Zelda Loeb, 18, has lived in Aspen her entire life. She loves skiing and theater, and recently became the stage manager for a local musical production.
By middle school, she realized she was transgender, and later began receiving gender-affirming care with support from friends and family.
But on Jan. 20, President Donald Trump issued an threatening federal funding cuts to institutions that provide gender-affirming health care for patients under 19 years old.
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Loeb was furious and worried about losing her health care.
鈥淭rump and his administration have made it exceedingly clear how much they despise trans people and want to do everything they can to get rid of them,鈥� Loeb said outside her home on March 2.
When Trump signed the executive order, Loeb was receiving gender-affirming care with the TRUE Center for Gender Diversity in Denver, part of Children鈥檚 Hospital Colorado.
In February, the nonprofit briefly halted its hormone-based care for transgender patients younger than 19 years old in order to safeguard federal funding.
However, when Colorado joined a over Trump鈥檚 executive order, an protected gender-affirming care providers across the state from federal funding threats. Children鈥檚 Hospital Colorado has since resumed hormone therapy and other gender-affirming medical care for transgender youth under 19 years old.
All of this turmoil concerned Loeb over what she would do if she lost access to hormones or other gender-affirming care completely.
鈥淚t would hurt a lot,鈥� Loeb said. 鈥淚've worked so hard to get to this point. I have done so much to be who I am today, and having that huge step back would be awful.鈥�
So as Loeb reaches adulthood, she鈥檚 been considering more ways to receive the body that aligns with her gender identity.
She was originally scheduled to get bottom surgery, a transition-related medical procedure, in June, but recently tried to move up the procedure.
鈥淏eing able to do it even two months sooner gives me a better shot at getting it done before something else happens,鈥� she said.
Loeb has gone through a lot to get where she is now. It took her over a year to get an appointment at the TRUE Center, and she鈥檚 seen multiple therapists, slowly increasing her hormone dosage, all while struggling with gender dysphoria and depression.
At every turn, she had to reaffirm that she wanted this procedure and that she was ready for the next step.
鈥淭he trans health care system is still very overly bureaucratic,鈥� Loeb said. 鈥淚 had all these extra hoops to jump through.
Not all transgender people are interested in gender-affirming surgery, but for those who are, the National Institutes of Health that less than 1% experience regret.
鈥淚t鈥檚 so rare that we see that, especially when we get to surgery,鈥� Dr. Sven Gunther, a plastic surgeon in San Francisco, said in a Zoom call on March 13.
Dr. Gunther, one of Loeb鈥檚 doctors, has been performing gender-affirming surgery for more than 15 years, and has seen his patients鈥� conviction when they decide to undergo surgery.
鈥淭hey've thought about this,鈥� he said. 鈥淭hey've talked with their surgeons. They've talked with therapists. They've talked with their primary care doctors. They've talked with their families, their spiritual leaders. These aren't decisions that we鈥檙e just making with a snap of a hat.鈥�
With among transgender people due to cultural stigmas and discrimination, gender-affirming care and procedures are considered lifesaving by .
Dr. Gunther sees a lot of joy as he witnesses these transformations.
鈥淭hey come in really timid and shy,鈥� he said. 鈥淭hey get their surgeries. They get healed, and they become themselves and actually see them bloom to themselves 鈥� the person that they've always been.鈥�
Loeb was able to successfully move up her surgery, but she continues to worry about how her younger friends will navigate their teenage years under the Trump administration.
鈥淚 know how awful it feels to have realized you're the wrong gender and not be able to do anything about it,鈥� she said. 鈥淎nd I can't even imagine how it would feel to have gotten to the point where you can start hormones and then suddenly that gets taken away from you.鈥�
For now, teenage transgender patients can receive gender-affirming care in Colorado while the lawsuit PFLAG Inc. vs. Trump is underway. However, the federal government is now appealing an injunction that鈥檚 blocking Trump鈥檚 executive order.
The Trump administration did not respond to a request for comment in time for publication.
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