Nancy Pelosi Launches National Effort to Restore Gender-Affirming Care for Trans Youth

Former House Speaker Nancy Pelosi has reaffirmed her commitment to securing access to gender-affirming care for transgender youth, responding to a wave of state-level restrictions and bans that have left many young people without vital healthcare services. In remarks to reporters at the San Francisco VA Medical Center on August 7, Pelosi stated, “That is something I’m working for at the national level, and we are hoping we can have gender-affirming care for our trans kids. It’s a sad thing for us… I don’t know what effect we can have nationally with what we have going on in the White House and in Congress” .

Over the past two years, more than twenty states have enacted laws that restrict or outright ban gender-affirming healthcare for minors. These laws range from prohibiting puberty blockers and hormone therapy to criminalizing medical professionals who provide transition-related care to youth. Proponents of these measures argue they are protecting children, but major medical organizations—including the American Academy of Pediatrics and the American Medical Association—have consistently maintained that gender-affirming care is evidence-based and often lifesaving for transgender youth .

The impact on families has been profound. Many have been forced to travel hundreds of miles to access care, while others are considering relocating to more supportive states. At the same time, several states—including California, New York, and Illinois—have enacted legal protections for transgender youth and their families, positioning themselves as “sanctuary” states for gender-affirming care .

Pelosi, who made history as the first woman Speaker of the House and has been a longstanding ally to LGBTQ+ communities, is seeking to address these restrictions through federal action. She acknowledged the significant political obstacles facing any national legislation, noting strong opposition from many Congressional Republicans who have advocated for bans on medical transition for transgender minors .

Pelosi’s office has not yet revealed specific legislative proposals, but her comments suggest ongoing discussions with Democratic colleagues and advocacy organizations. Earlier this month, officials from over a dozen Democratic-led states—including California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Washington D.C., and Wisconsin—filed a lawsuit challenging federal restrictions that block access to gender-affirming care for people under 19, further highlighting the national scope of the controversy .

Pelosi also emphasized her personal commitment to inclusion, telling reporters that she flies the transgender pride flag outside her office and that several of her colleagues do the same. “It’s a sad thing for us,” she said, reflecting on the impact of anti-LGBTQ+ policies and rhetoric. Her advocacy dates back decades, with Pelosi noting that she “lost friends” due to her support for LGBTQ+ rights during the HIV/AIDS crisis .

Transgender advocates and organizations have welcomed Pelosi’s renewed focus on federal action. “Trans youth deserve access to evidence-based care and the chance to thrive,” said a spokesperson for the Human Rights Campaign (HRC)—the nation’s largest LGBTQ+ civil rights group. “Efforts to ban gender-affirming care are dangerous and put lives at risk. We appreciate leaders like Speaker Pelosi who are willing to fight for our communities” .

Meanwhile, grassroots advocacy continues at the state and national levels, with LGBTQ+ organizations mobilizing parents, youth, and allies to defend access to care and push for legal protections. Recent polling shows that most Americans support transgender people’s right to access medically necessary care, though the issue remains highly polarized in national politics .

As the 2026 election cycle approaches, gender-affirming care for transgender youth is expected to be a major battleground issue—with significant implications for families, healthcare providers, and the future of LGBTQ+ rights in the United States.