender surgeries.
Vanderbilt University Medical Center (VUMC), Tennessee's sole provider of adult transition surgeries, has decided to discontinue the practice, "citing operational limitations." This is a first occurrence of a hospital closing out its adult wing for sex-change operations; it probably will not be the last.
Vanderbilt University Medical Center is discontinuing surgeries for transgender adults, the latest announcement for the Nashville hospital after a series of escalating concerns about its care for LGBTQ+ patients.
In a statement to the Nashville Scene, VUMC said:
Vanderbilt confirmed the end of gender-affirming surgeries to the Scene with a written statement. These surgeries include orchiectomies, a testicular removal surgery, and subcutaneous mastectomies, the removal of breast tissue also known as “top surgery.”
“Due to operational limitations and lack of surgical coverage, Vanderbilt Health will cease providing gender-affirming plastic surgeries for adults,” said a VUMC spokesperson in an email Friday afternoon. “Vanderbilt Health continues to provide nonsurgical gender-affirming care for adults 19 years and older. Vanderbilt Health does not provide any gender-affirming care for patients younger than 19. We are in the process of contacting our patients regarding these changes.”
VUMC has signaled this big change through a series of incremental ones. VUMC stopped its trans surgeries and puberty blockers for minors in 2022 when the TN legislature first passed its transgender ban, which held after the Skrmetti decision. In 2025, VUMC closed its LGBTQ health clinic. So, the handwriting was on the wall that VUMC was looking to the future and seeing that the potential risks of offering these surgeries to adults would outweigh any reward.
The VUMC health care system, which has been legally separate from Vanderbilt University since 2016, suspended gender-affirming surgeries for people under 18 in 2022 following a state ban on the treatment. That ban was upheld after reaching the U.S. Supreme Court. VUMC also turned over a list of transgender patients’ health records to Tennessee Attorney General Jonathan Skrmetti in 2023. Last year, VUMC gutted its specialized LGBTQ health clinic, a severe blow to transgender health. Conservative media and politicians, including Tennessee's U.S. Sen. Marsha Blackburn, previously attacked VUMC for offering transgender health care.
Read More: Falling Like Dominoes: NYU Langone Health Hospital Will End Its 'Transgender Youth Health' Program
TN Scores Big Win - Court Strikes Down Biden Title IX Rule Expanding 'Sex' to Gender Identity
As RedState reported, 22-year-old Fox Varian, a female who identified as male when she was 16, then underwent a full mastectomy, successfully sued and won a two-million-dollar settlement against the surgeon who performed the surgery and the psychiatrist who convinced her and her parents that this was the right thing to do. Prominent detransitioner Chloe Cole, who suffered a similar fate as Varian and has her own lawsuit pending against California doctors who transitioned her starting at the age of 12, said this of Varian's win:
Cole believes the new guidance and recent legal victory could lead to a wave of additional lawsuits.
"These lawsuits are going to flood the court system and make it so that these doctors realize that there is a huge liability to these procedures and give them no other sane choice but to stop doing this to children," she said.
According to legal analysts, it won't be just how the children are affected, but could open the door for adults who transition and then choose to detransition, as well as their families, to also mount lawsuits. There is even the possibility that victims of transgender killers like Audrey Hale could also find a path to liability. The legal landscape is often about testing precedents.
The ruling has quickly become part of broader public discussions about medical autonomy, youth healthcare, and the role of parents and clinicians in high-stakes decisions. Supporters of the verdict view it as accountability for providers who move too quickly. Others warn against drawing sweeping conclusions from a single case.
From a policy standpoint, the decision may be cited in legislative debates, insurance risk assessments, and regulatory discussions. However, it does not itself change medical guidelines or establish new laws.
Instead, it reflects how juries may evaluate similar claims in the future based on evidence presented at trial.
Just as we are seeing medical associations and hospitals changing their policies on transitioning minors, expect to see more hospitals also looking into the future and taking more definitive action on whether it is legally and operationally cost-effective to continue these transition practices for adults.
Editor’s Note: Do you enjoy RedState’s conservative reporting that takes on the radical left and woke media? Support our work so that we can continue to bring you the truth.
Join RedState VIP and use the promo code FIGHT to get 60% off your VIP membership!
Join the conversation as a VIP Member