Elliot Deybach, a nineteen-year-old U.S. citizen studying at McGill University in Montreal, Quebec, describes their experience of accessing hormone replacement therapy (HRT) at the McGill Wellness Hub as “seamless.” This past April, Deybach began the process to receive HRT by calling the center, and, by the end of May, in three appointments, they’d received their prescription. “It’s been incredibly easy and incredibly smooth,” they tell The Progressive.
But had Deybach tried to access the same prescription just three months earlier, they would have been denied care and told to wait until their nineteenth birthday. In January 2025, President Donald Trump issued Executive Order 14187, barring funding or support to “assist the so-called ‘transition’ of a child from one sex to another,” effectively banning clinics from providing gender-affirming care to U.S. residents under the age of nineteen. Shortly after, the U.S. Department of Health and Human Services (HHS) released a report reviewing “best practices” for children with gender dysphoria, condemning gender-affirming care such as puberty blockers and hormone replacement therapy in favor of “psychotherapeutic approaches” that include conversion therapy—a widely-criticized pseudoscientific practice that the the Supreme Court upheld as legal to provide in March.
Since Executive Order 14187 went into effect, the Trump Administration has taken aggressive action to ensure that young people like Deybach are prevented from accessing gender-affirming care. In early June, the Cleveland Clinic agreed to a ban on gender-affirming care for minors after a lawsuit brought against the clinic by the Department of Justice, who alleged that the medical center had falsely coded insurance claims related to gender-affirming care in order to provide care to youths under nineteen. The terms of the settlement were intense: the Cleveland Clinic agreed to halt gender-affirming care for minors for the next twenty years and pledge $2 million to provide access to reversal of gender-affirming procedures. Despite a temporary restraining order from a Maryland court, the federal government’s reactions have encouraged other healthcare institutions to preemptively close their gender-affirming services to minors. This includes blue states such as Massachusetts, Colorado, and California.
In April 2025, a “whistleblower” form created by HHS to allow members of the public to report gender-affirming care providers to the federal government had allowed users to report providers practicing in Canada. The form asks for the healthcare provider’s personal information, including a phone number, employer information, and address. When pressed for a reason by news outlets Pivot and The Breach, HHS quickly removed Canadian provinces from its drop-down menu. Speculated reasons include the government creating a watchlist, attempting to detain these healthcare workers should they attempt to enter the United States, or using it to thwart Americans who attempt to circumvent these laws by seeking care in Canada. At present, the form still allows users to submit entries with a non-numeric Canadian postal code.
In Canada, healthcare is run by individual provinces. Gender-affirming surgeries and hormone therapy are legal in all provinces and territories and covered by insurance. In Quebec, hormonal transition is legal for all ages, with doctor approval, and largely covered by provincial insurance. While HHS lacks the authority to enforce U.S. law across the Canadian border, Canadian medicine is now experiencing its own chilling effect on gender-affirming care, with some Canadian doctors refusing to provide care to Canadian-based U.S. citizens under the age of nineteen. In March 2026, McGill University’s Wellness Hub reportedly told the Montreal Trans Patient Union (TPU) that it would no longer provide HRT to U.S. citizens under nineteen in accordance with Executive Order 14187. While no official reason has been stated, the Wellness Hub informed the TPU that change was in accordance with legal advice it had received.
The chilling effect has reached Canada at a time when enrollment of U.S.-based students at McGill has grown substantially, with more than 2,300 U.S. citizens attending the school during the 2025-2026 academic year. Eike, an administrator for the TPU who asked that their real name not be used due to privacy concerns, tells The Progressive they were informed that the Hub had stopped offering gender-affirming care in March. But, they estimate that the policy actually went into effect in January. In late April, the TPU published a joint statement with Montreal trans rights activist Celeste Trianon condemning McGill’s unnecessary compliance with Trump’s order, driving considerable public attention to the issue.
“Even in my position of having some cynicism from being an activist, I was really surprised by [the policy] originally,” Eike says. “I do think it’s kind of telling that a lot of the doctors are very quick to view this as a liability, . . . as opposed to a necessary service that might expose them to some risk from a very scary [foreign] government.”
Eike says McGill’s policy on gender-affirming care has changed since the TPU began raising public awareness, in what the organization considers a victory. While the TPU was originally informed that McGill’s Wellness Hub would impose a blanket ban on HRT access for U.S. citizens under the age of nineteen, based on legal Canadian Medical Protective Association (CMPA), he says, it has since revised its policy to refer students to healthcare providers that are comfortable providing the service.
According to information provided to the TPU by the Wellness Hub, just two students were denied care as a result of the ban on HRT. Eike says the largest influx of students seeking hormones typically comes in August and September, as U.S.-based students arrive in a country where gender-affirming care for eighteen-year-olds isn’t legally prohibited. While the Wellness Hub’s policy reversal means these students will no longer have to wait until they are nineteen to access gender-affirming care, they will still likely face obstacles in the form of long wait times. They say there were just two doctors providing HRT at the Wellness Hub as of June. More are currently or have recently been trained, he says, but to his knowledge, only one doctor at the Wellness Hub is willing to provide this service to U.S. citizens under nineteen, creating a bottleneck for students seeking HRT prescriptions. The TPU says it is committed to working with the Wellness Hub to increase access to gender-affirming care for students, such as inquiring on patient intake forms whether students are based in the United States and under the age of nineteen.
But Deybach says they sought care at the McGill Wellness Hub specifically for its efficiency, citing shorter wait times than nearby clinics. “I was doing research about getting HRT in Montreal,” they say. “The difference in wait times is so big. At a lot of the clinics, the wait time will be six months to a year. Whereas at the McGill health center, there’s almost always someone available.”
The Wellness Hub forwarded The Progressive’s request for a comment to a spokesperson for McGill University, who said: “Physicians maintain clinical and professional autonomy. McGill does not govern physicians or direct them on what care they can or cannot provide. Medical decisions at the Student Wellness Hub are made solely between a student and a licensed physician, based on the student’s individual needs and circumstances. This includes decisions related to gender-affirming care.” The spokesperson did not respond to attempts to clarify when this policy went into effect.
Several trans students told The Progressive that they found Montreal to be a safe and welcoming environment for trans students. One Canadian-American McGill student from Illinois, who asked that their name be withheld due to privacy concerns, tells The Progressive that several of their trans peers are in the process of starting estrogen. “I wanted to go somewhere accepting and progressive,” they say, “and [McGill] is certainly one of those places.” Still, they’ve faced barriers to accessing support options; they’re currently on a six-month waitlist to join group counseling sessions at McGill’s Sexuality and Gender Identity Center.
“Being in Montreal, which is a very trans city, has had more of an impact,” says Deybach. “We’re lucky to study and live in a city that’s incredibly accepting of trans people and also has a lot of trans representation . . . . Trans issues aren’t always legislative. You see it much more in the interpersonal aspect of things. Even though, obviously, the United States is in a much worse situation than Canada is right now, there are still places where you can be safe and where communities can keep you safe.”