Penn State Health's letter informing Charlie Raught's parents that the transgender teen had to find a new doctor arrived on May 23 last year.
"It was upsetting for me to have to leave," Raught said, "because we had grown a nice bond and my past doctor was very down to earth and generally just a fun person to connect with."
The Seven Valleys teen is one of an estimated 300,000 transgender youths across the United States. Despite having supportive parents, the 17-year-old who'd been taking hormone replacement therapies for gender dysphoria found himself without medical care.
Across the country, 27 states have enacted laws limiting youth access to such care, but Pennsylvania is not one of them. Penn State Health cited "federal government directives" — the letter was sent months after President Donald Trump's executive order — as the reason it no longer offers certain forms of gender-affirming care to people under 19.
Penn State Health was one of at least 40 hospital systems, including UPMC, that voluntarily halted such care. As a result, an untold number of transgender youth stopped receiving care altogether or have been forced across state lines.
Raught, who started receiving treatment in 2023 after coming out to his parents, ultimately found a new doctor at Johns Hopkins in Maryland. He shared his story with the York Daily Record to put a human face to a subject many people don't understand and to offer hope to others.
WellSpan offers gender-affirming care to adults. UPMC was also not an option, because like Penn State Health, it stopped specific gender-affirming care to those under 19.
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Penn State Health spokesman Scott Gilbert confirmed that the system's restrictions on gender-affirming care remain in place.
Gilbert did note, however, that Penn State Health's Gender Care Clinic does still offer psychological care for those between the ages of 10 and 24.
Shortly after Trump's executive order, the U.S. Department of Justice sought subpoenas for the records of youth gender-affirming care patients. Some hospitals, including the Children's Hospital of Philadelphia, challenged those subpoenas in court. In June of this year, federal judges blocked the Trump administration from attempting to seize transgender youth medical records from New York hospitals. But while the legal battles ensue, the gender-diverse are left with fewer and fewer hospitals that offer gender-affirming care.
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For several days after receiving the letter, the Raught family simply didn't know what to do. It kicked off a series of phone calls as they worked to find a new doctor."I was shocked and had no idea how we were going to continue," recalled Charlie's mother, Christa Raught, who sat beside him during an interview with The York Daily Record.
Christa said her son is going "full steam ahead," rolling with the changes. She tries not to think, however, about what would happen if the Trump administration — or Pennsylvania lawmakers — hand down even more stringent restrictions.Additionally, a growing number of school districts in York County and beyond have passed restrictions on what bathrooms LGBTQ+ students can use, which sports teams they can compete on and even what pronouns staff can use to refer to them — with or without their parents' permission.For now, Raught's school district — he attends the Dallastown Area High School as a rising senior — hasn't followed in the footsteps of Dover Area, Eastern York or South Western.
Neither Raught is watching the news lately. The elder is worried and tries not to think about how her son might lose his access to his healthcare.
The younger Raught protects himself by relying on his friends, family and social media to tell him what is happening in the LGBTQ+ community, keeping track of the places he needs to avoid for his safety.
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"Because it's stressful," Charlie said.
Charlie Raught called it selfish not to worry about what is happening elsewhere because it doesn't impact him. But for his own sanity, he decided not to become obsessive.
Charlie worries about the attacks on the LGBTQ+ community, especially the transgender community. Over the past few years, anti-LGBTQ+ bills have popped up across the country and even in Pennsylvania. At the end of June, the Supreme Court upheld state laws that ban transgender girls and women from playing on teams they identify with.
This case also focuses on female transgender athletes and revealed that the court does not believe banning transgender athletes contradicts Title 9 or the Equal Protection Clause. It does not impact Pennsylvania athletes statewide due to the state lacking laws that align with the ruling.
Sen. Kristin Phillips-Hill and Rep. Joe D'Orsie , both Republicans, recently wrote an op-ed calling on the Pennsylvania Interscholastic Athletic Association and school districts to adopt a sports ban because the proposed bills were approved by the Senate, but not the House.
"Legislation isn't needed, but it might take a little courage," they wrote, adding the "ball is in their court" to the districts and the PIAA.
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Pennsylvania's governing body for high school sports previously left those decisions up to high school principals. In 2025, however, it voted to remove the policy — with PIAA officials saying it was designed to comply with President Donald Trump's order.
The Raughts point to the sheer volume of misinformation about transgender youth and gender-affirming care in the wake of the Trump administration's executive orders.
Health care for transgender adults and youth has become a highly politicized subject, fraught with exaggerated and false claims. In Congress and state legislatures, discussions tend to revolve around children and medications.
In reality, however, a recent study published in the medical journal JAMA Pediatrics found that fewer than 1 in 1,000 U.S. adolescents with commercial insurance received gender-affirming medications — puberty blockers or hormones — during a recent five-year period. The researchers found that no patients under age 12 were prescribed hormones, an indication that doctors are appropriately cautious about when to start such treatments.
Gender affirming care, according to the World Health Organization, is a number of options in the medical industry that are intended to help "support and affirm" one's gender identity. Trump also signed an executive order calling for the United States' exit from the World Health Organization.
According to the JAMA Pediatrics study, which encompassed data from more than 5 million teens from ages 8 to 17, less than 0.1% of American teens are either transgender or gender diverse. The study, which was released this year, ran from 2018 to 2022 and shows that no patient under 12 received hormones.
Only 926 adolescents with a gender-related diagnosis received puberty blockers from 2018 through 2022. During that time, 1,927 received hormones. The findings suggest that fewer than 0.1% of all youth in the database received these medications.
The database included insurance plans in all 50 states but did not include youth covered by Medicaid, the federal-state health insurance program for low-income people. Coverage under that program has been limited under the Trump administration.
The study did not look at surgeries among transgender adolescents. Other researchers have found those procedures are extremely rare among young people.
In York County, about half the local districts have already adopted a policy that bans transgender athletes.
It started in York County with the Red Lion Area School District in 2023, when the board adopted three restrictive policies, including requiring the parents to tell the school district what names to call their children. It also gave school staff an out if they didn't want to respect the parents' wishes.
All three of Red Lion's policies were drafted by the Independence Law Center, a conservative Christian law firm based in Harrisburg.
In addition to drafting the sports policy for Red Lion, the firm also drafted similar versions for Dover Area, Northern York County, Southern York County and South Western.
Eastern York also adopted a ban, but it was not written by the ILC. Rather, it was drafted by its in-house solicitor, Stock & Leader, even though the board did openly discuss the ILC and its policy.
West Shore also passed a transgender sports ban about a year ago. This version was also drafted by the district's then-solicitor, Tucker and Arensberg. It also pulled a section of the Northern York County policy, which was written by ILC, in place of what the district's solicitor wrote.
This Supreme Court case also comes over a year after President Donald Trump signed an executive order to ban transgender girls and women from their teams. He also signed an order to restrict gender-affirming medical care for transgender youth, which led many hospitals to change their policies to align with his order, including Penn State Health.
Charlie said those hormone replacement therapies are important and life-saving. He said the hormones, along with having access to binders and other things that help to affirm their identity, help so much more.
"Feel like who you are," Raught said.
"Make it more worth it to keep living," he said.
When he came out to his parents, he was in middle school and told them he was bisexual. He wanted to tell his parents then that he was transgender, but couldn't. It wasn't because he was afraid to come out as gay, given that he has a few family members who are. But this announcement was more daunting because it would prompt more actions and be more life-changing.
His mom, who sat down with the York Daily Record and her son for the interview, said what was changed was only on the outside to be more accepting of who he was.
"But you are still who you are then," she said, looking at her son sitting on the couch with her.
Charlie said, now looking back, it made sense. When he was in elementary school, he would always play the role of dad or brother. He described himself as a tomboy who wore his older brother's hand-me-down clothes. Halloween costumes were usually characters such as Indiana Jones or Teenage Mutant Ninja Turtles' Donatello, which he wore at least three times.
"Typical boy costumes," his mom said.
Then puberty hit when he was 11 or 12, and it became obvious.
"It never felt right," he said. He felt awkward.
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In the middle of summer 2020, when his family moved to Dallastown, he wore jeans and sweatshirts every day because he wasn't comfortable in his skin.
"It was miserable," he recalled. "Like 90-degree weather even if I had to go outside for something."
His first year at Dallastown was virtual because of COVID, but his second year, which was seventh grade, was in person. That's when he met a bunch of queer students he befriended, which helped something click into place for him. He realized who he was.
Charlie explained that before elementary school, he was aware of the transgender community, but it wasn't something he really registered before.
When Charlie came out to his parents a second time, Raught told the Daily Record her son was super brave because he prepared a slideshow or some similar type of presentation to explain who he was.
"He teared up, and I was like OK," his mom said, and then went to work reading books to learn how to support him.
She said there was no shock value, but rather it was all very natural.
Charlie's parents let him lead the way on handling his transition. For instance, he started going by CJ for a period before he became Charlie.
They went to court to change his name and legal documents, using guides the Rainbow Rose Center provides, which Raught complimented.
Both mother and son agreed it was good to get his papers changed when they did because it would have been more complicated to alter later when he had credit cards, licenses or house bills.
It was even easy to change his name with the school, the elder Raught said.
"It sucks that at a lot of schools, you need your parents' permission to change your name," he said, referencing the York County school districts that have adopted anti-LGBTQ+ policies in recent years.
Charlie mentioned one of his transgender friends who recently graduated had asked his teachers to refer to him by his surname, but he suspects the friend wasn't out to their family.
Charlie said he can't imagine what it would be like to not have the support he has. He recalls his struggle from a few years ago, before he transitioned. He also knows that if he didn't come out and have the support he had, his life would be different.
"As depressing as it is, buried," he said. He understands how hard it is to transition alone and couldn't imagine hiding that.
Hypothetically, he said, if he wasn't able to come out to his family, who made him feel comfortable with who he was, he didn't think he would have another option. One can wait it out, but five or six years from middle school is a long time, he said.
"Tell yourself it's not going to last forever," he said. "But it's still a really long time."
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A big hurdle for them was his periods. Every few weeks, he was reminded that his body wasn't completely aligned with him. But they found a doctor, who Raught described as fantastic.
He started on his period suppression and started feeling less awkward.
"I started getting a lot more comfortable just existing," he said.
He had hot flashes for a short period and then noticed his voice changed within a few weeks, which was huge for him. After that, he noticed his hair thickened, his weight distribution changed, and even his face shape.
Now, with a full beard growing, he's aware of what it would look like if he used the women's bathrooms, which is a policy in some of the local school districts and a push in some states.
"I would get so many weird looks," he said. "What is this guy in here with a gigantic beard doing? This is not a girl."
His mom added: "Imagine it is a 30-year-old doing it."
Being that he is in the marching band, he has had to use the bathrooms at some of the schools with the restrictive policy, including South Western. He usually uses the boys' bathroom to relieve himself, but prefers a gender neutral or family bathroom.
"One room with a toilet and a sink," he said, adding there could be a changing table. "All you need for a bathroom and it's perfect."
In Dallastown, he gets worried about using the boys' bathroom because he's heard his fellow male students are weird and like to pop their heads over the stalls to see who is in there.
"I was scared of that," he said, but he has not encountered that yet.
He had a bully or two in middle school, which is when the bullying was the worst. But his high school experience has been great.
But the school has been accommodating to him. Charlie can use the faculty bathrooms or the nurse's, which he said aren't great options because most are usually locked. He tries to time out his breaks for when he is near one of the unlocked faculty bathrooms near the gym, keeping to the same routine, and gets annoyed when he has to change.
When he's out, he feels safest with his girlfriend and friends. He is anxious that someone from his school might say something when he runs into them in the downtown area.
"I may be short, but I have a deep voice and I have a big beard," he said.
Charlie hopes that those who aren't out tell themselves the hate isn't going to last forever. If they can find their people, it will get better. He added that there are plenty of support groups, subreddits, and even events such as York Pride that can help.
The elder Raught said they should trust their gut. She feels like her youngest son is lucky because his whole family supported him. People should trust their gut and be themselves.
"If it's safer to be closeted, then do that," she said. "But I don't think it's always necessary and always the best option."
You can read the letter the Raughts received from Penn State Health below.
The following resources are available for those who need them:
Suicide and Crisis Lifeline: Dial 988
Dauphin County Crisis: 717-232-7511
The Trevor Project 24/7 line: 1-866-648-7386
The Rainbow Rose Center in York does not currently have set drop-in hours but has many services available at https://www.rainbowrosecenter.org/
LGBT Center of Central PA in Harrisburg. More information at https://centralpalgbtcenter.org/
GLO Harrisburg can be reached via https://www.gloharrisburg.org/
You can find more information about the state Human Relations Commission and file complaints at https://www.pa.gov/agencies/phrc
TransCentralPa can be reached at [email protected]
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This article originally appeared on York Daily Record: After losing his doctor, York County transgender teen finds hope