- Memorial Health in Savannah, Georgia, has canceled top surgeries for transgender patients, including those over the age of 19, citing a need to follow state and federal laws and regulations.
- The hospital’s decision comes in response to President Trump’s executive order seeking to end gender-affirming care for minors, although the order’s implementation has been paused by federal judges.
- Indigo, a 24-year-old transgender man, had his top surgery canceled by Memorial Health despite being above the age stipulated in the executive order, leaving him feeling disheartened and with limited options for obtaining the procedure.
To Indigo, gender dysphoria feels like his own personal dark cloud in the sky. Sometimes, the cloud is higher in the sky, something he doesn’t even notice. Other days, and in the weeks following being told he wasn’t going to be able to get top surgery, it felt like it was right over his head. All over his body.
“I can’t ignore it, because it’s right there,” Indigo said. “In the days leading up to the consultations and getting a surgery date, it was getting easier. Without that, it’s getting incredibly hard to manage my mental health. Being dysphoric is directly linked to my mental health—and for me, it’s a very painful experience.”
On Monday, Feb. 3, Indigo thought he was going to be able to get top surgery within the month. By Thursday, Feb. 6, he was told the surgery would no longer be an option to him, at least not in Savannah.
Indigo, who asked not to use his last name for privacy reasons, works as a volunteer, covering the front office and helping with outreach and events with the Savannah Pride Center. He was there, staffing the front office phone when Seaport Plastic Surgery called SPC to tell the executive director that Memorial Health would no longer be providing gender-affirming care to transgender patients under the age of 19.
Seaport would be using a Memorial Health operating room for the surgeries.
“Since I was a patient, they said, you’re going to have to know anyway, so I was, like, just tell me,” said Indigo. “I just sobbed for two hours because I’ve been trying for a long time to get this, just to be told nope, you can’t do it.”
Indigo is 24, older than the age limit, as are four other individuals whose surgeries were cancelled by Memorial Health.
This decision by Memorial Health was in response to an executive order signed by President Donald Trump at the end of January, which sought to end gender-affirming medical treatments for those under the age of 19.
The order said the federal government will not “fund, sponsor, promote, assist or support” gender-affirming care—puberty blockers, hormones and surgeries—for children. Institutions that receive federal research and education grants must stop providing gender-affirming care for children, and the President is changing any laws that rely on guidance from the World Professional Association for Transgender Health. Memorial Health, owned by HCA Healthcare, received federal funds through Medicare and Medicaid reimbursements.
Last week, a second federal judge paused the executive order, leaving patients across the country in limbo.
‘We’re talking about adults’
When questioned about the cancellations, Memorial Health released the following statement and redirected follow-up questions back to the statement:
Memorial Health has never had a gender-affirming surgical program, which would require certain standards of care across multiple clinical disciplines. Like other hospitals, we have a responsibility to follow state and federal laws and regulations. For gender-affirming surgeries, there are laws and regulations around age. We follow those. Licensed physicians use their training and experience to exercise independent medical judgment to assess patients’ needs and determine the course of treatment within those laws and regulations.
“It’s purposely misleading,” said Savannah Pride Center’s Executive Director Michael Bell. “We’re not talking about 19 and under. We’re talking about adults. We’re not talking about Memorial having a gender-affirming surgical team, because that doesn’t exist in this entire region. We’re talking about top surgeries, that are gender-affirming, that have been canceled for no reason, and a statement that talks about a non-issue.”
The Savannah Pride Center released a response on its Instagram account, calling for Memorial Health to reaffirm its commitment to equitable, patient-centered care for the members of Savannah’s transgender community.
“This is not just a concerning decision long-term for trans people,” Indigo said. “This is a concerning decision for everyone, if they are willing to ‘follow’ an executive order incorrectly. I’m not 19; I’m 24. I’m a functioning adult in society. I pay taxes, and you’re still going to deny access to the care that I want? If they’re willing to do it to me, who’s to say what other kinds of things they’d stop doing?”
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‘I have to deal with this literal weight on my chest’
Indigo had reached the final stages of trying to get top surgery. The process is long in any state, but especially in the South, where just five days after Indigo got the call, the Georgia State Senate voted 33-19 to pass SB 39. This bill, if signed by the governor, would prevent those on the State Health Benefit Plan and Medicaid from receiving gender affirming care, such as surgeries and HRT, another blow to LGBTQ+ healthcare in the state.
Indigo had already sat through an hour-long session with his therapist where he was asked to describe his gender identity, how he identified, and why, and how long he had known. He had received a letter of recommendation from his therapist. He’d done the half-hour long surgery consultation with a doctor, which consisted of answering similar questions—what is your gender identity? how do you experience gender dysphoria? how does does this impact your day-to-day life?—before taking pictures of and measuring his chest.
This was all for the end goal of getting insurance to cover the surgery. Before that, Indigo had spent hours and hours on research: What insurance companies cover top surgery? What specific surgeons are in the insurance’s network? What insurances cover both top surgery and hormone replacement therapy?
“I had to get the Savannah Pride Center to help because my old insurance wasn’t going to allow top surgery,” Indigo explained. “They helped me get an insurance that was relatively cost-effective, would cover my HRT, top surgery and regular life expenses going to the doctor. I had literally just that week, the week of the Seaport phone call, called my surgeon to get the ball rolling so we could send them all the information I gathered.”
Last Monday, he thought he was going to be able to get top surgery by March. But by Thursday, he was told the surgery would no longer be available to him, at least not in Savannah.
Indigo laid out the options that he had following the news: try to raise $8,000 to get plastic surgery without the help of insurance. He could try to finance it, and while he says he has good credit, it is not strong good to get a reasonable interest rate. He could go to Atlanta, to a specialist there, but that option was not ideal. Indigo would be out of his home for a maximum of two weeks to recover in a possible strangers house, an AirBnB or a hotel. All possible, but all costing even more money.
The last option, his least favorite option, would be waiting until he moved out of state, which will not be for at least another year. This option is significantly better for the surgery itself, cheaper and in a state with more trans and queer rights. But, the state is across the country and has a higher cost of living, on top of the cost of moving itself.
“I could wait…but, I don’t want to do that,” Indigo said. “It’s just so frustrating, and makes me so sad, because it’s just that much longer that I have to deal with this literal weight on my chest.”
This was supposed to be his year of freedom—the year he could go to the beach for the first time and be shirtless, to go to Stonewall and not have to worry about how his outfit lays.
“I was supposed to spend this year in complete freedom, ’cause this is it,” Indigo said. “This is all I need, this is the last piece of the puzzle. I was supposed to spend my last year of freedom in Savannah, with my family, and I was really looking forward to it. Now, I’m in a state of mourning.”
Destini Ambus is the general assignment reporter for the Savannah Morning News, covering the municipalities, and community and cultural programs. You can reach her at DAmbus@gannett.com
