Former U.S. House Speaker Nancy Pelosi has pledged to fight for the restoration of gender-affirming care for transgender youth across the country, amid a wave of state-level bans.
Speaking at a San Francisco medical centre on Thursday (7 August), the 85-year-old politician said the situation for trans youth in the United States is “really sad”, noting that she flies the transgender flag outside her office in solidarity.
“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,” Pelosi told reporters when asked about care access in California.
“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,” she added, acknowledging political challenges.
Pelosi, the first woman to serve as Speaker of the House, has a long history of supporting LGBTQ+ rights — from advocating during the HIV/AIDS crisis, which she said cost her personal friendships, to more recent criticisms of anti-LGBTQ+ Republicans, whom she labelled “losers.”
Widespread restrictions across the U.S.
While not banned everywhere, gender-affirming care for minors has faced extensive legislative attacks. According to LGBTQ+ advocacy group Human Rights Campaign (HRC), as of July 2025, 27 U.S. states had passed bans, though those in Arkansas and Montana are currently blocked or on hold.
The HRC estimates that 40.1% of transgender youth aged 13–17 — around 120,400 people — live in states with such bans. Several states also restrict public funding for transgender health care, which can prevent even adults from affording treatment.
Earlier this year, former President Donald Trump signed an executive order that would threaten federal funding to medical institutions offering gender-affirming care to minors. That order is currently blocked in court.
“U.S. officials have cut off transgender youth from essential, life-affirming care, throwing them instead into the crosshairs of a cultural war,” said Yasemin Smallens, LGBT Rights Officer at Human Rights Watch. “Families are being pushed to the brink, forced to navigate impossible barriers to care, while the federal government intensifies its assault on transgender rights.”
