What is allegedly the only hospital between Minnesota and Texas carrying out adult gender transition surgeries has decided to stop “due to operational limitations and lack of surgical coverage,” according to a statement that Vanderbilt University Medical Center (VUMC) issued last week. Scrutiny in 2022 over VUMC’s provision of gender transition procedures led the Tennessee legislature to ban these procedures for minors, a law that ultimately prevailed in the Supreme Court’s Skrmetti decision.

“Due to operational limitations and lack of surgical coverage,” the hospital told local news outlets, “Vanderbilt Health will cease providing gender-affirming plastic surgeries for adults. Vanderbilt Health continues to provide nonsurgical gender-affirming care for adults 19 years and older. Vanderbilt Health does not provide any gender-affirming care for patients younger than 19. We are in the process of contacting our patients regarding these changes.”

Reports conflict on the timing of this pause. “I’ve heard from a lot of trgoodans folks who were on the list to have consults, to have surgery later this year, and they received a letter Friday saying they were no longer on the list,” said Nashville Metropolitan Council Member Olivia Hill, who chairs the 40-member council’s LGBTQ+ caucus.

However, the Vanderbilt Hustler quoted an anonymous Vanderbilt professor with a gender transition surgery in April that “will go through.” The Tennessean cited former VUMC employee Landon Forrest, whose previously scheduled surgery in September has not been canceled.

Forrest told The Tennessean that the “next closest” locations providing the gender transition procedures she wanted were in Minnesota or Texas.

Just over three years ago, VUMC played an inadvertent role in Tennessee’s adoption of a law to protect minors from gender transition procedures. In September and October 2022, The Daily Wire exposed VUMC for its full adoption of the controversial procedures. The hospital publicly advertised puberty blockers and cross-sex hormones for minors, as well as double mastectomies for adolescent girls.

In a lecture published by The Daily Wire, VUMC’s Dr. Shayne Taylor extolled the monetary benefits of offering gender transition procedures, noting that “female-to-male bottom surgeries” are “huge money makers,” costing up to $100,000, making them a way to financially support the hospital’s more legitimate programs. Taylor, who has since left VUMC for private practice in Massachusetts, asserted that “gender identity is a more important factor than genitals in determining the sex of a transgender patient,” adding that the term “biological sex” has “no place or meaning in either science or medicine.”

Notably, VUMC may have planned to punish doctors and nurses who refused to participate in gender transition procedures on conscience grounds. In one video published by The Daily Wire, a VUMC doctor said that such conscientious objection would be “problematic” and bring “consequences.” The hospital soon announced a “Trans Buddies” program under which pro-transgender activists would accompany patients seeking gender transition procedures to make sure hospital staff used preferred pronouns and to discourage other behavior deemed “unsafe.”

In response to The Daily Wire’s revelations, the Tennessee House GOP Caucus sent a letter of concern to VUMC, which induced the hospital to announce it would be “pausing gender affirmation surgeries on patients under age 18 while we complete this review, which may take several months.”

The hospital’s response failed to satisfy the legislature. On the day after the November 2022 election, Tennessee House Majority Leader William Lamberth (R) and Tennessee Majority Leader Jack Johnson (R) introduced identical bills (HB 1 and SB 1, respectively) to protect minors from chemical and surgical gender transition procedures, likely taking place at VUMC. “When a child has gender dysphoria or body dysphoria, when they are uncomfortable with their appearance, the worst thing you could possibly do is say, ‘Well, if we just start cutting off body parts or giving you medication that was never designed for this, that will alter your body forever.’ That’s the worst thing you can do,” said Lamberth.

In February 2023, the Tennessee legislature overwhelmingly passed SB1 with bipartisan support. The law drew an inevitable legal challenge from the ACLU, then the Biden administration. However, in June 2025, the Supreme Court upheld Tennessee’s law, reasoning that it made distinctions on the basis of age and medical procedure, not sex as challengers had claimed.

Thus, the profit-chasing administrators who permitted these gender transition practices to be carried out on minors at Vanderbilt inadvertently played a role in catalyzing a nationwide movement to stop the very same practice.

Amid these legal setbacks, VUMC pared down its transgender program further, as those who used the program observed. In June 2025, Vanderbilt withdrew support from the Nashville Pride Festival and ended the “Trans Buddy” program.

Both decisions were cost-saving measures, suggesting VUMC’s gender transition business was not generating enough revenue to pay for non-medical sponsorships and staff for LGBT causes. By this point, it had also become clear that the future prospects of gender transition procedures, particularly those carried out on minors, were increasingly dim. Not only was the state legislature firmly opposed to the practice, but now under President Trump the federal government had begun investigating hospitals for noncompliance and possible fraud related to these procedures.

“At first, they tried to fight it the best they could,” Forrest said of VUMC, but “Vanderbilt cannot go back until the political climate changes.”

Now, VUMC has further curtailed its provision of gender transition procedures by announcing a halt to transgender surgeries, even on adults. This move comes after a woman who formerly identified as transgender won a $2 million verdict in New York state against her psychologist and plastic surgeon who rushed her through a double mastectomy at the age of 16. It also comes as the Tennessee legislature considers a bill prohibiting state-funded health insurance from covering gender transition procedures.

In other words, money-related motives to pause these surgeries abound for VUMC, just as VUMC once pursued these surgeries for the exact same reasons.

The official reasons VUMC gave for the pause were “operational limitations and lack of surgical coverage.” That could mean that they run increasing legal hazard for carrying out these surgeries, and that the surgeons they used to rely on have, like Dr. Taylor, moved away to “greener” pastures in far-left bastions.

When it suits their politics, the Left likes to locate health care decisions between doctor and patient alone. But sometimes, the doctor’s decision can change based not upon medical factors but upon the monetary incentives at play. And regulating those monetary incentives to ensure patient welfare is where the government plays a legitimate role.