Committee on Hospitals

Substance Use, Joint with Women, Gender Equity, and Hospitals. At this time, I would like to remind everyone to silence all electronic devices. Also, at this point going forward, no one is to approach the dais. No one. Chair, we're ready to begin.

Good afternoon and welcome to today's hearing on access to gender-affirming care and associated mental health outcomes for transgender and non-binary youth. My name is Councilmember Tiffany Caban. My pronouns are she/her. I'm the chair of the New York City Council's Committee on Mental Health and Substance Use. Thank you also to Councilmember Narcisse, chair of Hospitals Committee, and Councilmember Farias, chair of Women and Gender Equity Committee, for joining our committee in holding this hearing.

Before we begin, I'd like to recognize that we are joined by Public Advocate Jumaane Williams, Councilmember Harvey Epstein, Councilmember Simcha Felder, Councilmember Santos-Suazo, and Councilmember Areola on Zoom. Today, the committees are convening to discuss access to gender-affirming care in New York City and its role in improving health— mental health care outcomes for transgender and non-binary youth. It's no secret that transgender and non-binary New Yorkers have recently faced a barrage of threats, challenges and intimidation from the federal government.

Several institutions in our city have unfortunately capitulated to these pressures, and as a city, we are all worse off for it. Gender-affirming care not only allows individuals to live as their true selves, but it is also strongly associated with improved mental health outcomes for transgender and non-binary people. Transgender and non-binary youth especially are disproportionately burdened by poor mental health outcomes driven by reduced social support and heightened stigma and discrimination.

Yet research consistently shows that access to gender-affirming interventions is associated with roughly 60% lower odds of moderate to severe depression and over 70% lower odds of suicidality in youth. 70% lower odds of suicidality. We not only owe it to young transgender and non-binary New Yorkers to provide them with the care that we know can improve their lives and their mental health, but also to protect them from harm.

And at this moment, when so many trans and queer people in our city are seeing their rights being attacked and stripped away by the federal government and watching institutions that they rely on for their health care buckle under pressure, I stand as a queer New Yorker in solidarity with you. My commitment to you is that I will do everything in my power to work with you, to keep you safe, and to fight for our collective liberation.

Today, we will also be hearing 3 pieces of legislation relating to our oversight topic. One, Introduction 949, sponsored by Councilmember Schulman, which would require the Department of Health and Mental Hygiene to create and make available on their website LGBTQI+ health and gender-affirming care resources and a searchable map of LGBTQI+ health services. Resolution 208, sponsored by Councilmember Hanif, which calls on the New York State Legislature to pass and the governor to sign legislation that mandates all medical students in New York State receive anti-bias training.

And my own legislation, Resolution 547, which calls on the New York State Legislature to pass and the governor to sign legislation which establishes a gender-affirming care access program to provide support and increase access to gender-affirming care. I would like to thank the committee staff who worked to prepare for this hearing, as well as my own staff. And I will now pass the mic to Councilmember— Oh, and we're joined by Councilmember Aldawal.

And now I will pass it over to co-chair Councilmember Narcisse.

Hi, good afternoon. I am Councilmember Mercedes Narcisse, Chair of Committee on Hospital. I'm joined by my colleagues, Councilmember Tiffany Caban, Chair of the Committee on Mental Health and Substance Use, and Councilmember Amanda Farías, Chair of the Committee on Women and Gender Equity. Thank you for joining us today for this oversight hearing on access to gender-affirming care and associated with mental health outcomes for transgender and non-binary youth.

Gender-affirming care is a model of care that includes medical, surgical, mental health, and non-medical services to support and affirm an individual's gender identity. This type of care can include social affirmation, like adopting gender-affirming hair, clothing, and names, or medical affirmations, such as puberty blockers, hormone therapy, and gender-affirming surgeries. Transgender and non-binary youth experience significantly higher rates of anxiety, depression, mood disorders, and suicidal ideations than their cisgender peers, largely due to stigma, discrimination, and social rejection, and barriers to care that these individuals experience.

Research shows that access to gender-affirming care can substantially improve mental health outcome for transgender and non-binary youth. Despite local efforts to support, we know that the federal side is not on our side. The federal government is taking actions to limit access to gender-affirming care. These actions at the federal level present challenges for Health+ Hospital and DOHMH to continue providing the care that people need and deserve in our city.

As a registered nurse and a chair for— of a hospital committee, I am committed to ensure that every individual in our city get the care they deserve and needs to get through life. And what we need to do is continue pushing forward and making sure the bigotry around us, the policies that not on our favors, for us to continue addressing them.

And today we look forward to hearing from New York City Health+ Hospitals and DOHMH about the broader state of gender-affirming care access for our youth across the city of New York, including the availability of services at H+H facilities, DOHMH, and the programs and other city-supported efforts. We also seek their feedback on legislation before the committee. Together, we must work to ensure that transgender and non-binary youth have access to the care they deserve, and that our local hospital and health department can continue to provide such services.

Before we begin, I'd like to thank committee staff, Senior Legislative Counsel Rhea Ogazawara, a policy analyst Manu Butt, as well as the committee brand new legislative analyst Raina Lee. Welcome. For their hard work in preparing for this hearing, I'd also like to thank my staff, Frank Shea, Courtney Lee, and of And of course, Drashina Jalloh. I would like to recognize that we have been joined.

Who else that I miss? We don't miss anybody? You got everybody. So I will now turn it over to Chair Farias.

Thank you so much. Good afternoon, everyone. I'm Councilmember Amanda Farias, pronouns she/her, and I get to chair the Committee on Women and Gender Equity. We're excited to join the Committee on Mental Health and Substance Abuse and the Committee on Hospital and their chairs, Chair Caban and Chair Narcisse, for today's oversight hearing on access to gender-affirming care and associated mental health outcomes for transgender and non-binary youth.

As stated by my colleagues, access to gender-affirming care is a life-saving medical necessity that dramatically improves the mental health and overall well-being of gender-diverse, transgender, and non-binary children and adolescents. Every child deserves to grow up feeling supported in who they are. And supporting transgender and non-binary youth means defending their right to healthcare. Currently, access to gender-affirming care for young people is under attack nationwide.

An analysis by the Human Rights Campaign found that 27 states plus Puerto Rico have successfully passed bans on gender-affirming care for transgender and non-binary youth, affecting 48% of transgender youth nationwide. A recent survey found that 87% of transgender and non-binary youth and young people who's used hormones to support their gender transition or expression were concerned about losing access to this care.

These laws interfere with the ability of transgender youth, their families, and their providers to make the healthcare decisions that are right for them and access the medical care they need and can have devastating consequences. It is well documented that transgender and non-binary children experience anxiety and depression at higher rates than their cisgender peers. According to a 2025 survey published by the Trevor Project, transgender and non-binary young people who were unable to access the hormones they wanted were nearly twice as likely to attempt suicide than those who could.

Additionally, 4 out of 10 transgender and non-binary young people seriously considered attempting suicide in the last year. These young people are not inherently at a higher risk of these issues. Rather, they are in a world that fights their existence at every turn. These repeated attacks would weigh on any adult, so it is no surprise that young people feel the effects of a transphobic environment so acutely.

Gender-affirming care is backed by decades of research and supported by every major medical association in the United States. representing more than 1.3 million doctors. Every person has the fundamental right to access the healthcare they need without fear of discrimination, prejudice, or barriers to treatment that support their mental, physical, and emotional well-being. So today we'll hear from the administration and we'll ask, how are you ensuring access to gender-affirming care for transgender and non-binary youth in New York City, and where are you ensuring that accessibility for them?

Thank you to the members of the Committee on Women and Gender Equity who have joined us today. I'd like to thank our committee staff, Julia Goldsmith-Pinkham, Katie Salina, and Allie Stauffer, as well as my own staff, Daniel Curtin, for their work on today's hearing. Thank you so much, and I'll turn it back over to Chair Kavanagh. And now I'm going to turn the mic over to Public Advocate Jumaane Williams to deliver, deliver some remarks.

Thank you very much. As mentioned, my name is Jumaane Williams, Public Advocate of the City of New York. I want to thank Chairs Caban, Farias, and Narcisse and the members of the Mental Health and Substance Abuse, Women and Gender Equity, and Hospitals Committee for allowing me the opportunity to provide a statement. New York City has to expand access to gender-affirming healthcare services through public hospitals, school-based health centers, and community organizations serving LGBTQ+ youth.

In 2025, New York City enacted legislation that I was a sponsor of Local Law 126 and Local Law 127, which require the Department of Health and Mental Hygiene to create and distribute signs dealing with healthcare rights of transgender patients, including preferred pronouns and respectful treatment, for display across city hospitals and report on training provided by hospitals regarding medical for transgender individuals, respectively.

The city should also strengthen provider training on culturally competent care, ensure insurance coverage for medically necessary treatments, and improve coordination between mental health and primary care services. In addition, the city should continue protecting patient privacy and resisting efforts that could deter families from seeking care. These recommendations align with my longstanding support for healthcare equity and accountability in public systems.

The intersection of LGBTQ+ identity and the modern healthcare system remains defined by systemic barriers and persistent health inequities. While overall insurance enrollment has improved, LGBTQ+ individuals, particularly people of more color and transgender adults, face heightened rates of chronic disease, mental distress, and substance use disorders, all of which are exacerbated by stress. A critical driver of these disparities is a widespread deficiency in medical education, which frequently fails to equip clinicians with baseline competencies in sexual orientation and gender identity care.

Consequently, patients are routinely forced to choose between educating their own physicians, enduring misgendering and substandard treatment, or avoid the medical system entirely, which creates severe gaps in preventative and responsive public health outcomes. When any community avoids regular care, it's bad public health for everyone. Research demonstrates that access to gender-affirming care is associated with improved mental health outcomes among transgender and non-binary youth.

A longitudinal study found that youth who received gender-affirming care, medical care, experienced significantly lower rates of depression and suicidal compared— suicidality compared with those who did not receive such care. Improved access may therefore contribute to reduced mental health access— crisis, I'm sorry, greater school engagement, enhanced family stability, and better overall well-being. Discrimination, barriers to care, and social stigma contribute to health disparities among transgender individuals.

Government agencies must actively address these inequities through policy and service delivery. Today we'll hear 3 pieces of legislation by Councilmember Caban, which I'm a cosponsor, Councilmember Schuman, and Councilmember Hanif. I look forward to hearing from both advocates and the administration about these bills. Ensuring access to gender-affirming care for transgender and non-binary youth is both a public health and equity issue.

We must eliminate healthcare barriers and protect transgender New Yorkers from discrimination. Expanding affirming health services, strengthening mental health supports, and safeguarding patient privacy can improve outcomes for vulnerable youth while reinforcing New York City's commitment to inclusion, dignity, and evidence-based healthcare policy. I'd also like to add I have been very, very public about my continuing journey on these issues, and I've done that because I want to make sure people join me.

I am not trans, and I don't have any family members who are, but I have spoken to parents who love their children like my wife and I love mine, and I've spoken to mothers who love their child how my mother loved my sister and I. And I think it's incumbent upon folks like me to speak out, because when my children inevitably face some issues, I hope they're not fighting alone, and I hope people join them in making sure that they are protected.

And so I want us to all do the same, and I don't want people to use surgery, which is the least used medical access, to take away access from everyone. I saw that happen with abortion. Late-term abortions are not very prevalent, but they use that to take away rights from all women. So let's just make sure that we're really focused on making sure people have what they need to live their best lives.

Historically, when people don't like folks, when there are bias against folks, they don't disappear. They're just harmed, and their lives are made to be unnecessarily painful. So let's reverse that. Let's make sure that we can have people live, love, and be healthy in their lives, just like we'd want anyone else to. So access to healthcare would allow us to do that.

So I'm so thankful that we're having this hearing today. And I'm also always concerned when people are talking more about sports than children who are killing themselves. And so let's reverse that conversation and make sure that we're protecting everyone. Thank you. Thank you so, so much, Public Advocate.

Now I will turn the mic to the committee counsel to administer the oath to members of the administration. Thank you, Chair. We'll now hear testimony from members of the administration. Will you please raise your right hand? Do you affirm to tell the truth, the whole truth, and nothing but the truth before this committee, these committees, and to respond honestly to councilmember questions?

Okay, you may begin when ready.

Okay. Good afternoon. My name is Taylor Brown. I use she/her pronouns. I serve as the inaugural director of the Mayor's Office of Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual Affairs. Thank you to Chairs Caban, Narcisse, and Farias. and the members of the council committees on mental health and substance use, women and gender equity, and hospitals, as well as Public Advocate Williams for holding today's critical hearing.

My office appreciates the council's attention to gender-affirming care and associated mental health outcomes for transgender and non-binary youth, and I'm grateful for the opportunity to testify on these issues on behalf of the administration. I would like to begin by unequivocally stating that the administration firmly opposes the federal government's attacks on transgender and non-binary people. And we are deeply, deeply alarmed by the ways in which private healthcare providers in New York City have caved to pressure from the federal government.

New York City is fully committed to continuing to protect, support, and cherish transgender and non-binary New Yorkers of all ages. Gender-affirming care is a lifeline for many transgender and non-binary young people, and New York City will not leave them without the care that they need. Gender-affirming care refers broadly to a set of specific interdisciplinary services, interventions, and treatments provided to individuals living with gender dysphoria.

Almost all major medical associations and leading world health authorities support gender-affirming care for transgender and non-binary youth living with gender dysphoria. Today, the WPATH World Professional Association of Transgender Health Standards of Care Version 8 and the Endocrine Society's Endocrine Treatment of Gender Dysphoric Gender-Incongruent Persons are the most widely accepted clinical protocols and policies for the treatment of gender dysphoria in both adult and youth patient populations.

Recently, there has been much fearmongering propaganda and intentional mischaracterization about gender-affirming care for transgender and non-binary young people. It is important to be clear that gender-affirming care, like all healthcare, is individualized and patient-centric. Decisions about gender-affirming care, again, like all healthcare, are made by the patient, the patient's caregiver in the case of youth and adolescents, and the provider.

Treatment protocols for transgender and non-binary youth are based on age, the onset of endogenous puberty, and the relevant clinical criteria. For those who meet certain clinical criteria, treatment may include psychological and psychiatric care, as well as non-medical support in the social transition a transgender or non-binary young person may take. Thank you. including coming out and informing others about their gender identity and how they would like to be treated, using a gender identity consistent name and pronouns, adopting clothing, grooming, hairstyles, chest binders, and other compression garments, padding, and other forms of gender expression, and using gender identity consistent facilities and spaces in both public and private life.

For those at the early stages of puberty and older, the introduction of puberty suppressants, commonly referred to as puberty blockers, which pause the development of secondary sexual characteristics that are inconsistent with gender identity. And finally, the treatment protocols for those at late— at mid to late adolescent age and older, the introduction of hormone therapy, which allows a transgender or non-binary young person to undergo puberty consistent with their gender identity.

Opponents of gender-affirming care for transgender and non-binary youth often falsely claim that gender-affirming surgeries are being performed on transgender and non-binary youth of all ages and at high rates. This is not true. While there is limited data available on this specific issue, a 2024 study by researchers at the Harvard T. Chan School of Public Health found little to no utilization of gender-affirming surgeries by transgender and non-binary youth.

Transgender and non-binary young people living with gender dysphoria have higher rates of depression, anxiety, serious psychological distress, and suicide risk compared to their cisgender peers. These mental health risks are not driven by being transgender or non-binary, but by stigma, discrimination, rejection, and a lack of supportive services. I would like to share some data points from the Youth Risk Behavioral Survey conducted by the Health Department in 2023 that illustrate the mental health challenges that transgender and non-binary youth in New York experience.

In 2023, public high school students who identified as transgender, 42%, and non-binary, 38%, 8%, some other gender identity at 45%, or questioning at 28%, were more likely to report suicidal ideation when compared to those identified as cisgender at only 16%. Those who identified as transgender, 49%, non-binary, 29%, and some other gender identity, 33%, or questioning at 61%, were more likely to report attempting suicide. compared to their cisgender peers who had a rate of 9% of reporting attempting suicide.

Evidence has shown that when transgender and non-binary youth have access to the gender-affirming care they need, their mental health and overall well-being improve. Access to gender-affirming care is essential healthcare for the youth who need it. The federal government has waged an all-out campaign against transgender and non-binary people, especially our youth and their healthcare. Care. Confronted with executive orders, federal funding cuts, federal investigations, and regulatory policies across the nation and here in New York and New York City, providers of gender-affirming care for transgender and non-binary youth have begun ceasing the provision of care and discharging their patients.

Notably, in New York City, 3 major providers of gender-affirming care for transgender and non-binary youth— NYU Langone, Mount Sinai, and New York Presbyterian— began ceasing their provision of care in early 2025 following one of the first presidential executive orders. Over the last 3 weeks, both Mount Sinai and NYU Langone, in the face of federal investigative subpoenas, entered into settlement agreements with the United States Department of Justice, agreeing seemingly to end the provision of puberty blockers and hormone therapy to transgender and non-binary youth for the treatment of gender dysphoria permanently.

This has resulted in immense fear, harm, and significant breaches of trust in the transgender and non-binary community. It has also resulted in an increased vacuum for care for transgender and non-binary youth here in our city and for those who come to our city seeking care. Mayor Mamdani, Commission on Human Rights Commissioner and Chair Christine Clark, and I have all spoken out on private medical institutions who have capitulated to the federal administration.

On September 9th, I spoke at a rally outside of Mount Sinai criticizing their settlement with the Department of Justice. The Mamdani administration has been and remains committed to ensuring that transgender and non-binary youth are able to access their medically necessary gender-affirming care. In June 2026, we announced a proactive $15 million investment to protect, ensure, and expand access to gender-affirming care for young transgender and non-binary New Yorkers.

This investment, spread across 3 years, provides emergency funding to directly support providers of gender-affirming care for trans and non-binary youth, connect trans and non-binary New Yorkers to care and to fund research amid these escalating federal attacks. This funding is broken down into the following 3 initiatives. The majority of the funding will go to a direct care access fund for providers of youth gender-affirming care.

The Department of Health will implement a new fund to support qualified providers of pediatric gender-affirming care in their provision of care to youth patients and to address financial shortfalls resulting from any denials or reductions in federal funding. This funding will ensure the continuity of care for medically necessary puberty blockers and hormone therapy for transgender and non-binary youth in accessible and affordable care settings.

The city will also launch a confidential and dedicated call and chat line at the Health Department that will link people to available services related to gender-affirming care in New York City in real time. The city will also fund research to identify gaps in healthcare care access and outcomes. The Health Department will conduct mixed-method research grounded in partnership with academic and community experts.

We welcome the opportunity to discuss partnerships with you all. The funding will also bolster support for gender marker changes on vital records through the Department of Health, as well as support for overall coordination, evaluation, and data analyses for gender— for the gender-affirming care initiatives that I just went over. Building on the Trans Rights Are Human Rights campaign that the administration previously launched to provide education and resources to transgender and non-binary New Yorkers about their legal and civil rights, including in healthcare, my office is finalizing a comprehensive rights and resource guide that we hope to publish as soon as possible.

The administration will continue to work across agencies to ensure that transgender and non-binary New Yorkers are informed, protected, and served, especially during these unprecedented times. Critically, the city continues to provide age-appropriate gender-affirming care through services offered by both the Department of Health and NYC Health and Hospitals. And finally, I want to thank Councilmember Schulman for putting forward Intro Number 0949-2026.

We support this bill and agree it is critical to provide information and resources to LGBTQI New Yorkers about healthcare services that are available to them. The Health Department already has several resources for LGBTQI New Yorkers, including a suite of web pages, the LGBTQ Healthcare Bill of Rights, and the Pride and Care: Health Tips for Transgender and Gender Nonconforming and Nonbinary People booklet, available on the Health Department's website in 13 languages.

The Health Department's NYC Health Map is currently available online as well. LGBTQI New Yorkers seeking care can search the Health Map by LGBTQ services and more. My colleagues from the Health Department have a few points to clarify in the, in the bill language and look forward to discussing the bill further. Thank you again for the opportunity to provide this testimony.

I look forward to discussion today and answering any questions helpful to the council on these issues. And I will turn it over to my colleagues from the Department of Health. Or sorry, Health and Hospitals. Oh, sorry. Sorry. Health and Hospitals. We've met on Zoom, but it's never the same in person. Thank you very much, Taylor.

Good afternoon to Chairwomen Caban, Narcisse, and Farias, and members of the Committees on Mental Health and Substance Use, Hospitals, and Women and Gender Equity. I am Dr. Andrew Wallach, the Ambulatory Care Chief Medical Officer at New York City Health+ Hospitals. I am joined today by my colleague, Dr. Omar Fattal, the Chief Behavioral Health Officer at Health+ Hospitals.

Good afternoon. As the public safety net healthcare system, Health+ Hospitals' mission is simple: to provide comprehensive health services equally to all New Yorkers, regardless of their ability to pay, and to deliver the highest quality care with compassion, dignity, and respect. Furthermore, we aim to promote and protect health in its fullest sense: the total physical, mental, and social well-being of the people of New York City.

Thank you for the opportunity to testify before you today. Health+ Hospitals has continuously prioritized support for the LGBTQ+ patients and staff in keeping with our values, relevant laws, and regulations. In 2011, Health+ Hospitals became the first U.S. municipal healthcare system to mandate LGBTQ+ training for all staff members, and we continuously provide trainings on LGBTQ+ mental health through e-learnings and live training programs that focus on culturally responsive care.

In 2014, Health+ Hospitals Metropolitan became the first municipal hospital to open a healthcare center specifically dedicated to the needs of LGBTQ+ LGBTQ+ patients. Today, Health+ Hospitals operates these Pride Health Clinics in 8 of its facilities, including Bellevue, Elmhurst, Gotham Health Gouverneur, Gotham Health Judson, Jacobi, Lincoln, Metropolitan, and Woodhull. Regardless of the type of care a patient comes to Health+ Hospitals for, We treat each patient as a whole person, working with them to support their physical, mental, and social well-being within the context of best clinical practices and regulatory authority.

We know gender-affirming care does not have a one-size-fits-all approach, and health and hospital providers, with informed consent, work closely with patients and their families and/or legal guardians To equip them with the tools they need to provide the necessary mental and emotional support throughout their gender-affirming healthcare journey. As clinically necessary, Health and Hospitals medical teams will make referrals to behavioral health teams to ensure minors are getting the care that safeguards their mental well-being, as well as ensuring that our patients' physical needs are equally met.

All of our behavioral health providers have the training and skills to address the needs and provide care to all of our patients, and this includes providing gender-affirming care. To do so, we use the patient's correct pronoun, create a safe space for non-cisgender person to explore their gender expression, and document in our medical records in a gender-affirming manner.

We work with families to support and work through gender-related issues when they come up in treatment. Additionally, Health and Hospitals offers the LGBTQ+ Mental Health Training, which is an annual voluntary course facilitated by the Institute of Human Identity. The curriculum informs mental health providers on key social determinants that impact the LGBTQ+ population and best practices in delivering affirming psychotherapy to this community.

Additionally, We partner with our communities to offer localized support whenever possible. For example, the Elmhurst Suicide Prevention and Youth Program offers free workshops and services to schools, community-based organizations, and agencies across Queens with the goal of reducing the rates of suicide for youth. While this program primarily meets with youth ages 12 to 24, with an emphasis on Black, Indigenous, and people of color, as well as the LGBTQ+ Youth in Queens.

Additional workshops are available to family and staff from other local organizations. Also, Health+ Hospitals is a co-sponsor of Trans Health Fest, which connects transgender, gender-diverse, and non-binary New Yorkers to healthcare, legal, and social support resources here in New York City. Providers at Health+ Hospitals receive extensive training to ensure they are delivering culturally responsive care to meet the referenced physical, mental, and social needs of minors seeking gender-affirming care.

These trainings include references to the World Professional Association for Transgender Health Standards of Care Version 8 guidance, which was developed by global professionals across medical and sociological fields to provide clinical guidance to healthcare professionals supporting transgender and gender-diverse individuals throughout their healthcare journey. This guidance uplifts Health+ Hospitals' mission to promote and protect health in its fullest sense and bring the highest level of comprehensive care into our exam rooms.

Health+ Hospitals is proud to have received designations from leading national benchmarking organizations for inclusive policies, best practices, and equitable treatment and inclusion. All 18 Health+ Hospitals eligible facilities earned the LGBTQ+ Healthcare Equality Leader designation in the Human Rights Campaign Foundation's Healthcare Equity Index. This is a recognition that these facilities have received every year since 2015. Additionally, all 5 of Health+ Hospitals' long-term care facilities earn the LGBTQ+ Long-Term Care Equality Leader designation in the Human Rights Campaign Foundation and SAGE's Long-Term Care Equality Index in 2025.

Above all, Health+ Hospitals recognizes the importance of both being an innovator and an advocate to ensure that every person, youth or otherwise, who walks through our doors is treated with compassion, dignity, and respect when seeking gender-affirming care. With our purpose to care for all New Yorkers, Health+ Hospitals will continue to meet each patient where they are to achieve these goals.

No exceptions. Thank you for the opportunity to testify today on this most important topic.

Thank you very much for your testimony and for being here. I'm going to just start off with some questions around clinical evidence and research. The clinical literature— and this was touched upon in, in Director, in your testimony— but including studies published in peer-reviewed journals and guidance from the American Academy of Pediatrics and the Endocrine Society consistently associates access to to gender-affirming care with meaningful reductions in depression, anxiety, and suicidality amongst transgender youth.

What does DOHMH— what does the administration understand to be the strongest available evidence on the relationship between access to gender-affirming care and mental health outcomes for TGNB youth? And how does that evidence inform the agency's public health guidance? Councilmember, we have representatives from DOHMH who will be responding to the question and answer portion. Oh, great. Okay. Yeah.

If we're at that pace— Yeah, they can come up now. Yeah. Okay. Thank you. Apologies. We just have to swear you in also. It's super quick. Yeah. Will you please raise your right hand? Do you affirm to tell the truth, the whole truth, and nothing but the truth before these committees and to respond honestly to councilmember questions?

All right. You may— do you— did you have separate testimony you wanted to give, or— okay, great. Perfect. Then you can dive right in. Fantastic. Good afternoon. My name is Marnie Davidoff. I am the Assistant Commissioner for the Bureau— excuse me— of Children, Youth, and Families and Developmental Disabilities at the New York Department of Health and Mental Hygiene.

So in response to your question, as so many of the council members have spoken about today, We know that there's overwhelming evidence that when transgender and nonbinary youth have appropriate access to individualized gender-affirming care, their mental health is improved. In 2022, there was a prospective study of 104 young people aged 13 to 20 who identified as transgender and nonbinary, and it found that receipt of gender-affirming interventions was associated with a, you know, lower odds ratio of moderate to severe depressive symptoms and significantly as well lower odds of self-harm or suicidal thoughts.

And a 2023 study that tracked 300 youth who identify as trans or non-binary, excuse me, for 2 years as they were receiving gender-affirming hormone therapy also showed significant decreases in depression and anxiety. And, you know, we really believe firmly that this evidence is critical to shaping the way that we approach health and mental health care for youth and are really using this to inform, you know, some of the planning and work that is ahead of us that was discussed earlier.

And you should stay put because my line of questions is mostly for you. I'm not going anywhere. Okay, great. So research has also shown that transgender youth who are denied access to puberty blockers or gender-affirming hormone therapy are at significantly elevated risk for suicidal ideation and self-harm compared to those who receive care. Does DOHMH view access to gender-affirming care as a suicide prevention strategy, and is it reflected in the city's suicide prevention planning?

Yes, DOHMH absolutely, along with other validated public health sources views access to gender-affirming care as part of a broader suicide prevention strategy. You know, the Trevor Project's research, which was also cited earlier, shows that access to gender-affirming care and gender-affirming environments significantly reduces suicide risk among transgender and non-binary youth. And all of our youth suicide prevention initiatives are designed first and foremost to reduce suicide disparities among marginalized youth.

And this includes LGBTQ+ youth. Yeah. And to that point of suicide prevention strategy, I just want to move to 988 for a second because that's another tool that we have for people of not just different gender identities, but just different experiences, different demographics. Has DOHMH seen changes in the crisis line or behavioral health service utilization amongst TGNB youth since federal actions began?

And do you know, like, how it's being monitored at this point? Yeah, thanks for that question. So we are very cognizant of the stressors that TGNB individuals are experiencing as a result of federal actions. The of course health department remains committed to improving LGBTQ health and well-being. The 988 counselors do receive specific training on meeting the needs of LGBTQ youth communities and the specialized services that are available to them.

So if a caller requests LGBTQ plus you know specialized services, the counselors are able to make that referral. And there is also a searchable database online when any New Yorker can use to find services that are affirming. However, the intervention, because of the nature of the intervention, because it is a time-limited crisis intervention and it is anonymous, we don't require, right, the caller to offer any demographic information.

We may not be able to track with confidence, right, the number of callers who identify. Mm-hmm. as TGMB or LGBTQ broadly. And so we only have demographics for a very small number of those callers. So yeah, right now we can't accurately give you a, you know, a demographic trend. And I mean, again, I know that at large the TGMBI community is on high alert and understandably cautious about what they're divulging even to these resources in this moment in time.

And that's, that's because of the current political environment and the attacks from the federal level. And so to that end, right, the political environment has created what many clinicians describe as a secondary mental health crisis separate from any underlying gender dysphoria. that's driven by fear, uncertainty, the experience of having care disrupted or threatened. And we hit the pieces around, you know, it's not, it's not a person's gender identity that is the cause of mental health stress or distress, but the treatment from others that they receive around that.

And then now we're layering on top these other fears because of the political environment. Can, can you talk about the evidence show if it— what evidence shows about mental health outcomes when care is delayed, when it's interrupted, when it's denied compared to when it is accessible? And is DOHMH communicating that to providers and families? And very quickly before you answer, just want to acknowledge that we have been joined by Councilmember Brooks-Powers.

Okay. Thanks. Thank you. I'm going to hand it over to Director Brown to kick us off. Yes, thank you for the question, Councilmember. We know that undiagnosed, untreated, and undertreated gender dysphoria often becomes more severe over time, leading to further exacerbation of both physical and mental health disparities and risk with age. This is similar to any chronic health condition that is left untreated or when care is interrupted.

A recent study published in Nature highlights the devastating impacts of anti-trans legislation legislation in states, finding that these bans, a collection of laws that restrict rights including access to gender-affirming healthcare, have led to a 72% increase in suicide attempts among transgender and non-binary people compared to states without such legislation. These findings are also supported by an article analyzing several more recent studies published by the American Psychological Association as well.

Thank you. I really appreciate that. And just to underscore that This is something that's not unique across the board in that sense. There are tons of people who are being denied access to mental health care for a number of reasons, again, at the hands of the federal government and the distress that causes. I am somebody who lives with a chronic health condition and the period of time it took to get a diagnosis and the difficulty of being seen and heard and really taken seriously and treated was— it was a really, really difficult time as an adult with access to consistent mental health care.

And still, I struggled immensely. And so I cannot imagine what young folks are struggling with when they're not sure where they can get their care. I have a couple more questions and I'm going to hand it over to my co-chair.

But beyond medical care, what does DOHMH understand to be the most important protective factors for TGNB youth mental health? Just as examples, you know, such as family acceptance, affirming schools, community connection, things like that. Yep, there are many protective factors, and the— I'd say the most widely protective factor is connectedness to parents. So family support and affirmation is absolutely critical as a protective factor.

Others include connectedness to other, you know, adults, caring adults, adult relatives, adults in the community, peers and friends, teachers. Youth development opportunities, and feeling safe in the community. Those were all protective factors. And I'm looking at— and that goes for, you know, transgender, genderqueer, genderfluid questioning youth. And these were protective factors against depression, suicidality, and substance use.

Can you go into— can you flesh out those— that sort of definition of connectedness for folks? Yeah. I mean, I think that the definition of connectedness is tied into the idea of affirmation and support. So it's being seen for who you are, who you— the gender identity that you are choosing, right, to present as, the pronouns you're choosing to use, right, that those are all affirmed and supported.

And yeah, that's a critical part, I think, of that connectedness factor. Yeah. I mean, obviously there's a large scope of what parental responsibility looks like and how children, even when we're adults, 'cause we still carry that parent relationship trauma around, like, you know, differences between being fed and housed and being emotionally supported and seen and understood, et cetera, et cetera.

So thank you for fleshing that out. I appreciate it. And then my last question before handing it over to Chair Narcisse is, You mentioned that parental support is one of the strongest protective factors for mental health, the mental health of transgender youth, and research consistently shows that family acceptance dramatically reduces suicide risk. So does DOHMH have any programming or resources specifically designed to support parents and caregivers of TGNB youth, both in understanding the mental health benefits of affirming care and in navigating the current climate of misinformation?

And if not, is there capacity to develop develop that? And again, before you answer, I want to acknowledge that we have been joined by Councilmember Lee. Thank you. Yes. So the Department of Health and Mental Hygiene supports a set of programs that offer both family peer support and youth peer support. We have what we call the Family Youth Peer Support Alliances.

There is one per borough. And there's also a training and technical assistance center associated with these alliances. And the training center, the Strong Families and Communities Training Center, has been providing trainings to all of our peer advocates on working with LGBTQ youth and their families and to help them, you know, to navigate related systems and to provide the variety of peer supports that are needed.

Thank you. Specifically, we've had a lot of focus among the Queens Alliance provider and the Staten Island Alliance provider have really been doing a lot of work in this area. And, you know, including running groups, right, for individuals and their families and really building their capacity to serve. Shout out to Staten Island. Yeah. All right. I have a few more questions, but I'm going to pass it over to Chair Narcisse.

Thank you, Chair. 2 things as I'm sitting here and processing about life is acceptable in society that we live in and accessible to the best healthcare that you can get as a human being. It's treating each other fairly, and unfortunately that We have, like my colleague just mentioned, you have difficulty and you don't have that support. And we want to see New York City is a place where we support one another.

And it's very important for us to be mindful about what's going on in our society. So I thank you for being here answering our question.

Mental health, let's— we talk about the service capacity and mental health continuity. Mental health, what does HNH clinical experience show about mental health outcomes for youth once they have stable access to gender-affirming care? Hi, good afternoon. I can't comment on individual cases, but I can agree with everything that was said before. for me. You know, there's research and evidence that shows that access to gender-affirming care does improve overall mental health outcomes, including lowering depression, lowering suicidality, and improving overall mental well-being.

Thank you. Does HNH have enough licensed mental health clinicians to serve TGNB patients? Yes, I'm happy to share that we do have capacity to— in our child and adolescent behavioral services, we offer the whole spectrum of services for children and adolescents in all boroughs. And we welcome all New Yorkers, including LGBTQ+ patients. And we've made it very easy for people to access care in our system 2 ways.

One is that they can be referred by their medical team, and their medical team can connect them internally behavioral services, or people can call on their own. It's one number, the contact center. I can mention it, 1-844-NYC4NYC, and all they have to say is, I want to be connected to behavioral services, and we take care of it from there.

And by the way, I'm very proud of HNH providing those services because we know when other hospital facilities not receiving patients, HNH, you know, if you're listening, to know that. H&H is on your side. The city hospital never turn people away. What does H&H see as the value of coordinating mental health support with gender-affirming care? Yeah, great.

Thank you for those comments and for the particular question. I have to say, I'm entering my 29th year working at New York City Health+ Hospitals as an internist. And one of the things I'm most proud about our healthcare system is its longstanding history of integration of both physical and behavioral health services through programs like collaborative care and primary care, which focuses on depression and anxiety.

And I would say that coordinating gender-affirming care with mental health support as clinically necessary, and of course with informed consent, we know and we've heard leads to better mental health outcomes. So here at New City Health+ Hospitals, this is absolutely a process that we use to provide full care to the patient. But I'm going to turn it over back to Dr.

Fattal for additional comment. Yeah, I agree 100%. And we, you know, do it on behalf of the patient, so we don't rely on the patient to have to connect the dots. So if the patient is already engaged in treatment in primary care, primary care team would make the referral to behavioral health, and the reverse is true. If someone starts their care in behavioral health and we realize that they need medical services, then we connect them with medical services internally.

And for disclosure, I work for H&H as a nurse, so I don't want people to think I'm biased. Let's be clear, I work and then I believe in the care that you're providing. And if I may say, it was Elmer's Hospital, which would never turn anyone away. So— We don't mind you being biased.

Have staff observe increased anxiety among patients and families about the federal environment or Medicaid changes? Yeah, you know, it's hard again, as Dr. Fattal said a moment ago, to comment on specific patients, but I would say broadly speaking, yes, we are starting to hear rumblings from the patients to whom we provide care. However, from our perspective, it is always, always our hope that H&H creates an environment of support and reassurance for all patients, including those seeking gender-affirming care.

And as such, shout out to my colleagues at H&H who really do a fantastic job of updating guidance on our public-facing websites and our social media channels, as well as through patient emails and during visits of patients in the exam room with the care teams to make sure that they feel safe and they're provided with all the necessary information because we know getting accurate and correct information is critical.

That's right. And we have been joined by my colleagues Wilson in the house. How does H&H involve and support parents and caregivers, given the role of family acceptance as a protective factor? Yeah, for all our child and adolescent behavioral services, including the family, the legal guardian, the other caregivers involved in the care of the patient, is core to what we do in treating all our patients.

And this is definitely true in the case of LGBTQ patients and in the case of providing gender-affirming care. While we're at it, do we create a support system for the family specifically? Because we know in some culture is more difficult for acceptance. And that's the reason when I started, I talk about acceptance and accessible and where we are in life.

Yeah, definitely. We're, you know, we have this in mental health in general because there's a lot of stigma and there's a lot of resistance sometimes from families, communities. So we're used to doing that. We're very used to including other caregivers, including the communities. You know, we do a lot of work, for example, in schools. We're present in 50 schools in New York where we provide mental health services.

So we have this as part of the way we provide services for children and adolescents, and we apply the same when dealing with gender-affirming care or when working with LGBTQ patients. Okay. So if a family actually come with the young folks and they are not as kind of like not in a place where they, because what I have found in my time in the ER, sometimes they can be an obstruction for you because of their belief or whatever it may be.

So do you kind of like providing that kind of support right away to make sure the family kind of have an understanding and more— kind of like helping with the process of providing the care for that young person? Yeah, 100%. We treat the whole person. We, you know, don't look only at the mental health side of things.

We look at the whole person, and treating the whole person includes including their family and involving them. I do have to say that we practice within all 4 corners of the law, and we practice within the New York State OMH guidelines and regulations. So obviously we all of this within the available guidelines that we have. Okay.

Pride Health Centers. The 4 Pride Health Centers are primarily located in Manhattan, the Bronx, and Brooklyn. For TGNB New Yorkers in Staten Island or outer Queens, distance can be a meaningful barrier, particularly now that some private hospitals hospitals' programs have pulled back. Are there any plans to expand access points even for mental health services, specifically in those boroughs?

Great. So I can start and then I'll pass it back to Dr. Fattahl. And thank you for that question. I would say the last time I was sitting in this room was during the COVID pandemic giving testimony. And if we were to look back historically, I'm kind of a glass half full kind of guy, that one of the positives that came out of the pandemic was our ability to turn on telehealth or virtual care literally overnight in the midst of the pandemic.

And one of the things, again, that I'm very proud of New York City Health and Hospitals is our continuation of those services to, as I said before, reach New Yorkers where they want to be met. And so we have relied very much on telehealth or virtual care to reach patients throughout all 5 boroughs in the city. Now, to your, to your question, I would say we continuously monitor the need or the demand for clinical services throughout our system.

And indeed, we work as a system, right? So I want to be very clear that a system works in that not all services are available at each and every center, but as a system, we work together. So if I'm patients at Bellevue and I don't have a particular service there, I can refer that patient to one of our other facilities.

And telehealth is absolutely a tool for convenience. And I would say— and I was going to turn it over to you, Ammar— but certainly in the behavioral health realm, lends itself very nicely to that exact type of care. So maybe if you have additional comment. Yeah, 100%. This one— this is one of the few things that— the good things that came out of COVID has really transformed the way we deliver care.

We've actually published studies on this from H&H where we saw higher show rates for people who are using telehealth. So we very much use that. And as Dr. Wallach mentioned, in behavioral health, if you think about it, most of what we do is based on talk therapy and we don't really need to like touch the person or do a physical exam.

So it lends itself very nicely to telehealth. And Chairman Meneses, if I may, Just to say, we offer a Pride Center at Lincoln, Bellevue, Woodhull, Metropolitan, Elmhurst, and Jacobi. And in addition, there are 2 additional sites as well. So it's not just 4 sites within our system. Gotham Health, both Gouverneur and Gotham Health-Judson. Thank you. And I want to say thank you for all your support and the advocates in the room to continue making sure that New York City, when it comes to healthcare, is for all of us, no matter where you're from, no matter what gender, just like hold New York City together.

Thank you for your service. And I'll pass it back to Mike Harley. Thank you, Chair. And I'll go ahead and pass it over to Chair Farias. Thank you so much.

And thanks for all of your testimony this morning, folks. Just really quickly on local data, does NYC Youth Risk Behavior Survey or any other DOHMH survey capture gender identity specifically? Someone on the panel, you want to come back up? Thanks. Yes. The Youth Risk Behavior Survey for both high school and middle school New York City public school students does capture data on gender identity.

Okay. And since we do capture that data, what does it show, if at all, anything around depression, anxiety, self-harm, suicide attempts or ideations among TGNB youth compared to their cisgender counterparts? Yeah, it shows health disparities for sure. So it shows that students who identify as transgender are more likely to report report electronic bullying, feeling persistent sadness or hopelessness, suicide ideation, and suicide attempts than cisgender students.

So for example, in 2023, we saw that public high school students who identified as transgender or non-binary or some other gender identity or questioning were more likely to report suicide ideation. So those groups were 40— the groups, sorry, let me say this differently. The percentage of each of those populations that reported suicide ideation were for transgender, it was 42%.

For non-binary, it was 38%. Those who said that they identified as some other gender, it was 45%. And those who identified as questioning, it was 28%. And that's again the percentage who reported suicidal ideation. Versus those who identified as cisgender, it was 16%. So that's just— we have data on the various outcomes, but that's just one example that illustrates the disparities.

Thank you.

I'd like to talk a little bit about the NYC LGBTQ Healthcare Bill of Rights. We know the Bill of Rights directs individuals who experience discrimination or denial of care to file complaints through the NYC Human Rights Commission. Can you walk us through what support, if any, is available to a young person or their family in the immediate aftermath of a care disruption or before a formal complaint process actually gets underway?

Yes, I'll briefly touch on this, and I just want to clarify Chair Farias, you're speaking about a patient who is discharged and immediately prior to filing a complaint, you know, in the event that they need medication or ongoing services. Yes. And what the process is prior to in terms of referring directly to the Bill of Rights that we have in the city.

Yeah. And so, you know, my understanding of this, and I think we, you know, we may have to get back to you, but I'll pass it back to my colleagues to if they have additional information. And so the way that I thought about this question, I'll say, is that my understanding, I guess, of New York State law anyway, in regards to patients who are in an inpatient hospital setting, they actually do have certain enumerated rights in regards to discharge and continuation of care and continuity of care.

I'm unaware at this time of a similar sort of analog in relation to city law, and that may just be because of regulatory purview. Mm-hmm. But I will say sort of in a private clinic, all physicians are licensed and regulated by the state board, and professional rules for physicians expressly state that it is professional misconduct potentially malpractice to discharge a patient without figuring out a plan to make in a reasonable amount of time to make sure that they are going to be able to find a provider and ensure continuity of care.

And they also need to be available in that time to provide care and on an emergency basis. And I'm not sure if my colleagues have any other— anything else to add on that point? Oh, wonderful. Sorry. And I would also assume not only in timeframe, but also potentially in the language they speak, et cetera, they're receiving whatever after— like whatever care needs to come, right?

Like we're also— I just want to throw it out there that we should also be making sure we're bilingual, which I'm making the assumption that we are in terms of aftermath care. I mean, I believe our language access rules would require that. that. We're just going to swear you in before you— Yeah, sure. Please raise your right hand.

Do you affirm to tell the truth, the whole truth, and nothing but the truth before these committees and to respond honestly to councilmember questions? Yes. Okay, you may, you may answer. All right, and in addition to what the director shared is that, you know, we're also really excited to be utilizing a portion of the $15 million investment to launch the call and text line to act as an appropriate— as an important backstop for New Yorkers to link them to care services and information and resources related to gender-affirming care.

Okay. So I guess I'll follow up after the hearing.

I just kind of want to better understand if there— what are the actual steps? I mean, we do a lot of this throughout the City of New York depending on what agency it is, and I'd like to know what the steps that we have in place to ensure that that care is underway and actually being performed. Let's see.

So I would like to talk about— I mean, specifically, Director Brown, if you can speak a little bit about your litigation experience and how that is informing the initiatives the office is undertaking in the current federal environment that we have here? I feel like you spoke a little bit to that in your testimony, but would just like to hear how you're framing or the framework of the initiatives coming out of the office.

Yeah, thank you for the question. And so for those who don't know, prior to this position, I was an Assistant Attorney General in the Civil Rights Bureau here in the Office of the New York State Attorney General, Letitia James. Before that, I was a staff attorney at both the American Civil Liberties Union and Lambda Legal, and I was doing impact litigation on behalf of transgender people across the country.

And, you know, I graduated from law school in 2017, so, you know, that was right when Trump was elected. So I really cut my teeth in doing a lot of that very early litigation as well as it continued on. And so I would say, and my work's specifically was focused on healthcare in a very real way because of my own sort of personal story in that.

And so because of the types of cases I led and their significance, that has given me deep expertise in both civil rights and constitutional law. I think it also has given me clearly, but even from a personal perspective, but a very deep understanding of the issues facing LGBTQIA people and especially where those issues intersect with government. You know, my office's work is done in the shadow of unprecedented federal hostility and serious changes to the legal landscape.

And so in the shadow of that, my litigation experience primarily suing governmental entities and actors and challenging unconstitutional or unlawful executive orders, laws, policies, regulations, and what have you, it's given me a deep understanding because we also have those tools. And so it has given me a deep understanding of how to use those tools and other— and others that government has in order to effectuate true change in people's lives for the better.

Are there any federal actions or legal developments that you're planning or the office is planning to watch more closely or track? You know, I think that is something I consider that an obligation of my office. I think I— and I'm often in contact with my colleagues and work closely with my colleagues in the Office of Chief Counsel as well as the Law Department in monitoring any legal, regulatory, and especially federal action, I guess tweet at this point, that could potentially impact LGBTQIA people.

So that is something— and again, so that goes to things like Federal Register, tracking the Supreme Court docket, and also just looking at litigations in both our federal and state courts. And is there anything that comes to mind for, in terms of counsel support, whether that's for the office, for any of the initiatives, or any of the federal-level legal items that you folks are going to be tracking and watching, any support that can be coming from the counsel side?

Yeah, and again, so, you know, at a certain point I won't be able to to reference my relatively short tenure. But I will say at this stage preliminarily, not so much on that, in thinking about some of the sort of planning that I'm doing, one thing that's coming up for me and has been coming up for me in my practice as a civil rights litigator is the issue of data.

And I think we've been referencing that today. And I do believe that that could and probably likely would require a legislative fix, or not but solutions and innovation, I guess I should say. At a very high level, when we work towards solutions for systemic issues affecting historically and intentionally marginalized communities, data is key for many reasons, including evincing the problem, understanding the scale of interventions required, formulating solutions, monitoring their— and monitoring their efficacy.

Thank you. Oh, I should also say, and, you know, I'm also very eager for to hear from you all and to meet with LGBTQI people in your districts to understand their needs and what's impacting them as well. And so I just want to say that to you all. I appreciate that. Thank you for the responses today. I'll kick it back over to Chair Kavanagh.

Thank you. Thank you. And I deeply appreciate Chair Faria's questions around collaboration opportunities with, with council, just to If it wasn't already clear, you have really, really eager, willing partners in the council. You know, we passed a number of TGN-CNVI protections at the municipal level. We've worked together, obviously, in getting funding for our community. And so we're here to be partners in that innovation.

I want to follow up on this line of questioning that the chair just engaged in. What is the Mayor's Office of LGBTQ Affairs, the coordination with other agencies look like? You started to touch on it, but if you could go into some more specifics around it. And, you know, will you be doing any outreach to hospitals about the benefits of providing access to gender-affirming care to youth and mental health impacts?

Is it a situation position where, like, they already know, and so maybe that's not necessary. But yeah, I'd be curious to know. Yeah, I mean, that cooperation began on day one of my tenure in this position. And I think that— and I know that that comes from a fundamental belief that government services are for all people in New York, including LGBTQIA people.

And so, you know, my office, I think of it as a way to ensure that agencies are providing those services that are inclusive of LGBTQI people who are sometimes often, you know, not thought of or, you know, solutions aren't sort of centered. And so just off the top of my head, I can say I've had many conversations with CCHR, Law Department, OCH, my wonderful colleagues at both Health and Hospitals and the Department of Health, and I'm planning other things to to work with fellow agency and office heads.

And so, yeah, I mean, I think that just has to be built into my work. Because, again, those especially, you know, when we are talking about agencies dedicated to homelessness prevention, healthcare, housing, what have you, those are all LGBTQI issues. That's right. And thus my community must be taken into account in those decisions. And also sharing the important work that those offices are doing.

I think sometimes the public may not have an awareness that those offices may be for them and are required to serve them as well. And it brings to mind, too, I just had a conversation with Commissioner Martin from the Department of Health who is planning some things around HR1, and that's something that is certainly going to impact LGBTQIA people. we've had conversations about sort of how do we get more information to the communities that I serve specifically.

And apologies, could you please repeat the second part of your question? Or was there a second part? No, I think you very thoroughly answered the question. I'm going to hand it over to colleagues, but I just— as you say that, you know, the council's LGBTQIA+ caucus obviously has has for the past several years been putting out a policy plan and roadmap, and I want to give a really, really big shout-out and acknowledgment to now Councilmember Wilson, who at the time was the chief of staff to Councilmember Botcher, and really, really anchored a lot of the work that we did on the Pride in Policy report.

There is an updated version of that coming out soon, but I think that's also an area for us to be able to collaborate And we can be talking about legislative interventions. But is Wilson next? Oh, because he's not here. Okay. And with that, I'll pass it over to Councilmember Wilson.

Thank you, Chair. Appreciate those comments. Hi there. Thank you for your testimony. I have a— for H&H. When a major hospital system stops providing gender-affirming care for youth. How does the city assess the resulting impact on both the hospital capacity and the mental health of the affected patients? And who is responsible for tracking those outcomes? Yeah, so I'll start and then I'll pass it over to Dr.

Vittal. And just to say, it's hard for us to comment on what the private hospitals are doing. But we stand, as we've said in our testimony, at the ready to fully support all patients in need of care, no exceptions. And so as part of any other type of care that New York City Health+ Hospitals provides, whether it's cardiology or GYN services, we regularly monitor what that demand is and we look at our capacity within our system and we adjust, you know, what is available to patients.

So it's no different for gender-affirming care, and it's something that we keep a close look at. But Omar? Yeah, exactly same thing for mental health. We, you know, our mission is to serve all New Yorkers without exception. And I'm happy to say that we do have capacity in mental health right now. We've made it very easy for New Yorkers who are looking for help to get it.

This is for all New Yorkers, including LGBTQ+ people. One number, 1-844- NYC for NYC. All they have to do is ask to be connected to behavioral services and we can connect them to care. Are there system-wide safeguards that help ensure patients do not experience abrupt interruptions in medically necessary care, especially during periods of policy uncertainty? So I can start again on that, and I would say there have been no— And if there's anything that need to get back to us on, that's fine too.

Thank you. But just to say, we have not changed our scope of practice for gender-affirming care at New York City Health+ Hospitals. Can I? Okay. I guess I would just say, can H+H commit to notifying the council of any significant policy changes affecting equitable access in a manner that protects patient privacy? Yeah, so again, privacy and patient rights is critical to healthcare.

It is a partnership between the patient and the care team, and so we certainly adhere to all regulations and rules, specifically HIPAA, and do everything we can within the bounds of the law as far as release of information. So we'd It is something that we take very seriously. As a member of the Health+ Hospitals community, we have annual compliance updates that all staff members must go through in addition to the trainings.

So this is something that is very near and dear and important to us. Thank you, Councilmember.

I have, I think, just 2 more questions at the moment. I want to touch on the New York City Health Map for a moment. We have it, right? Okay, great. So it currently features a dedicated LGBTQ health services portal that allows New Yorkers to search for providers by geographic proximity and medical need. Can you talk a little bit about how the map is maintained and specifically how frequently provider information is verified and updated?

Yeah, please, please raise your right hand. Do you affirm to tell the truth, the whole truth, and nothing but the truth before these committees and to respond honestly to councilmember questions? Sorry, yes, I do. Good afternoon. My name is Andrea Howard. I'm the Deputy Commissioner for Disease Control at the New York City Health Department, and I use the pronouns she/her.

So, the LGBTQ health services are a section of the Health Map, and that was first launched, this particular section, in 2018. And since that time, it's gone ad hoc. updates. Participation is voluntary, and providers have to consent to their information being included in the Health Map. And participating providers are responsible for informing the health department when that information needs to be updated because of contact information changes or services change.

Now, recognizing that that is not always done, and particularly in rural areas— Yes. light of the recent changing care landscape, we're undertaking a comprehensive review of this section. This will include surveying all providers that are currently included in the Health Map to make sure that they continue to provide culturally competent and affirmative services and that the information is accurate.

We'll also be reaching out to additional providers through consultation with our networks to see if they would like to be included. Now, in the interim, we have reached out to certain providers when we know that services have been changed. For example, we reached out to Mount Sinai and to NYU facilities, and we revised their listing to reflect that they no longer offer gender-affirming care to youth.

Okay, thank you. Yeah, I think You're acknowledging sort of the gap that people can proactively tell you things are changing, but some people you're going to end up having to chase down. Obviously, NYU, Mount Sinai, that's— it was big news, so it was easy to track that down. But are there other ways that you're looking into whether the directory is accurate?

And how often are you finding that you're doing it or that you think it it necessitates doing? And also, how is that process being resourced? Yeah. So as I mentioned, we're currently planning to launch a survey later this fall so we can do a comprehensive update. In the meantime, if any of you know of any information that is inaccurate, please let us know and we can reach out to the provider and verify.

Okay, great. And, you know, I think even in terms of being proactive, Obviously, there are lots of organizations, service providers, advocacy groups that are on the ground and have their— have relationships with families that are navigating this in real time. And so I think that also might be a good place to do some proactive outreach to get that information more quickly.

Okay. For a TGNB person or their family navigating the map, is there any indication of which providers specifically offer gender-affirming care for youth as distinct from adult services? Thank you for the question. So users of the healthcare map can filter by the 4 different types of services: primary care, gender-affirming care, sexual health care, and behavioral health care.

And they can also filter by providers that offer services for adults or for youth. Okay. Thank you.

I'm going to turn it over to Councilmember Epstein. Do you have questions? No? Okay. Then thank you very much for being here and for your testimony and for the continued collaboration with the council. Appreciate you. Okay, we'll do the first panel. So the first panel is— No, I hear you. Okay. So we are now going to be opening the hearing for public testimony.

I want to remind members of the public that this This is a government proceeding that decorum shall be observed at all times, and as such, members of the public shall remain silent at all times. The witness table is reserved for people who wish to testify. No video recording or photography is allowed from the witness table. Further, members of the public may not present audio or video recordings as testimony, but may submit transcripts of such recordings to the sergeant-at-arms for inclusion in the hearing record.

If you wish to speak. speak at today's hearing, please fill out an appearance card with the sergeant-at-arms and wait to be recognized. When recognized, you will have 2 minutes to speak on today's oversight topic and legislation. If you have— did we say 2 or 3? You can say— we should do 3. 3 minutes to speak on today's oversight topic and legislation.

If you have a written statement or additional written testimony you wish to submit for the record, please provide a copy of that testimony to the sergeant-at-arms. You may also email written testimony to testimony@council.nyc.gov within 72 hours of this hearing. Audio and video recordings will not be accepted. Oh, I forgot that we do it. Damn it. I can't even read this.

Okay. And so for our first panel, we have Maxima Rodas. Nat Moog, and please correct my pronunciation if I've got it wrong. Filament and filament kind. And Asha Lyons. Got it. Wishing Asha well. All the healing vibes. Okay, once you guys are all settled, um, whoever wants to start can, can start. Just make sure your mics are on.

All right, thank you so much, Chair Farias, um, Chair Caban, Chair Narcisse, and members of the Committee on Women and Gender Equity, Mental Health and Substance Use, and Hospitals for holding this hearing and providing us with the opportunity opportunity to testify today. My name is Nat Mogay, pronouns they/he, and I'm the Director of Advocacy and Programs at the New York Transgender Advocacy Group, where we focus on creating pathways for TGNC/NBI New Yorkers to build leadership and drive advocacy and grow community rooted in collective care and power.

Although New York State has been established as a safe haven for trans youth, health-related societal barriers still prevent our community members from accessing the care we need. These barriers include housing insecurity, cost barriers, lack of culturally competent providers, food insecurity, and unreliable transportation. 17.3% of transgender New Yorkers have reported cost barriers for needed medical care compared to 7.3% of non-LGBTQIA individuals.

22.2% of trans New Yorkers have also reported unreliable transportation and housing insecurity as a barrier to receiving healthcare versus 17.1% of non-LGBTQIA individuals. This gap in accessibility has been exacerbated by hateful rhetoric by the federal administration, placing providers and TGNC/NBI clients under extreme fear. Healthcare should be universal. However, we are living without a system that guarantees medical coverage for all residents.

Even as a 27-year-old trans activist, I have been without a healthcare provider for 4 years now. No PCP, no dentist, none of that. There's a major shortage of providers who understand our communities. Nearly one-third of LGBTQ New Yorkers report that there are too few healthcare providers trained in LGBTQ issues. And amongst trans and gender nonconforming New Yorkers, more than half identified the lack of LGBTQ-trained providers as a significant barrier.

This shortage places an unfair responsibility on patients, and TGNC/NBI people frequently have to educate their own healthcare providers about our bodies, our medications, and our basic healthcare needs. And a patient should not have to become a medical educator simply to receive competent care. Thank you. We all know that there's been moves towards shuttering healthcare for our community, and there are clear attempts to restrict our access to safe and affirming resources.

These moves will be detrimental and deadly towards our community members, and while opponents try to restrict access and instill fear, our city has the opportunity to remain a leader and dedicated to our people. We make the following recommendations to the City Council and urge support for the following. following to prioritize constitutional and legal protections for our community.

We support Intro 949, we support Resolution 0208, and we support Resolution 0547. Thank you for allowing us to testify, and we look forward to working with you to make sure that trans folks get the support they deserve. And I will also email over my testimony alongside our trans youth that we have here and provide my contact information.

Thank you.

Thank you, Chair Amanda C. Farias, Chair Tiffany Caban, Chair Mercedes Narcez, and members of the Committee on Women and Gender Equity, the Committee on Mental Health and Substance Abuse, and the Committee on Hospitals for holding this hearing and providing us the opportunity to testify. My name is Maxima Rodas. I use the pronoun she/they, and I'm a program participant at New York Transgender Advocacy, NYTAG.

Based on my personal experience with the healthcare system in New York City, I can say that on numerous occasions, Even after deciding to begin my transition and having female listed on all my identification documents, I've been faced situations where I was misgendered. Staff at many institutions and clinics are still not trained to properly relay affirming information from the front desk to the healthcare professionals we are seeking care from.

Within the scope of what it is understood and known regarding affirmative care, there are many other factors involved that are often overlooked, such as diagnosis for diabetes, cancer, high blood pressure and cholesterol, heart problems, and skyrocketing numbers of mental health cases, and much, much more. Alongside these, many people in our TGNCMB community are immigrants, undocumented, vulnerable, marginalized, discriminated against, and criminalized.

When it comes to healthcare and public services, they face formidable barriers, including fear and lack of services. To take my own case on as an example, I'm 52 years old and I've been living with HIV for over 33 years, on ART treatment for the past 16 years, and I have other conditions requiring constant medication evaluation and checkups.

While I'm fortunate enough to have a place to live, others who lack housing face overwhelming stressful situations and constant strain of contending with a system that often offered no help at all. It is a system designed to make access difficult or one that is accessible only to privileged few. I support the passage of HR 949 because of a major impact it will have on folks like myself.

I would like to thank the Committee on Women and Gender Equity and the Committee on Mental Health and Substance Use for the opportunity to testify, as through these testimonies we are also sharing the experiences of others who may not be present here today but who do have a voice. Thank you. Thank you. Oh, and we've been joined by Councilmember Gutierrez.

All right, whenever you're ready.

Thank you, Chair Amanda Cifarias, Chair Tiffany Kavanagh, Chair Mercedes Narcisse, and members of the Committee on Women and Gender Equity, the Committee on Mental Health and Substance Use, and the Committee on Hospitals for holding this hearing and providing us with the opportunity to testify. My name is Filament Kind. My pronouns are they/he, and I'm a program participant at the New York Transgender Advocacy Group, where we focus on creating pathways for TGNC/NBI New Yorkers to build leadership, drive advocacy, and grow community rooted in collective care and power.

I am here today to explain why I believe Intro 949 is an essential step towards guaranteeing the health and safety of trans New Yorkers. 6 years ago, I was hospitalized after coming very close to ending my own life and engaging in self-injurious behaviors. 4 years ago, I did so again. My life then felt like a maze with no end.

I was lost. I did not know who I was, and I didn't feel like I fit anywhere I found myself. I'd known for many years that I was queer and trans, but a piece was still missing. For me, that missing piece was medical transition. Thank you. Luckily, in 2023, I made a friend, Joe, who guided me to community health clinics where I could receive the gender-affirming care I was seeking when I did not know where else to— where else to turn or where to start.

Once I made my first appointment at Callen-Lorde, I knew for certain that starting HRT was what I wanted. I am now 2 years on testosterone, and I can say without a doubt that testosterone and queer joy have been the most effective antidepressants that I've ever been on. Gender-affirming care is suicide prevention. Now, some trans folks in New York City may not be so lucky.

I am an English-speaking white US citizen, so finding queer community was easier for me to access. This information is primarily spread by word of mouth, creating gaps in access to this crucial healthcare for those who don't have such community or connections yet. Intro 949 would create for many of these folks access to healthcare that could save lives.

We thank the Committee on Women and Gender Equity, the Committee on Mental Health and Substance Use, and the Committee on Hospitals for their continued support and leadership in protecting TGNC/NBI New Yorkers. We make the following recommendations to City Council and urge support for the following to prioritize constitutional and legal protections for TGNC/NBI folks. We support Intro 949 to create a resource map related to the unique healthcare needs of LGBTQI individuals, including health— including information regarding access to health services and obtaining and providing gender-affirming care.

We support Resolution 0208 mandating all medical students in New York State to receive anti-bias training. We support Resolution 0547 to create a gender— to establish a gender-affirming care program in the Department of Health to ensure the continuity of gender-affirming care services in the state. We thank the Committee on Women and Gender Equity and the Committee on Mental Health and Substance Use for its continued support and leadership in protecting TGNC and BI New Yorkers.

Thank you for allowing us to testify, and we look forward to working with you to make sure trans folks get the support they deserve. Thank you. Thank you so much. Thank you for your advocacy. Even more so, thank you for sharing your deeply, deeply personal stories. And I just want to say to the young folks who have joined us and are submitting written testimony, I cannot wait to read it.

And thank you so, so much for engaging in this process. What you bring to us, we take incredibly seriously, and we're going to do everything possible to be as supportive as we can. So thank you.

Oh, okay. Our next panel includes— and again, apologize if I don't pronounce it correctly, you are here to correct me— but Ocean D. Waves, Cygnus Pavo, Zev Frank, and Ellis Jablansky. All right. Okay, y'all can start. Whoever can start first, doesn't matter. And just make sure you press the button on your mic when you speak. There you go.

Hi, my name is Ocean D. Waves. I am 20 years old. My pronouns are he/him. Fascism depends on complicity in violence, both physical and nonphysical. 3 private hospitals— Mount Sinai, NYU Langone, and NY Presbyterian— have halted or restricted gender-affirming care for trans youth. This should provoke rage across communities. One of fascism's central tools is desensitization to the heinous.

To view something so beautifully complex and so deeply human as being transgender as though if it were a crime is inhumane. A person's right to exist should not be dictated by anyone but themselves. I am an Afro-Latino transgender man, and I am homeless. When I wake up every morning, right after I get out the shower, my routine is the same.

I put my tea gel on each shoulder. That's how I start my day. This is not optional or abstract. It is how I care for myself. How I move through the world, how I be myself. My hormones make the challenges of being homeless so much easier. I go out into the world with a clearer mind than I ever had, a confidence that flows wherever I stand, and a self-love that I wouldn't have otherwise known.

A beautifully complex journey of understanding my gender, breaking boxes, is what it means to be transgender. Prior to hormones, I was not present in my body. No matter how much I forced myself to live with myself, my subconscious always knew that hormones were what I needed. Biochemical dysphoria is not something known to many. Biochemical dysphoria is caused by not having the right hormones in your body.

I had biochemical dysphoria, and I was miserable beyond belief. It has been proven time and time again that gender-affirming care is the solution, that gender-affirming care keeps us alive. Gender-affirming care lets us experience life like our cisgender counterparts. Intro 949 will address these challenges, and it would benefit me, my community, and my loved ones by providing them equal opportunities and access to medical care.

Examples of this include gender-affirming care, dental care, primary healthcare, reproductive care, mental healthcare, and beyond. To deny gender-affirming care is to deny science. It's complacency and genocide. We are trans youth, elders, and adults, all who just want to go outside and freely be themselves. No one should be denied the right to be free. We support INT0949-2026 Shulman to create a resource map related to the unique healthcare needs of LGBTQI individuals, including the information regarding access to LGBTQI health services and obtaining and providing gender-affirming care.

We support Res. 0208-2026, mandating all medical students in New York State receive anti-bias training. We support Res. 0547-2026 to establish gender-affirming care program in the Department of Health to assure gender-affirming care services in the state. We thank the Committee on Women and Gender Equity, the Committee on Hospitals, and the Committee on Mental Health and Substance Use for the opportunity they have given me to be able to use my voice to help my community.

We appreciate your continued support and contributions in regards to the protection of T, G, and C and B New Yorkers. Trans folks will know the community has their back. We are only as strong as our community makes us. I'm going to make a year on T in 2 days. This has been the best year of my entire life.

The ability to be unapologetically human is a human right. Thank you.

Thank you. Whenever you're ready. Thank you, Chair Farias, Chair Caban, Chair Narcisse, and members of the Committee on Women and Gender Equity, the Committee on Mental Health and Substance Use, and the Committee on Hospitals for Whole holding this hearing and providing us with an opportunity to testify. My name is Zev Frank, a youth advocacy fellow at NITAG.

I am a young transgender community member with lived experience on how frightening and confusing it can be trying to find information about TGNCNB health services and gender-affirming care that is accurate and approachable. It's going to be incredibly difficult, especially for a young person with no experience in handling their own healthcare, to find this information by themselves. Even for those of us who have allies in our lives that support us, it doesn't mean that they know everything about our needs or health.

When I needed dental work done, I talked to my parents and they helped me find a dentist, deal with insurance. When I needed hormone replacement therapy, they were more lost and confused than I was. Like so many people, I had to extensively search for the resources I needed on the internet, and it was daunting. There is so much misinformation out there and a lack of accurate information.

As a TGNB person, it can be scary trying to find medical information and practitioners you can trust. If I had verified information and resources from the city during my search, it would have taken away so much of that doubt and fear. I was eventually fortunate enough to be able to find a doctor I can trust who is both welcoming and knowledgeable about transgender healthcare.

At 25 and after over 6 years of medically transitioning, I am still learning vital information about my own reproductive health. Due to a lack of access to relevant resources. Alongside this, most medical professionals I have seen either didn't know or did not provide a safe environment for me to ask. Access to safe, affirming healthcare is vital to individuals in the TGNCNB community and can be genuinely life-saving.

Making this information more accessible to those in NYC who need it through legislation like Intro 949 will undoubtedly be life-changing for many. We thank the Committee on Women, and Gender Equity and the Committee on Mental Health and Substance Use for its continued support and leadership in protecting TGNCNB New Yorkers. Thank you for allowing us to testify, and we look forward to working with you to make sure trans folks get the support they deserve.

We make the following recommendations to City Council and urge support for the following: to prioritize constitutional legal protections for TGNCNBI folks, support Intro 949 to create resource map related to the unique healthcare needs of LGBTQI+ individuals. We support Resolution 0208, and we support Resolution 0547. Thank you. Thank you.

Thank you, Chair Amanda— Chair Farias, Chair Caban, Chair Narcisse, and members of the Committee on Women and Gender Equity, the Committee on Mental Health and Substance Use, and the Midian Hospitals for holding this hearing and providing us with the opportunity to testify. My name is Ellis Re Jablonski. I use pronouns he/him. I'm a program participant at the New York Transgender Advocacy Group.

Receiving medical care as a trans person does not come with the same guarantee of safety and respect as with our cisgender counterparts. Earlier this year, I was getting ready to leave the house when I received a phone call from my former provider Mount Sinai, who I hadn't been to since 2018. 2022 that they were under oath to the administration to hand over all the personal information of their trans patients who received gender-affirming care there as minors.

I was furious not only that they could do this because it was a blatant HIPAA and privacy violation, but that the hospital gave in so easily to pressure. The woman that on the phone that I was speaking to insisted that the hospital's hands were tied. Ultimately, the information release was deemed unlawful by federal court, but no patient should ever have to have that of fear that their doctor could do something like that to them.

This is a unique risk that we as trans patients face when our identity is weaponized into a political talking piece. In other adverse medical experiences, I've been misgendered and deadnamed even when the dermatologist's office has a preferred name and pronoun box on the intake paperwork. I went to the orthodontist for a retainer fitting when the doctor unsolicited tried to sell me a phony gender-affirming procedure, cosmetic tooth procedure, when I've just come in for a checkup.

Health visits can be stressful enough as is. Having a piece of legislation like Intro 949 will allow people to find healthcare providers who respect trans patients and prioritize protecting our health and our dignity. We thank the Committee on Women and Gender Equity, the Committee on Mental Health and Substance Use, and the Committee on Hospitals for their continued support and leadership in protecting TGNC/NBI New York workers.

We make the following recommendations to the City Council and urge support for the following to prioritize constitutional and legal protections for TGNC and BI folks. We support Intro 0949, we support Resolution 0208, and we support Resolution 0547. We thank the Committee on Women and Gender Equity and the Committee on Mental Health and Substance Use for its continued support and leadership in protecting TGNC/NBI New Yorkers.

Thank you for allowing us to testify, and we look forward to working with you. Thank you. Oh yeah, you can pull it over to you or switch it. It's up to you. There you go.

Thank you, Chair Farias, Chair Caban, Chair Nises, and members of the Committee on Women and Gender Equity, the Committee on Mental Health and Substance Use, and the Committee on Hospitals for holding this hearing, providing us with the opportunity to testify. My name is Cygnus Pavo. I use they/them pronouns, and I'm a Youth Advocate Fellow at the New York Transgender Advocacy Group.

As a trans person who is currently receiving gender-affirming care, I've struggled in the past and still struggle now to find a healthcare provider that fits my needs. I personally had to search long and hard to find a gender-affirming clinic that is not only accessible but affordable and reputable. Receiving gender-affirming care in any form, from hormone therapy to affirming surgeries, is an extensive process and it will affect every other type of healthcare you receive.

I am currently struggling to find a primary care physician that I know will not discriminate against me because I am medically transitioning. I've had friends in the past who went to CVS or any other major pharmacy to pick up their hormone therapy, only for them to be interrogated and even outright refused their medication. I have even more friends that can't access gender-affirming care because of affordability issues. issues or not being able to access knowledge regarding clinics that will accept their insurance.

Trans people, even in New York City, which is considered a safe haven, struggle to find places to receive healthcare without facing discrimination. Across the US, gender-affirming care is being outlawed, and private hospitals such as Mount Sinai and NYU Langone are capitulating to the federal administration and restricting who can receive care. Having a portion of the Department of Health and Mental Hygiene's website Dedicated to LGBTQ+ healthcare would be a vital commitment to NYC's LGBTQ+ citizens, a commitment that is rare to find in this political climate.

We support Intro 949 to create a resource map related to the unique healthcare needs of LGBTQI+ individuals, including information regarding access to LGBTQI+ health services and attaining and providing gender-affirming care. We support Resolution 0208, mandating all medical students in New York State to receive anti-bias training, and we support Resolution 0547 to establish a gender-affirming care program in the Department of Health to ensure the continuity of gender-affirming care services in the state.

We thank the Committee on Women and Gender Equity and the Committee on Mental Health and Substance Use for its continued support and leadership in protecting transgender, gender non-conforming, and non-binary New Yorkers. Thank you for allowing us to testify, And we look forward to working with you to make sure trans folks get the support they deserve. Thank you so, so much for being here and for your testimony.

I actually— I have a question for y'all, and I'm putting you on the spot. So if you can't think of it now, I just want to invite you to follow up with me, with my colleagues, so that we can be in conversation around it. But I am just wondering, you know, it's clear that you all support the 3 pieces of legislation that we heard about in the hearing today, but do you think that there are other things that the city government could or should be doing to better support you and the folks in your community?

Ignore that. And any one of you can jump in, any and all of you. I guess I guess for me, the hardest part of receiving care has definitely been mental health care. It's hard to find a therapist or a provider that is gender— that is aware of the struggles of a transgender person. And so I really would like to see if there's any way to improve access to mental health care for transgender people, especially since our health and our, like, mental safety is really being tested in this political climate.

So I think definitely just improving access to mental health and psychiatric care would be really helpful. Thank you. Does anybody else— go ahead. Something that I would like to see changed government-wise is for the government to stop erasing trans and queer history. there was a Marsha P. Johnson monument, and they took that down. And they pretend like trans people or queer people just don't exist.

And we do. We always have throughout time, throughout history. And erasing our history doesn't erase the people. So I— I, and just us as a collective, would really appreciate if people put focus on history, transgender and queer history, because that's important. We need it to move forward. And I really, really appreciate that. It's obviously part of the playbook, and that's well heard, and it's something we're pursuing to make sure that we are increasing the number of representation in our cultural institutions, that we're adding more monuments, and more than that, knowing that we're creating history right now.

And so we need to put money in the, in the hands of queer and trans artists and just people that are doing incredibly good work. And, you know, it goes all the way back even to Nazi Germany. Like, in addition to persecuting Jews, the first thing they did was loot and put on fire all of the research that had been done in the premier center for sexual and gender health that they were doing in Germany at the time.

So that is really well noted and taken. So thank you for that. Does anybody else want to add? I think I just want to add, especially if they're talking about, you know, safe like reliable healthcare for transgender people. I think that can go beyond, you know, like gender-affirming care and also just like when it comes to like finding safe, you know, medical practitioners to go to, or, you know, in so many aspects of life.

But I think this is one where people can be very vulnerable. Like, I know in like my experiences and heard other people say this too, like experiences with medical practitioners, even like, you know, a dentist, like something outside of like seeking gender-affirming care, it can— being visibly or openly trans can really impact the care you receive. And it can be really a difficult task trying to find someone you can trust and try to find like safe, reliable care.

Yeah, thank you. Thank you. I guess it's difficult to say because just, you know, what's even within the ability and scope of the city council. I mean, I kind of just, what you're doing right now, which is just, you know, listening and actively listening to voices of, you know, trans people, just trans and gender nonconforming residents, I think, is really the most important part because, you know, obviously with everything going on right now, and it's just something like today where we're coming in to talk about one aspect of our lives, which is the medical section, but there are other, you know, aspects.

Like, we face difficulty and discrimination in that area, but then there are other areas of our lives as well that we are just there are not institutional accommodations for. I guess to give an example, sometimes I'll use— and this is, I don't know, to give an example, sometimes I'll use the city exercise recreational facilities. I'll go to the public swimming pool, but I can't really— my ability to use something like that that other people may take for granted is not really— it's been a longstanding issue because there isn't a gender-neutral restroom that I would have to go separately to the front desk and then ask them for the key each time to unlock the single stall.

And I might just come out of the pool just dripping wet and be like, hey, can you unlock it? Just every single time. There's not— there isn't that space that's carved out for us. And it can make the day-to-day frustrating and really grueling. So it's Yeah, I mean, really, really just being open to input, like you're doing now, and really just— because I think something— and I think the— I've really admired Mayor Mumdadi's initiatives where he speaks about this publicly, but I think particularly in the media, there's so much negative and false messaging pertaining to trans people, just, you know, spreading completely just fearmongering that's not based in any form of reality whatsoever.

And I think just media, positive media representation, and telling authentic and positive stories about trans people, I think is just so important in any shape or form. That is, yeah, so in the way that I see it, that's the most important. Thank you. Thank you. Well, y'all are brilliant and powerful, and so just encourage you, please be in touch.

We'd love to stay in communication, and we're all ears. And I think Chair Narcisse has a question. No, I was just gonna add that your strength, willing to testify, willing to have the conversation, is what's gonna make— it's just with your love, with driving it, will push out the hate toward anyone else that come behind you. So you taking the leads, you are leaders, and continue being the leader and advocate and make your voice not— let no one shadow your voice, but let your voice be out.

And you have the greatest advocates around here too. So keep on coming, telling us, and then we'll be, you know, making sure that we do what we're supposed to do in our end. Thank you for being here. Thank you, guys. And I just want to acknowledge that we have been joined by Councilmember Perina Sanchez. Well, we were joined.

See you later.

Thank you. Thanks so much. Okay. All right. Next up, we have our Manhattan Borough President, Brad Hoylman Siegel. Yeah, you came a long way, Borough Prez. I did. I traveled across the street. Yes, it's a change from Albany where I have a 5-minute commute from Union Square. Quite a luxury. Thank you. Thank you, Chairs Gabon and Narcisse and Farias and members of the Committee on Mental Health and Substance Use Hospitals, women and gender equality.

I'm Manhattan Borough President Brad Hoylman Siegel, proud to represent the borough where the modern LGBTQ+ human rights movement was born at Stonewall 57 years ago. And I really want to thank the council and your leadership for convening this hearing, and to the families, the young people, providers, and advocates fighting to protect the life-saving medical care that we're discussing today under the threats from the Trump administration.

I'm extremely proud to stand alongside you. You know that we face a targeted campaign to end medical care for transgender youth. At least 27 states have enacted bans or laws restricting gender-affirming care for trans youth. And as more countries, more— Thank you. As more of the country closes its doors, New York is slowly becoming one of the last safe havens and bastions of healthcare for the LGBTQ+ community.

But none of us can take that protection for granted. On October 13th, the Trump administration is expected to implement a federal rule ending Medicaid and CHIP reimbursement for this care for young people. And this year, As we know, the Department of Justice under Trump issued subpoenas to hospitals nationwide, including several here in New York City, seeking the private records of young patients.

I've heard from so many families whose children's records were among those demanded by these subpoenas. It is a uniquely terrifying situation to be in, to do everything in your power to make sure your child receives life-saving medical care, and that's what it is, and then to have the federal government violate your children's and your family's rights to medical privacy.

I had the privilege of working with colleagues in Albany in passing New York's SHIELD Law and what's called the SHIELD Law 2.0 to provide the strongest possible protections to transgender New Yorkers and their families and medical providers against the abuses in the legal process. The SHIELD Law 2.0 protects patients and providers from attempts by out-of-state prosecutors to find them liable or seek information in New York simply for providing, seeking, or obtaining life-saving care that is legal in New York State.

It also requires New York institutions that receive requests for protected health information, even from the federal government, to notify the Attorney General and affected patients before any disclosure. Because of the Shield Law 2.0, the families whose records were sought by the Trump Department of Justice through federal grand jury subpoenas were at least notified with enough time to get to court.

With help from Lambda Legal, the ACLU, and Knight-Crew, they won an injunction still active today that blocks the Department of Justice from obtaining these records. But as you are well aware, a state law cannot override federal law and cannot by itself stop a federal investigation. It also cannot protect what does not exist. We need providers to actually provide care.

And as the Trump administration continues its crusade, its shameful crusade, there are fewer and fewer willing to do so. Thank you. This month, as we know, 2 of Manhattan's largest hospital systems, NYU Langone and Mount Sinai, reached agreements with the Department of Justice to end youth gender-affirming medical care. I think we're all disappointed by this decision and by what they mean for these young people and families who relied on these institutions.

I'm also greatly concerned that we still do not have clarity on the details of these settlements, including how the hospitals will ensure continuity of care for patients currently undergoing treatment. Make no mistake, this is the result of the federal government uniquely obsessed with stopping transgender people from getting healthcare and stripping away their basic rights. But as Dawn Gabriel, the mother of a 17-year-old whose records were included in the grand jury subpoena here in New York, told me, quote, in New York, we protect our children.

We don't feed them to the beast, especially for political convenience. As access to this care declines, families need clear and accurate information about where the care is still available. Councilmember Schulman's Bill Intro 949 would require DOHMH to publish LGBTQ+ health and gender-affirming care resources, and maintain a searchable map of these health services. I urge you to consider and pass this legislation.

I also applaud the resolutions before you for Albany to act on similar measures. But our work isn't finished. I was glad to see the Council commit $15 million to providers. But unfortunately, that's still not enough money to cover the impending loss of Medicaid dollars. So the city and the state need to do everything in our collective power to meet these needs.

Thank you again to the council and the advocates in this room today who continue to fight for the right of transgender young people to live and thrive in New York. And thank you for the opportunity to testify today. Thank you, Borough President. We really, really appreciate it. Also appreciate the, the good work and the collaboration.

Okay, next up we have Judith Goldner, Bree Ferrin, Tatiana Cruz, Alexia Soule, and Ronan Tuggle. All right. Anybody can start. Can you hear me now? Judith— my name is Judith Goldner. I'm the attorney in charge of the Civil Law Reform Unit at the Legal Aid Society, and I want to thank the council for holding this very important oversight hearing.

I want to start by saying, you know, the— we are— we at Legal Aid are very committed to ensuring that everyone who has gender dysphoria is given access to the medically necessary care that they deserve. We were lead counsel in Cruz v. Zucker, which was our lawsuit against New York State to ensure gender-affirming care folks who need that care.

We are obviously very concerned about not just what the Trump administration is trying to do here, but also that hospitals such as Mount Sinai and NYU are dumping patients. They are not providing continuum care. You— everyone needs to know that that's not what's happening. Thank you. We appreciate that that care is still available for young people at the city hospitals.

We are a bit concerned, however, that the $15 million is not going to go to care for young people, and it's care for, you know, young people that is most at risk right now. So it's super important, I think, for the council to make it clear to the city that it's so critical for the city to continue to provide that care to folks who are not otherwise going to be able to access it.

We support— we're very supportive of Resolution 0547, which calls on the legislature to pass A819 and S7985. Which would ensure, which would establish a gender-affirming care program. And we want to make sure that the state is going to continue to provide that care to people. We are mostly supportive of Intro 0949. We do, we are somewhat concerned about the mapping part of this because it could could lead to harassment and threats.

And so we would be happy to work with the council on figuring out ways to, you know, allow people who should have access to information without opening it up to people who might behave badly. And thanks again for doing this. We are always available for to help folks with issues as they come up as well. Thank you so much.

Thank you. And I'm— we're eager to be in conversation and hear more. And I'm sure the sponsor of the bill is as well. Thank you. We will reach out. Great. Thank you.

Good afternoon, everyone. And thank you, Chairman Tiffany Caban, the members of the Committee on Mental Health and Substance Abuse, and the New York City Council for holding this important oversight hearing on access to gender-affirming care and associated mental health outcomes for transgender and non-binary youth. My name is Tatiana Cruz. I am a trans activist and a member of Make the Road New York and NYC Trans and Queer Coalition.

I fled Florida and came to New York because I needed a place where I can live openly and authentically. I needed community. safety, and access to healthcare that recognized me for who I am. Here in New York, I found those things. Gender-affirming care is medically necessary, evidence-based healthcare recognized by major medical organizations. This is healthcare and not a political debate.

For me, access to this care has profoundly improved my emotional and psychological well-being. It helped me feel comfortable in my body, confident in myself, and able to live as the woman that I know myself to be. All of these have also helped me even overcome substance abuse. This is why this issue is deeply personal to me. I also think about a young trans girl named Jade, whom I met when she was 12.

She is now 17. I have watched her grow up, but I have also watched her struggle recently after losing access to gender-affirming care that she once received. At 17, Jade should be focused on her future, her dreams, her education, and becoming the person that she wants to be. She should not have to be struggling because access to her healthcare was taken away.

Her story reminds us that access to care cannot depend on where someone lives or on changing political circumstances. That is why— yes, that is why New York Trans and Queer Coalition supports Resolution 548. 47 and 208 in its call for a statewide gender-affirming care access program. We need continuity of care, stable providers, statewide coordination, and long-term investment so transgender New Yorkers can access the healthcare that they need.

I came to New York because I needed the opportunity to live, heal, and thrive, and I want Jade and every transgender young person to have the same opportunity. Without having to leave home to find it. Thank you for your time. Thank you for your testimony. Hoy, I say in Spanish. Está bien. Buenas tardes a todos y gracias a la presidenta Tiffany Cabán, a los integrantes del Comité de Salud Mental y Uso de Sustancias y al Consejo Municipal de Nueva York por llevar a cabo este importante importante audiencia de supervivencia sobre el acceso a la atención de afirmación de género y los resultados asociados de salud mental para jóvenes transgénero y no binarias.

Mi nombre es Alexia Sol, soy activista y miembro de la comunidad de Made in Rock New York. En lo personal, de joven no obtuve acceso a terapia hormonal ni a cirugías, mucho menos acompañamiento. Tampoco conté con apoyo emocional para transicionar, así que tuve que vivir una vida que no quería realmente. Es triste decir que tuve 2 intentos de suicidio por no saber cómo llevar mi vida como una mujer trans, porque vivía una identidad en la cual no me sentía plena y segura.

Esta tarde estoy aquí testificando porque queremos que la ciudad de Nueva York se comprometa a ser parte del cambio y pedirles que no permitan que los jóvenes trans vivan lo que yo viví cuando joven. Que ninguna infancia trans tenga que sufrir y Y llorar en un cuarto a solas por no tener acceso a terapia hormonal y al apoyo, especialmente de la familia y de los especialistas en salud, que estos especialistas cuando obtuvieron sus licencias hicieron un juramento de salvar vidas en vez de permitir que una vida dejara de existir.

Antes de negar el acceso a la terapia hormonal a una persona trans, piensen en lo que esa persona puede estar viviendo y pensando. Quizás Lo que está en su mente es que no hay salida, que no puede ser quien realmente es. En cualquier rincón del país o del mundo, un pequeño ser humano puede estar pensando en rendirse y acabar con su vida hoy, porque la sociedad le está negando el derecho a vivir su proceso de transformación, a ser quien realmente es.

Hoy día quiero hablarles directamente a esos jóvenes trans que piensan que están solos. Quiero recordarles que no lo están, que nos vean a quienes hoy hemos sancionado, que a pesar de que no fue fácil, al final del día nuestras vidas son similares a la metamorfosis de una oruga que se arrastra y lucha contra viento y marea, pero que un día esa oruga se convierte en una hermosa mariposa.

La coalición hace petición al consejo de seguir invirtiendo en acceso a la atención médica de afirmación de género para personas sin seguro o con seguro insuficiente, que existan organizaciones comunitarias de salud LGBT Q+, servicios de salud mental para jóvenes, que la recopilación de datos respete la privacidad y ayude a identificar las deficiencias en los servicios. La coalición también apoya fuertemente las resoluciones 547 y 208.

Estas resoluciones brindan a nuestra comunidad la oportunidad de navegar el sistema de salud y encontrar proveedores de salud que entiendan las necesidades de nuestras comunidades. Las personas trans están siendo atacadas a nivel nacional. Y queremos que la ciudad de Nueva York siga liderando en términos de buenos servicios de afirmación de género. Es una realidad que muchas de nuestras comunidades trans viajan de otros estados para servicios de afirmación de género.

Queremos que Nueva York sea el faro que guíe a nuestra comunidad al bienestar. Todas las personas transgéneros o no binarias merecen una atención médica oportuna, asequible y que afirme su identidad, apoyando Bienestar físico y mental. Instamos al Consejo a impulsar esas propuestas legislativas, a seguir invirtiendo en la atención comunitaria y a fortalecer la rendición de cuentas para que todos los neoyorquinos puedan acceder a la atención que merecen.

Gracias. Gracias. Quiero que todos escuchen tu testimonio, así que leeré la traducción. I want everybody to hear your testimony, so I'm going to read the translation. translation of it. Good afternoon. I'm going to skip the thank you to me and the committee. Personally, when I was young, I did not have access to hormone therapy or surgeries, much less support.

I also did not have emotional support to transition, so I had to live a life that I did not really want. It is sad to say that I had 2 suicide attempts because I did not know how to navigate life as a trans woman, because I was living an identity in which I did not feel fulfilled or safe.

This afternoon, I am testifying because we want New York City to commit to being part of the change and ask you not to allow trans young people to live through what I experienced when I was young. May no trans child have to suffer and cry alone in a room because they do not have access to hormone therapy and support, especially from their family and healthcare specialists.

These specialists, when they obtained their licenses, took an oath to save lives instead of allowing a life to cease to exist. Before denying access to hormone therapy to a trans person, think about what that person may be experiencing and thinking. Perhaps what is in their mind is that there is no way out and that they cannot be who they really are.

And in any corner of the country or the world, a small human being may be thinking about giving up and ending their life today because society is denying them the right to live through their process of transformation and to be who they really are. Today I want to speak directly to those trans young people who think they are alone.

I want to remind them that they are not, that they Look at those of us who today, who today have transitioned, that although it was not easy, at the end of the day, our lives are similar to the metamorphosis of a caterpillar that crawls and struggles against wind and tide. But one day that caterpillar becomes a beautiful butterfly.

The coalition requests that the council continue investing in access to gender-affirming healthcare for uninsured and underinsured people, that LGBTQ+ community health organizations exist, mental health services for young people, and that data collection respects privacy and helps identify gaps in services. Coalition also strongly supports resolutions 547 and 208. These resolutions will provide our community with the opportunity to navigate the healthcare system and find healthcare providers who understand the needs of our communities.

Trans people are being attacked at the national level, and we want New York City to continue leading in terms of good gender-affirming services. It is a reality that many of our trans communities travel from other states to seek gender-affirming services. We want New York to be the beacon that guides our, our community toward well-being. All transgender and non-binary people deserve timely, affordable, and identity-affirming health care supporting their physical and mental well-being.

We urge the council to advance these legislative proposals, continue investing in community care, and strengthen accountability so that all New Yorkers can access the care that they deserve. Gracias.

Hello, my name is Bree Ferrin. My pronouns are she/her, and I'm a nurse practitioner at Planned Parenthood of Greater New York. Thank you to the chairs and the committees for convening this important hearing, and thank you to the bill sponsors who are advancing legislation to ensure that transgender, non-binary, and gender-nonconfirming youth have equitable access to the resources they need to live full lives.

Planned Parenthood of Greater New York is a trusted provider of sexual and reproductive healthcare and education programs for committees— communities throughout New York. In 2025, we conducted over 3,100 gender-affirming hormone therapy visits, providing care to over 1,500 individuals. I've had the honor to provide care to many of those patients myself. It has been my profound privilege to see the joy, comfort, and improved mental health that comes with accessing this life-affirming and life-saving care.

I've also bore witness as repeat Repeated attacks from the Trump-Vance administration cause increased anxiety, uncertainty, and despair. We've seen the burden on patients trying to access care that has historically been out of reach and steeped in stigma and discrimination. Attacks nationwide that further limit access to compassionate, affordable, and comprehensive healthcare have forced many in the community to go without.

It's imperative that New York remains a beacon for trans people seeking care, regardless of the federal political wins. Planned Parenthood of Greater New York supports Intro 949, Resolution 208, and Resolution 547, which ensure New York State and New York City are providing critical resources to transgender youth. We especially applaud Resolution 547, which establishes a gender-affirming care fund to provide financial support for the necessary medical and surgical care.

I personally hope that Resolution 208 can be expanded to include nursing pharmacy, and allied health students as well. At PPGNY, we are dedicated to providing and protecting inclusive, affirming healthcare. We commend the council for advocating for the rights of all people. New York must continue to provide chance for— protect our transgender youth. We look forward to continuing to work with the council to ensure healthcare access for all.

Thank you for your time and dedication to championing this issue. Thank you.

Thanks. Good afternoon, all. Thanks so much for the chairs and the committees for holding this hearing today and giving us an opportunity to testify. My name is Ronan Tuggle. I use they/them pronouns. I'm the digital organizing strategist at the New York Civil Liberties Union, also known as NYCLU. With the federal attacks on gender-affirming care and hospitals' recent capitulation, the NYCLU has seen a tremendous uptick in the number of intakes we receive from trans New Yorkers.

And disturbingly, we're also hearing anecdotally about an increase in suicides among trans people in the United States, which I know many folks have spoken to today. The most common intake calls we field are from loving, supportive parents who are trying to figure out where they can access the healthcare their children rely on to thrive as their authentic selves.

Gender-affirming— Sorry. Gender-affirming care is healthcare. People seek it for all kinds of reasons, from precocious puberty to middle-aged hair loss to a diagnosis of gender dysphoria. This care is necessary for people to live in their bodies with dignity and health. When it comes to young people, every family should have the freedom to love and support their child, which includes the ability to make private medical decisions free from political interference.

New York City and state have a role to play ensuring New York remains a place where trans people can thrive, and the legislation the committee considers today is an important part of that project. The NYCLU strongly supports Resolution 547, which supports the creation of a state-level gender-affirming care access program. This program would greatly support trans New Yorkers' ability to continue to access the healthcare we rely upon to be ourselves and chart our own futures.

However, Resolution 547 includes a very narrow definition of gender-affirming affirming care focusing entirely on medical care. The resolution should be amended to reflect the state's definition of gender-affirming care, which also includes mental health care and other forms of affirming care, but also excludes non-consensual surgeries conducted on intersex young people. The NYCLU also strongly supports Intro 949, although we do want to note some concerns around the MAP requirement, which could potentially put a target on the backs of gender-affirming care providers, especially in this political context.

The state-level hospital transparency bill, currently A10203 Brozek in the Assembly and S8965 Hinchie in the Senate, could serve as a model for a city-level legislation and help prospective patients identify where to find other frequently denied types of healthcare, such as reproductive healthcare. Thank you so much for the opportunity to provide testimony and for your focus on supporting trans folks and and access to gender-affirming care today.

Thank you.

Thank you so much to all of you. And especially would love to have folks follow up on expanded definitions and other things to kind of strengthen the proposed legislation. Appreciate that. So everybody good? Okay. Thank you so much. Councilmember Gutierrez was just acknowledging the fact that I've been working on my español. She helps me with my Spanish language interviews.

Our next panel is Jan Oesting, Bianca Garcia, Reyna Bien. Is that what they put us there? Okay. Galloway and Kristen Clifford.

We're just going to pause for a couple minutes and the chair will be right back. Thank you.

All right, so one more time, we have our panel, Jan Oesting, Bianca Garcia. Oh, that's BNA. Why is— why is— I— girl. Don't blame it on me. I'm looking at a tight BNA. Bianca over here. So Jan Oosting, BNA, Garcia Reyna, Bien, Wren Galloway, and Kristen Clifford. And if I butchered anybody's name, please correct me. Thank you.

Good afternoon, Chair Caban, Ferreras, and all the other council members that are here with us today. My name is Wren Galloway, and I serve as the advocacy manager at the Ali Forney Center, which is the nation's largest provider for LGBTQ unhoused youth. Also a proud member of the NYC Trans and Queer Coalition. I want to amplify what our other members said and really strongly amplify what the youth panel said as well.

It was a really strong testimony from our youth, and invite folks to really marinate in what they not only said, but listen and believe what they said as well. But what we know here is Gender-affirming care is medically necessary, evidence-based healthcare recognized by every major medical association. We also cannot separate gender-affirming care from mental healthcare. Without access to mental healthcare, we cannot fully support the mental health of transgender and gender non-conforming youth.

And without accessible affirming care, we cannot fully support their gender-affirming expansion as well. As somebody that works with transgender and gender non-conforming youth all the time, as we had to unfortunately hear. We know that folks struggle with gender dysmorphia, things like suicide, and amplified anxiety trying to receive these services. So every day we try to work not to remove these opportunities from them.

So I simply wanted to invite people in to accept that these things are not only happening, but really think about how people are getting to their appointments, how people are understanding their identities as as they're navigating these healthcare systems. For many, there are barriers that are compounded by things like homelessness, immigration status, and unstable healthcare coverage. Delays are interrupted, which really removes care and postpones treatment, which creates fear, uncertainty, and worsens mental health conditions.

As attacks continue in this country, I want to really invite us into a couple questions I have for council here. so we can try to start to remove these gaps together. Are there enough affirming care providers to meet this demand? Which neighborhoods continue to lack services? How long are young people waiting for affirming mental healthcare? And how are the city agencies measuring whether access to gender-affirming care is improving in our healthcare systems?

As New York continues to strengthen access to care, we encourage city to continue to prioritize the strong privacy and security protections for those patients and healthcare professions. In today's climate, these safeguards are being taken away, and these personal information are essential to making sure people are protected. So I really want to just drop in lastly. So the coalition supporting Intro 949, but we need to make sure that not only is this resource regularly updated, but we need to make sure that there are barriers to care and making sure there are protections there.

So information alone is not enough, but making sure that that information is not being shared out to those that should not be receiving it. It must be paired with continued investments in our providers' capacity, affirming mental health services, and healthcare navigations at community-based organizations that young people already trust. Every transgender and gender nonconforming young person deserves timely, affordable, affirming care, as you all know.

So I appreciate your time today. I will continue to add more into my written, but thank you so much.

Thank you. And don't worry about my name. So thank you so much, Chair Tiffany Kavanagh and Chair Narcisse and Freitas and the New York City Council for holding this oversight hearing. My name is Vianney Garcia, and I'm a community organizer with Make the Road New York and a member of New York Trans and Queer Coalition. We are testifying before you this afternoon because we want to confirm our commitment to our communities and to highlight our needs.

As a transgender woman, access to gender-affirming care is vital because it helps us find guidance, information, and amplify our options for navigating the healthcare system in a way that is appropriate and safe for us. I remember when I was 17 buying and injecting myself hormones from buying— that I buy from the street or from the black market. market.

In my experience, it's not an isolated case. As a community organizer, I have heard many stories from community members about the lack of information and how difficult it is to find gender-affirming care providers who understand, respect, and humanize our lives and our transition. Gender-affirming care is medically necessary, advanced-based healthcare recognized by all major medical associations. Now, thanks to the leadership of New York City, I can say that I have a better chance to transition with my doctor guidance.

Trans people like me still face attacks on healthcare, bodily autonomy, and basic human rights across the country. In addition to that, trans people also face difficulties navigating the health system. This virus is a gap to prevents the trans community from receiving the care we deserve. Our coalition also strongly supports 499, which co-established an LGBT directory. As a trans woman working with, you know, with my community, having a directory could help us facilitate and guide people toward healthy and safe transition.

We want also the city of New York to support Resolution 208 and 547. This resolution will help us as New Yorkers to potentially— those traveling from other states for access to better gender-affirming practices, ensure their names and pronouns are respected and feel safe when speaking with their doctors. New York has become a national leader in protecting transgender and non-binary communities, but this leadership is not going to be only, you know, by law, but also people actually access to care they need.

And the reason why I'm saying this, I'm out of my script, but I just want to say that it's important to continue talking about this issue because we have a lot of people, not only like people who born in this country, but also people who are coming to New York to be who they want to be, right?

People are still injecting the hormones that buy from— that they buy from the street. They also inject silicone from, you know, from the black market. And we really need a healthcare system that really support everyone. Doesn't matter gender or color, whatever it is, right? So, And we're going to continue doing this work. And it was really so inspiring to see a lot of youth people here too.

Thank you. Thank you.

My name is Raina Bien. I'm the parent of a non-binary 7th grader and the board chair of Transformative Schools. Thank you all for the opportunity to provide testimony today. The last couple of years have been very challenging for me and the other parents I know trying to raise happy, healthy trans children in a world that feels like it's been abruptly turned upside down.

My 12-year-old has been kicked out of NYU, lost the doctor to whom they confided deeply personal information, and had their medical records tied up in a lawsuit brought by our federal government. The families that are struggling the hardest now are families like mine, with younger kids that need puberty blockers, the life-saving medications that put a temporary and reversible reversible pause in puberty to give kids breathing room while they consider long-term medical decisions.

Our families are locked out of the practices that have seemingly arbitrary age limits like 16 or 14 or 13, as we learned when we called around, and that does include various H&H locations. We're driving multiple hours out of the city to clinics that have vowed they will keep going, paying out of pocket to private practitioners who don't take insurance in the hopes that will keep their practices safe, anxiously navigating care with the overburdened local clinic that has too many patients, and in the case of too many families I know, moving abroad.

What does all this say about our city that calls itself a trans sanctuary, that has promised it will not turn its back on trans youth? I applaud the City Council and Mayor's Office for promising more money for youth gender-affirming care, But the details of how this money is spent is equally as important if it is to reach the most vulnerable population of younger trans children.

Can you lean on the organizations already receiving city money to expand the ages they serve? Can you provide funds for training new providers, including for puberty blocker implants? If an H&H expansion is not on the table, then how about a city-run pediatric and teen clinic? I urge you to think creatively with a bold new vision because pouring more money into how things have been done in the past will not solve our problems.

We need new systems to keep children's care local, affordable, and protected from whatever the federal government plans next. Thank you.

Hi, my name is Kristen Clifford and my pronouns are she/her. And I am the proud mom of 2 trans kids, one of whom is still a minor. NYU Langone ended healthcare for my teenager not because of medical science, but because of political pressure from the Trump administration. Our family's private medical records have been requested by Trump's Department of Justice.

We have that injunction for now. NYU's recent deal with Trump's Department of Justice is a shakedown down, and NYU paid over $8 million and stopped medically necessary healthcare. This is the environment that we are all living in. I am so grateful that both of my children were able to receive excellent gender-affirming healthcare at NYU, and especially puberty blockers, and especially these puberty blocker implants.

Having that time is so important to early teenagers I cannot stress this enough. And puberty blockers, and especially the implant, has been one of the things that parents struggle to access the most in the past few years. I do believe some of it is because of the way that it has been coded by insurance companies, where it used to be in-office and now it is coded as surgery.

And if there's anything that the city can do, we would appreciate that. Our care was been— was taken away twice. After the first time, it was restored. And then again, as I was protesting in Washington, D.C., some of us were arrested. And as I got out of jail for protesting to gender-affirming care, I got a message saying that NYU had cut my child's gender-affirming care.

We need the city and state to do everything they can to support trans kids. My children's mental health was greatly improved by gender-affirming care. I have watched them blossom and grow and become their true selves. The fascist dictatorial federal government is attacking our children and our families. The political environment is harming our children. causing anxiety, fear, and despair.

And parents know what it is like to try to keep our kids alive. And not all of our kids make it. A teenager in my neighborhood in Queens committed suicide by jumping off the Queensboro Bridge a few years ago. They had been bullied for being trans. We need to do everything in our power to support trans kids, especially in light of the harmful federal actions.

And we need to step in. The city needs to step in and provide gender-affirming care. One of my questions for the city is, how can the city attract— Thank you. You can get tissues. How can the city attract and support more gender-affirming care practitioners? This is something that we need as a sanctuary city. Gender-affirming care is life-saving care because I've seen that up close in my own home.

Trans kids need all the support they can get to become trans adults, and parents need support. So many parents are scared to reach out because of all of the anti-trans rhetoric and hatred. They're scared to get help for their families. This resource map is really important because we share information in a whisper network, but then if we have this research map, this resource map, we are all worried about the providers and about the safety and about families who— families don't come forward because they're afraid of being doxxed.

I'm grateful, I'm so grateful to all the people who are here today supporting trans youth. And I support all of— all that New York City can do to, to do gender-affirming healthcare access. Thank you.

I want to thank you all for your testimony, especially for the parents that we have with us. You have provided us with What we've needed to hear, but also suggestions on what could come next. And so I just want to create another space if there's anything that you want to expand on in terms of how else the city can support you and your, and your families at this time.

And obviously our door is open and we want to be having those conversations. And also, my God, y'all are incredible parents. So thank you. Thank you. You know what? Our kids are lucky because they have us, and there's so many kids that don't have parents like us, and the city needs to support all of those kids. Okay, thank you.

All right, do we have another panel? Yes. Okay, our next panel includes Kimberly Blair, Annabelle Ruggiero, Ray Blazin, um, JJ Cleo Mizrahi, and Andy Bowen. And again, please, I apologize if I mispronounce your name, correct me. And yeah, step on up. Okay, ready when you are. Hi, good afternoon. My name is Jazay Clayo Mizrahi, and I'm a longtime New Yorker, and I use they or they.

Every time I come here to City Hall, when we are talking about measures that are affecting the most marginalized, it's usually in the end after corporate interests. I really appreciate everyone who's still here, but we know that it's a challenge to wait when not. all of the City Hall, especially those who are trans allies that really need to hear the testimony of those of us who are struggling.

I'm gonna do my best to go through, and I also sent a written testimony as well, as I wasn't feeling well. We know that trans people are being dehumanized and stigmatized across America and across the world as punching bags, and that even as a trans adult, I know that for my inner child and for trans youth that I am protecting, it is crippling my mental health.

Living with hysteria and fear of thinking even today, if I take my hormones, am I going to be targeted? Am I going to be mocked? Am I going to be harassed again on the subway and the train? Am I going to be mocked and denied care while in the hospital? And so on. We know that gender care is more than just surgeries or HRT, right?

It's support, support groups, it's counseling, it's social services. These are all the elements that people are forgetting that encompasses gender-affirming care. And I'm only here because of trans ancestors who paved the way, but we know that we're still struggling here in New York City. When I was working at the New York Public Library during COVID not only was I discriminated on the basis of gender and my disabilities, but DC 37 in the largest union for the city, did not even have any trans-affirming care that I had to pay out of pocket during the pandemic and was not even trans-competent, and I had to keep re-explaining myself to my union member.

I come from a tradition that says if you save a life, you save the world, and that you're able to break any rule in the Torah as long as you save a life, and that is part of what's bringing me here today. We know that trans people are facing, even in New York City, systematic barriers for jobs.

So thinking about accounting about how much it is to think, how much am I gonna pay for food today, or my hormones, and having to check. We know that 3 out of 5 LGBT adults are without food, and that is proven from HRA. When I was detained and denied certain care in a psych ward for just walking while trans in one of your city hospitals.

I had a relapse because I was not given certain medication and just like my hormonal treatment. Let me just continue to go through my story. We know that it's hard enough to communicate our needs when both in City Council and in state we still do not have one, one TGNCI elected official, and I hope that I'll be part of a generation that will break that glass ceiling.

We know that with FBI, the hate crimes of trans women of color at 79%, more than any other marginalized demographic. We have went yesterday to even rally against Mount Sinai and NYU, and they are debating, do we care more about our values, or do we care more about our money to cave into Trumpism? I could go on and on and on, but I even just wanted to just be able to think about those who are most vulnerable, again, that we're here for youth.

If you even spend an evening at Black Trans Liberation Kitchen, on average they have 200 trans youth. Most are malnourished, most are forced into sex work here in New York City, and are not always getting HRT by approved medical care. And we know from our elders who are not even here, what does it mean when we do not have medical care that is proper.

I'm going to be here around afterwards, but I just wanted to be able to remind you that, again, even for those of us who are able to get some aspects of our gender care approving, that still gender care, some aspects are really class-based. There's— just for even a letter for FFS, I had to wait over 5 years.

Certain operations and care, like vocal feminization, is for those with certain types of insurances. So I really wanted to put into a factor that this is affecting trans people across generations, and thank you so much for being here. Thank you, and we'll be sure to read the, the full of your written testimony you submitted. Thank you.

Hello everyone, I'm Annabelle Ruggiero. I'm strictly speaking on behalf of myself today, but I am an ACT UP rabble-rouser who helped organize the protest at Mount Sinai I that Director Brown spoke at, and I'd like to take the opportunity to thank her publicly for being there. To start, today's hearing and bills are great steps. Intro 949 fulfills a demand our community has been asking for.

As someone who had the opportunity to advocate for this kind of resource, I'd like to personally thank Councilmember Schulman and her staff. But these are steps that needed to happen over a year ago. The situation has, quite predictably, deteriorated rapidly over the past year. A few short months ago, the governor became the likely culprit behind appropriations for gender-affirming care being cut from the state budget, and now 2 hospitals have folded to fascist inquisition.

I must admit, I am personally invested in inflicting political and reputational damage on both Mount Sinai and NYU Langone. And yet, I find it hard to lay blame fully at their feet. At the end of the day, they made a cruel calculation: either defy the federal government and rely on insufficient municipal funds to make up the difference, or abandon trans youth.

The context and local policy environment these calculations were made under is due to a collective failure. To be blunt, this is the fault of the relative inaction by the state government, the city council, and both recent mayoralities, Adams and Mamdani. Not them personally, but their mayoralities. So while I am happy with the legislation before us today, we demand more.

We demand far more. We need to make a public example of both Mount Sinai and NYU Langone. We need to financially support institutions who stand by their patients. We need every fascist capitulator to know that the support of the people is predicated on them not folding. We need a tax for the rich to make up for feral cuts to everyone's healthcare.

And in these bleak times, we need you, the mayoralty, the governor, and the AG to be proactive instead of reactive. Thank you. For a more concrete idea of what we can do, no more municipal funds to any discriminatory healthcare institutions. Thank you.

Hi, my name is Ray Blazin. My pronouns are they/them. I have served as a public health professional for the city in social services serving the LGBTQ and unhoused community before, but I am testifying today in a personal capacity, and the views expressed are my own regarding Intro 949. An LGBTQ resource map does exist at DOHMH. This was addressed earlier.

However, not only will this particular bill codify and protect its existence, which is necessary in times in which our access to our own health is becoming more and more difficult to access across the country, But it also leaves room for greater granularity when it comes to reliable information about individual providers. This map becoming a more concrete and expanded resource has the potential to be a lifesaving mechanism through increasing— by increasing accessibility through readily available information.

As somebody who recently had their provider leave their practice at NYU Langone at a clinic that was previously an all-queer local clinic that had been bought out by NYU, Knowing I was a patient in a practice where some providers would be supportive of my identity and work with me to provide me with specialty knowledge about my own health, and that some would not be suited for that endeavor, was anxiety-inducing and made me reticent to seek care and resulted in the disruption of my care for both ordinary wellness and for chronic conditions.

I had to rely on word of mouth and quietly speaking to other staff members in the hallways days to gather office opinion on who would be outfitted to respectfully tend to my healthcare needs for a long-term, reliable, and culturally responsive provider to a queer and transgender person. Having a map expanded with the weight of DOHMH and the city's authority and consideration of standards behind it, and with care and regard for provider safety in turn, would make the inevitable— the inevitable repeat of that situation, because it will happen again to me at some point.

Sooner, I hopefully— I hope later. But it will make that experience a lot smoother and more accessible and reduce meaningful barriers. This can also potentially reduce siloing of care to specific institutions, many of which are Manhattan-based that are already listed, who strain to serve the sheer number of people who require safer services and provide an invaluable resource to many other New Yorkers.

There is also, I want to put forward for consideration the fact that the bill as it stands does not have a time span indicated on what would be a reasonable implementation time on that map. And given that it is unclear if the existing map is being amended or if a new one is being created, I do think a lifetime on that, what that can look like, would be appropriate.

Thank you.

Great. Thank you for Good afternoon, and thank you, Chairs Caban, Farias, and Narcisse, and members here today. I am Kimberly Blair. I'm the Senior Director of Policy and Advocacy at Girls for Gender Equity, an organization that works intergenerationally through a Black feminist lens to center the leadership of Black girls and gender-expansive youth of color. Thank you. At a time when trans and non-binary people are under nationwide attack, GGE stands firmly here today on behalf of our BIPOC, trans, and gender-expansive youth of color.

We stand also as a member of the NYC Trans and Queer Coalition to support Intro 949, Resos 208 and 547, which we see as stepping stones towards increasing access to life-saving care. As someone who has spent the majority of her career at the intersections of reproductive justice and mental health policy, I'm here to tell you that an estimated 1 in 5 TNGC/NBI youth report attempting suicide, and that nearly 50% seriously consider attempting suicide within any given 1-year period.

In past years, the increase in anti-trans laws in in 19 restrictive states have significantly increased incidence of past-year suicide attempts among these youth by as much as 72%. While New Yorkers might think we're immune because we don't live in one of these restrictive states, our TGNCMBI youth consume this anti-trans rhetoric and experience bans right here from trusted healthcare facilities.

Conversely, the NIH reports TGNC and MBI youth who have high social support and gender-affirming environments report suicide attempt rates at less than half the rate of those without. We believe these bills are interventions that would help us increase the social support necessary to combat these negative mental health outcomes among our youth. Intro 9409 especially would help organizations like mine from spending a fair amount of staff time creating and updating our own internal resources annually to support gender-expansive youth.

We don't see this as the response— complete responsibility of CBOs to do this while also navigating one-to-one case management, supporting students' financial and immigration needs, and providing life-saving education and programming to aid TGNCMBI youth self-discovery and identity formation. Due to time restrictions, we plan to submit the rest of our commentary via written, including suggested bill edits. But I want to thank you again for taking the time today to listen to and stand up for as allies to our TGNCMBI youth.

We hope that you vote these bills favorably out of Thank you.

And I just want to— I want to take a moment to say I appreciate what you said about your faith. One of the things I love about the Jewish faith is the idea that none of us is beyond redemption. And yeah, when you, when you save a life, you save the world. And, and going beyond that, I think about the way that these institutions have capitulated.

And another part of the Jewish faith is like, You don't sacrifice any. It's like we get there together, or we don't get there at all. And so I think it's really, really powerful that you all are here and making it clear that that's the case. And so I'm really proud to be fighting with you all. So I appreciate you.

Thank you. Yeah, go for it. Yeah, I just— it's always hard to, like, time consume with everything. But, you know, I'm thinking about also as someone who grew up in New York who did not know about my rights and about accessing certain safe spaces, you know, about how, for example, growing up in the Orthodox Jewish community, there's misinformation.

When I came out, my mother said to me not long ago, she says, all you'll ever be is a prostitute. And my father said, all you'll ever be— no one will ever love you. And these are messages we're internalizing that they are taking from the media, right? And I had to make a really hard predicament over a decade ago where where my mother said, either you comply to my rules, despite paying the rent and able by law to, you know, not have to observe her faith, you know, because we have a different Jewish denomination.

She said, either you have to take your hormones and you have to leave, or you don't. And, you know, I was subjected to abuse for many years and never got help. And this is the reality for many people, and there's so many stories of people who, whether they leave a fundamentalist faith or whether they're not in a supportive environment, and what does that do to them long-term about having internalized about who they are and feeling fearful that you're hated and that you're paranoid.

And it's still even hard— I'll just end with transgender— trans elders to remind you that not everyone's against you, but I will say that everyone in the community is on guard. Thank you. And it breaks my heart to even go to a support group and see people terrified of just simply wanting to change other parts of their documentation and feel like we have to hide until the Trumpism is over.

So thank you so much. Thank you all.

Okay, this is our last in-person panel. We have Angelica Jatanandan and Muhammad Irtaza. Again, I apologize. Please correct me. And then we'll have one Zoom panel. Andy, I think I called you earlier. Get it. Yeah, come on up. Yeah. Sorry. All good. No, you're good. You're good. All right.

Good afternoon. My name is Angelica Jadunandan. I use she/her pronouns, and I'm the mother of an 8-year-old transgender daughter. 3 years ago, my family moved from Florida to Brooklyn in search of the legal protections New York offers transgender people. I'm now a member of District 15's Community Education Council and an organizer with Parents of Gender Expansive Kids.

I grew up in a conservative Christian home and knew nothing about transgender Gender people when my daughter told me she was a girl at three years old. She didn't say I think I'm a girl or I wish I was a girl. She said I am a girl. So I listened and I learned. I joined parent groups, bought the books, and read the research.

And what I found was remarkably simple: trans kids have the best outcomes when they're loved and supported. Along the way, I also encountered a lot of confusion. rhetoric about trans youth. To clear things up, my daughter isn't a girl trapped in a boy's body. She's a girl who was born into a world that decided she was a boy before she could speak for herself.

We put children into one of two boxes before they're ever even born and expect them to spend their lives fitting into them. But gender, biology, and nature are are far more complicated than that, and it's precisely that diversity that brings beauty to our world. My daughter knows she doesn't need to look or dress a certain way to be a girl.

In fact, she prefers shopping in the boys' section because that's where she finds the video game shirts. And above all others, the title she claims is a gamer. I don't know whether my daughter will ever need gender-affirming medical care. She's only 8 years old. She also has several medical conditions that require us to see multiple specialists. And as her mother, I selfishly hope that she won't have to navigate any more medical challenges.

But if gender-affirming care is something she needs to feel safe, comfortable, and fully herself in a world that constantly tells her she can't be. We need that option to be on the table. My family came to New York City because we believed our daughter would be protected here. Families across this country have looked to New York City as a beacon of hope where their children can live freely and access the care they need.

It's up to all of us to make sure this city remains that place. Thank you. Thank you. Thank you.

Good afternoon, Chairs Caban and Farias, members of the Committee on Women and Gender Equity and Mental Health and Substance Use. My name is Andy Bowen. I am founder and executive director of a now year-old-ish organization called Queer Budget Center, a national organization that uses government budget advocacy to strengthen vulnerable communities' material resources. I miss working with you all and have joined the MIC Trans and Queer Coalition.

I'm also a proud gender-affirming care patient at NYC Health+ Hospitals, which has provided me the best care of my life. I co-signed the asks and questions of the MIC Trans and Queer Coalition partners, and I will emphasize some extra points. It's important to note, given the capitulation of Mount Sinai, NYU, and Presbyterian, that the Trump admin loses when challenged, and other hospital systems have put up fights, notably in the Midwest.

It's notable that after many losses in court, the Centers for Medicare and Medicaid Services have held off finalizing their proposed rule that would condition hospitals' participation in Medicare and Medicaid on its offering of gender-affirming care. With that in mind, we need a whole-of-government approach to fight the feds. I look to the entire Mamdani administration, including the Law Department, Chief Counsel, and Corporation Counsel, to align on a unified goal of protecting gender-affirming care in line with the New York City Human Rights Act, actions of the Attorney General and other AGs across the nation who not only hold the Trump administration to account, but in many cases hold their own healthcare systems to account.

And yes, I recognize the state is the regulator for hospitals, but the city has a lot of leverage. The city holds contracts with these health systems. These contracts are in many cases for important services that they shouldn't— that shouldn't be ended or interrupted. However, the funding gives more leverage for the city to hold these systems to the humans— to the city's human rights laws.

The city should use that power to compel continuation of care for trans and gender nonconforming people to the extent legally possible. As to the bills, I support them and will provide feedback in my written testimony, which will be submitted after the fact. On Reso 547, the governor must follow the example of City Council and the mayor in making historic investments in gender affirming care.

The community is suffering and waiting. I cannot echo hard enough also the need to expand gender-affirming care for all ages, and that care needs to be widely geographically accessible. The city as a government has the resources, and we have the law on our side. Thank you.

I appreciate you so much. Thank you. I appreciate you, and, and thank you so much for, for your testimony. I just again want to provide an opportunity to both of you if there are other things beyond what you stated in your testimony that you think the city can or should be doing to support you and your families.

So I work on the CEC, and we've been talking about mandated curricula and Right now, one of the programs is Wit and Wisdom. There's no LGBTQ+ representation in that. Teachers, if they choose to teach, they have to supplement that. They have to rework the whole lesson plan to include that. And then it also— changes from school to school.

Do you have a supportive principal? We have guidelines in New York City that protect these kids, but it's not always the case that they're followed. Right. And so just making sure that our kids are learning about— I mean, for my daughter to learn about people like herself and to make sure that families are receiving support. At the school level too, not just medical.

Thanks. Yeah, thank you so much. I am so overwhelmed with too many thoughts, and I am afraid of saying the wrong thing right now. We'll talk. We'll talk. Having been a former— and worked for the previous administration, I feel like I know too much, so I'll step back. We were very glad you were there. Oh, thanks. Yeah.

Thank you. I'm not sure I was.

Okay, so we're gonna move to Zoom. I think we have one person on the Zoom. Suhaili Mendez. You may begin.

Hi, good afternoon. Chair Caban, Chair Farias, and members of the committees. My name is Suhaili Mendez, and I'm the policy and legislative coordinator at New York Lawyers for the Public Interest, or better known as NYLP. NYLP is a civil rights organization that advances justice for people with disabilities, immigrants, communities of color, and other historically marginalized communities. And through our UndocuCare TGNCI+ program, we work directly with transgender, gender nonconforming, and intersex immigrants, including young people and their families, to help them access healthcare, housing, as well as legal services.

Thank you so much for holding this very important hearing. NILPI is proud to support Intro 949, Reso 208, and Reso 547, all of which are important steps toward improving access to healthcare and mental health outcomes for transgender and non-binary New Yorkers. At a time when transgender and non-binary youth face growing barriers to healthcare across the country, New York City has an opportunity as well as a responsibility to continue leading.

Access to gender-affirming care is not only a healthcare issue, it is a civil rights issue. Every young person deserves access to care that respects their identity, protects their dignity, as well as supports their physical and mental health, health being. Transgender and non-binary youth experience disproportionately high rates of depression, anxiety, and suicides. These outcomes are not caused simply by a young person's gender identity.

Rather, they're often the result of discrimination, stigma, bullying, family rejection, as well as systematic barriers that make it harder to access healthcare and support services. These barriers often are greater within immigrant youth, particularly those who are undocumented and seeking asylum. Many of these individuals and families we work with has fled violence and persecution because of their gender identity.

They frequently face significant trauma while also navigating complex healthcare, housing, and immigration systems. Fear of government institutions, misinformation about eligibility of services, language barriers, and experiences of discrimination can prevent people from accessing the care that they need. That is why the legislation before the council today is so important. Intro 949 will create— will require the creation of LGBTQI+ health and gender-affirming care resources, including a searchable provider directory.

Time has expired. You can finish your thought. No, finish it. Finish your thought. You're good. Okay, my man's just doing his job. No problem, noted. So, um, we support Intro 949. We also support, um, Reso 208, which recognizes the critical role and bias that continues to play in healthcare settings. Anti-bias trainings for medical students can provide future providers to better serve transgender and non-binary patients, immigrants, and people with disabilities and other historically marginalized communities.

And lastly, we support Res. 547, which calls for the establishment of gender-affirming care program within New York State Department of Health to help ensure continuity of care care. Consistent access to medically necessary healthcare is essential for many immigrant patients. Disruptions in housing, insurance coverage, or access to providers can make continuity to care particularly difficult. And I will be providing more detailed testimony for record, and I thank you so much for the opportunity to testify today.

Thank you.

Thank you to everyone who Thank you. Thank you, Director Brown. Thank you to all of our witnesses who testified. If there is anyone present in the room or on Zoom that hasn't had the opportunity to testify, please raise your hand. Okay. Seeing no one else, I would like to note that written testimony, which will be reviewed in full by committee staff, will be submitted— may be submitted to the record up to 72 hours after the close of this hearing by emailing it to testimony@council.nyc.gov.

I also want to thank Director Brown for staying here for the entirety of the public testimony. Thank you for being here.

And I want to close by saying it is really, really simple. I want— we want every trans child to grow up to be a trans elder, period. And I want those kids to be able to play, to make friends, to engage in sports, to build whatever kind of family they choose to build in and to enjoy what I view as the best city on the planet.

So I just— I've been really moved by the testimony today and all of our shared commitment to really looking out for each other. I know that there is a lot more that government needs to do, and we're here to fight to be able to do that. And just thank you.

And I don't know if— Thank you. If, Chair, you have anything else. No. All right. Well, thank you. And, and with that, we close today's hearing.