Transgender patients are facing a dire situation as UMass Memorial has canceled all appointments with Dr. Ashley Alford, a renowned surgeon known for performing gender-affirming surgeries. This abrupt decision has left patients in a state of distress and uncertainty.
One patient, Avery, who wished to remain anonymous due to fear of repercussions, expressed her devastation: "I’m crushed. I can’t stop crying. This surgery was life-changing because it finally gives me the body that’s right for me. It has been ripped away with no explanation or follow-up plan."
Avery's vaginoplasty, or bottom surgery, was scheduled for the following month and had been booked nearly a year in advance. She had spent months preparing and even switched to a more expensive insurance plan to cover the procedure. After receiving a call about the surgery's cancellation, Avery sought answers. A hospital staff member informed her that all of Dr. Alford's appointments had been canceled, but provided no further explanation.
The sudden cancellations and lack of clarity have caused patients to feel anxious and uncertain. Some have waited years for the opportunity to undergo bottom surgery and feel comfortable with their bodies. Now, they're questioning whether Alford's sudden unavailability means UMass Memorial is shutting down its vaginoplasty program due to pressure from the Trump administration to stop gender-affirming care.
GBH News spoke with six of Alford's patients, all of whom reported receiving calls over the last two weeks about canceled appointments or difficulties scheduling future visits. When they inquired about rescheduling, hospital staff told them it was not possible at that time.
UMass Memorial declined to provide a reason for the cancellations or confirm whether Alford's patients would be referred to another doctor. However, they denied that they were curtailing gender-affirming care in a statement: "Although appointments may at times need to be canceled or rescheduled due to the availability of a specific provider, nothing has changed in UMass Memorial Health’s commitment to providing comprehensive, evidence-based health care, including gender-affirming care, to all members of our community."
Alford, the only surgeon in Massachusetts to provide gender-affirming vaginoplasties outside of Boston, introduced a modern surgical technique in 2023. This technique utilized abdominal tissue and robotic technology to create a more realistic and functional vagina compared to more commonly practiced procedures. Several of her patients have praised her as the best vaginoplasty surgeon in New England due to her technique and kind demeanor, making them feel comfortable throughout an intimidating process.
The sudden cancellations come at a time when the federal government has been pushing medical centers nationwide to stop providing gender-affirming care to children and teens, including proposing rules that would withhold Medicare and Medicaid funding from health care facilities offering such care. In response, many hospitals and clinics have stopped providing medical treatments like puberty blockers and hormones to minors.
Gender-affirming surgeries for teens were already rare before the current Trump administration took office. The American Society of Plastic Surgeons recently recommended that doctors wait until a patient is 19 years old to perform a surgical procedure. At UMass Memorial, Alford did not perform bottom surgery on anyone under 18.
Some patients fear that UMass Memorial is particularly susceptible to federal funding pressures. Last fiscal year, the health system reported a significant operating loss, and it cut multiple programs around Central Massachusetts. Chrissi Bates, an advocate for transgender healthcare and Alford's first patient to undergo the surgery, suspects that these factors may be the reason behind Alford's sudden unavailability.
Bates and other patients express their disappointment and hope that Alford will resume her practice at UMass Memorial. They also emphasize the need for more transparency from the hospital to determine their next steps, whether it's following Alford to a new hospital or finding a new surgeon.
Kara Earp, whose surgery with Alford was canceled, has already scheduled a consultation with a doctor at Beth Israel Deaconess Medical Center in Boston. However, she worries that other hospitals might also stop performing bottom surgeries. Earp, who moved to Massachusetts to seek gender-affirming care, said, "I probably won’t actually be happy until I wake up from surgery and it’s all over with."
The situation highlights the challenges and uncertainties faced by transgender patients in accessing essential healthcare services, especially in the face of political and administrative pressures.
