The Trump administration's push to end gender-affirming care for transgender youth is having a chilling effect on health systems, prompting some to pull back on the services in states where they remain legal.

The big picture: Children's Hospital Los Angeles, Stanford Medicine and Pittsburgh's UPMC are among the facilities pausing or shutting down services following federal probes and concerns that funding could be at risk.

• That's despite a judge temporarily halting President Trump's executive order that would strip federal funding from hospitals providing gender-affirming medical services to minors.

What they're saying: "Certainly there have been a lot of threats, which have translated into a lot of fear," said Kellan Baker, executive director of the Institute for Health Research and Policy at Whitman-Walker, the LGBTQ+ health center.

Driving the news: The Federal Trade Commission will hold a public workshop today to "gauge the harms consumers may be experiencing" surrounding gender-affirming care for minors.

It's the latest in a string of Trump administration actions that show the federal government isn't backing down from its goal to stop surgeries, hormone treatments and puberty blockers for youth with gender dysphoria.

• Attorney General Pam Bondi earlier this year directed prosecutors to investigate providers of gender-affirming surgical procedures, which she characterized as female genital mutilation.
• She also directed the Justice Department's civil division to investigate drug manufacturers and distributors for making false claims about on- or off-label use of puberty blockers and hormone therapies, as well as providers for billing Medicaid related for what she called "radical gender experimentation."
• The FBI last month requested tips from the public on hospitals and providers offering gender-affirming care for youth.
• CMS in May sent letters to nine hospitals seeking information about informed consent protocols for kids with gender dysphoria, adverse events related to procedures and financial data for all pediatric gender-affirming surgeries covered at least in part by a federal program.

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President Trump yesterday signaled he could give drugmakers at least a year before imposing duties of 200% on their foreign-made products as part of a strategy to increase domestic manufacturing of medicines.

Why it matters: The announcement renewed questions about whether Trump will follow through — and whether his administration's ever-shifting trade policy is conducive to companies making long-term investments.

Driving the news: Trump said during a Cabinet meeting that sector-specific levies on drugs imported into the U.S. would come "very soon" but added he'd give manufacturers time to bring more operations to the U.S.

• Details on pharmaceutical tariffs "will come at the end of the month," Commerce Secretary Howard Lutnick told CNBC.

Leerink Partners analyst David Risinger wrote in a note that it could all add up to a win for the industry, because the duties won't be implemented immediately and it's not yet clear whether the administration will make good on the threat.

What we're watching: Trump in April launched a so-called Section 232 investigation that could end with a recommendation to put a certain tariff rate on drug imports.

• Risinger said it will be interesting to see what the probe concludes regarding the effect on national security of drug imports from manufacturing hubs such as Ireland and Switzerland.
• Trump used the same law to set the first round of steel and aluminum tariffs in March.

There are four distinct varieties of autism, each linked to unique genetic profiles — a discovery that could offer new insights into the neurodevelopmental condition, according to a new study in Nature Genetics.

Why it matters: The findings come as HHS Secretary Robert F. Kennedy is pushing federal efforts to identify an "environmental" cause for increased autism incidence by September.

Driving the news: A Princeton-led research team examined data from more than 5,000 children in SPARK, an autism cohort study funded by the Simons Foundation.

• After analyzing more than 230 traits including social interactions and repetitive behaviors, they identified four subtypes: "social and behavioral challenges," "mixed ASD with developmental delay," "moderate challenges" and "broadly affected."
• They then linked the subtypes to distinct genetic mutations, identifying divergent biological processes in each.
• For example, children in the "broadly affected" group showed the highest proportion of mutations not inherited from either parent, while the "mixed ASD with developmental delay" group was more likely to carry rare inherited genetic variants.

Autism is known to be highly heritable, with many implicated genes. But the researchers said standard genetic testing only explains about 20% of cases.

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President Trump's signature tax and spending legislation is now law, and that means cuts to Medicaid spending.

The big picture: The law sets in motion almost $1 trillion in reductions to Medicaid and other health policy changes, likely forcing states to make corresponding reductions to their programs or to pick up a greater share of obligations.

• But because states have varying names for their Medicaid programs, experts say Americans may not realize the cuts and first-time federal work requirements apply to them. So there could be unpleasant surprises when the changes finally come.

What every state calls Medicaid

🧳 The National Cancer Institute faces an exodus of clinicians, scientists and other staffers, some fired, others leaving in exasperation with Trump broadsides against research. (CNN)

💉 Pediatricians are weighing the risks of vaccinating ahead of schedule with the threat of shot shortages looming. (Bloomberg)

💊 Pfizer chief corporate affairs officer Sally Susman is departing the company after roughly two decades, CEO Albert Bourla announced Tuesday. (Axios)

🤦🏼‍♀️ A woman tried to rid her body of plastics. Plastics won. (The Atlantic)