This article was originally reported by Caleb Kaufman of Pittsburgh’s Public Source, copublished with The 19th, and republished through Rewire News Group’s partnership with The 19th News Network. 

On a summer day, Lee sat waiting in a doctor’s office, playing GamePigeon on his phone, telling family stories with his mom and deciding where to get dinner.

It seemed like an ordinary afternoon, yet the reason for Lee’s appointment was far from ordinary.

Lee, 17, was there because the UPMC health system, headquartered in Pittsburgh, had cut off the gender-affirming care he’d been receiving for two years—a change driven by a federal executive order. A pharmacy mix-up meant his final puberty blocker shot never came, and the “weaning off” period his doctor had promised vanished. Within a month, he was experiencing hot flashes he hadn’t felt since starting treatment. Lee was devastated when he learned he could no longer receive treatment. “You feel like you’re starting from rock bottom,” said Lee, who plans to start classes at Carlow University this month.

The sudden disruption of care brought national policy directly into Lee’s home. On June 30, UPMC cut gender-affirming care for patients under 19 citing compliance with a January executive order from President Donald Trump. However, the care remains legal in Pennsylvania, and critics say the decision was less about the law than about protecting federal funding. A UPMC spokesperson said while they “empathize deeply” with impacted patients, the Trump administration has made it “abundantly clear” they can “no longer........

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