Center for Transyouth Health and Development (CTYHD)
The Center for Transyouth Health and Development (CTYHD) was previously a component of the nonprofit Children’s Hospital Los Angeles (CHLA). CTYHD provided so-called “gender-affirming” care and sex-change procedures for minors and differentiated itself from other entities that practice the so-called “gatekeeper” model, choosing instead to develop the “least restrictive environment possible.” 1
Contents
Following a January 2025 executive order by the second Trump administration to end federal funding for “the so-called ‘transition’ of a child from one sex to another,” the Center for Transyouth Health and Development at CHLA announced it would cease its operations on July 22, 2025. 2 3
Background
The origins of the Center for Transyouth Health and Development (CTYHD) trace back to the Division of Adolescent Medicine at Children’s Hospital Los Angeles (CHLA), founded in 1963, although no specific date is given for CTYHD’s beginnings. 4 CTYHD claims to be one of the oldest centers of its kind, operating for over three decades, with thousands of minors having been treated. 2 From 2015 to 2017, the CTYHD’s patient count increased from 415 to more than 900, with the youngest patient being three years old. CTYHD’s medical director has promoted “cross-sex hormones to kids as young as 12.” 1 5
Treatments that were available at CTYHD included gender transition treatments and mental health services. It offered family assistance programs and connections to external resources, alongside case management to aid with legal name and gender marker changes. Peer support groups were available for community engagement and to promote voluntary participation in research studies. In addition, CTYHD offered a resource guide explaining tucking and chest binding, two uses of undergarments to create the cosmetic appearance of cross-sex traits, to parents. 1
Closure and Investigation
Following a January 2025 executive order by the second Trump administration to end federal funding for “the so-called ‘transition’ of a child from one sex to another,” the CTYHD at Children’s Hospital Los Angeles (CHLA) announced it would cease its operations on July 22, 2025. 2 3
The Trump administration’s order followed a probe by the America First Legal Foundation, which was founded by Stephen Miller, later White House Deputy Chief of Staff for Policy and homeland security advisor in the second Trump administration. 6 7
America First Legal Foundation investigated the Biden administration and the National Institutes of Health’s (NIH) promotion of so-called “gender-affirming” care. The investigation argued that the Biden administration was promoting gender transitions for minors while simultaneously funding research into the safety of those same treatments and acknowledging that there was a “scant evidence-base” showing safety or long-term effects of such treatments. The research claimed that “no known US studies have examined similar outcomes among transgender youth with gender dysphoria.” The investigation also revealed that some studies “already reported lower bone mineral density for children taking puberty blockers,” and that no data existed beyond two years examining the “longer-term physiological effects (sic) on transgender adolescents taking sex hormones,” yet “previous studies had shown a higher incidence of cardiovascular events in adults taking sex hormones.” 8
Financials
Center for Transyouth Health and Development (CTYHD) was a project of Children’s Hospital Los Angeles (CHLA), which reported $1,730,952,838 in revenue, $1,818,061,032 in expenses, and a net income of -$87,108,194 in 2024. Net assets stood at $1,687,007,869. Program services accounted for $1,456,216,998 or 84.1 percent of revenue. Contributions totaled $194,581,501 or 11.2 percent. Total assets reached $2,668,662,474, with total liabilities at $981,654,605. 9
On the expense side, other salaries and wages comprised $815,865,085 or 44.9 percent of total expenses. Executive compensation was $12,175,927. Director, president, and chief executive officer Paul Viviano received $2,263,905 in compensation and $31,392 in other compensation in 2024. 9
In 2024, CHLA reported government grants totaling $68,982,462. 10
Leadership
From 2006 until the Center for Transyouth Health and Development (CTYHD) closed in July 2025, the medical director was Johanna Olson-Kennedy. Olson-Kennedy was also at one point Southern California co-chair of the Progressive Caucus of the California Democratic Party. 11 12
As of October 2025, Paul S. Viviano is the chief executive officer at the Children’s Hospital Los Angeles (CHLA), a position he has held for ten years. 13