GOMA, Congo — The Rwanda-backed rebels who captured eastern Congo ‘s key city of Goma sought to reassure its residents Thursday, holding a stadium rally and promising safety under their administration as they try to shore up public support amid growing international pressure.

The M23 rebels continued advances elsewhere in eastern Congo despite their own announcement of a unilateral cease-fire, and the U.N. secretary-general called for them to lay down their guns and agree to mediation. Health officials, meanwhile, said the rebellion had disrupted a key medical lab in Goma.

As thousands gathered at the stadium in Goma, which the rebels captured last week with the support of troops from neighboring Rwanda, M23 political leader Corneille Nangaa told the crowd that the city had been “liberated and sanitized” and that new administrative heads have been appointed.

“I ask you to sleep well because we bring you security; this is our priority,” Nangaa said. “Starting next week, the children return to school. Let all state agents return to their offices. The displaced people are returning to their homes.”

The rebels are backed by some 4,000 troops from neighboring Rwanda, according to U.N. experts. They are the most potent of the more than 100 armed groups active in Congo’s east, which holds vast deposits critical to much of the world’s technology.

Unlike in 2012, when the rebels first captured Goma but held it for only a short time, analysts say the M23 is now eyeing political power and eager to show it can govern.

One of those at the rally Thursday, Emmanuel Kakule, a Goma resident, said he is still worried about the situation in Goma.

“I came to listen to their project,” the 26-year-old said. “I don’t know if I’m convinced. … We’re still afraid.”

M23 rebels have claimed another town in eastern Congo.

Kevin S. Vineys/AP

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Kevin S. Vineys/AP

Rebels continue to advance despite unilateral ceasefire

Earlier this week, the rebels announced a unilateral ceasefire to facilitate humanitarian aid, but the Congolese government later dismissed that as a “false communication” amid reports of continued rebel advances in the east.

On Thursday, the rebels were advancing into South Kivu province and were 50 kilometers (30 miles) from the provincial capital of Bukavu, according to Nene Bintou, president of the civil society in the province. The rebels also had seized a town in the mineral-rich region a day earlier after the ceasefire was declared.

The advance has caused tension and fear among residents in Bukavu, with many fleeing to surrounding villages further afar from the city. Public transportation has also become less available, forcing some to trek for hours with their children and belongings.

Three Swiss aid workers killed

Three Congolese employees of a group known as Swiss Church Aid were attacked and killed Wednesday during a mission in North Kivu province’s Rutshuru territory, about 65 kilometers (40 miles) from Goma, the group said in a statement.

The group, which is investigating the incident and suspended other projects in the province, called the attack a “serious violation of international humanitarian law.”

A critical laboratory under threat in Goma

Africa’s top public health body, meanwhile, sounded notes of alarm Thursday, saying that the rebellion had disrupted services at a high-security medical lab in Goma involved in the control and surveillance of infectious diseases such as Ebola.

The disruption at the National Institute of Biomedical Research lab underscores “the need for the decentralization of laboratory capacity” in the region, said Yap Boum II, a manager at the Africa Centers for Disease Control and Prevention.

Boum, in an online briefing, said that collection of samples for illnesses such as mpox had been disrupted and that the rebellion has led to dozens of mpox patients fleeing from treatment centers, raising the risk of the disease spreading.

U.N. chief asks rebels to silence their guns

The U.N. and aid groups have expressed concern about the safety of the displaced people in Goma. Before it was captured by the rebels, the city was a critical humanitarian hub that hosted many of the more than 6 million people displaced by conflict in the region.

On Thursday, U.N. Secretary-General Antonio Guterres issued an urgent appeal to the rebels and their Rwandan military backers to “silence the guns” and stop the escalating fighting in the region, stressing that there is no military solution to the conflict in the mineral-rich region.

“It is time for mediation. It is time to end this crisis. It is time for peace,” Guterres told U.N. reporters.

The U.N. chief announced that he will be flying to Addis Ababa to take part in a meeting of the African Union Peace and Security Council next week, “where this crisis will also be front and center.”

“We also see the continued threat by other armed groups, either Congolese or foreign,” Guterres said. “We have countless reports of human rights abuses, including sexual and gender-based violence, forced recruitment, and the disruption of lifesaving aid.”

Malawi directs preparation for peacekeepers’ withdrawal

Meanwhile, Malawi President Lazarus Chakwera, said that he’s asked the commander of his country’s peacekeepers in eastern Congo to begin preparations for their withdrawal.

Malawian troops are part of a regional peacekeeping force supporting Congolese army in the region. At least 3 Malawian troops and 14 South African soldiers — also part of the force — have been killed in the fighting.

Chakwera said on Wednesday that the withdrawal was “to honor the declaration of a ceasefire” by the rebels and to pave the way for negotiations and a lasting peace. He did not give a timeframe for the Malawian troops’ withdrawal.

South Africa’s President Cyril Ramaphosa, however, said his country’s peacekeepers would remain in Congo to show its commitment to a peaceful resolution of “one of the world’s most intractable conflicts.”

Ahead of a summit of African countries starting Friday in Tanzania to discuss the conflict in eastern Congo, Ramaphosa said the leaders would be reiterating “our call for a ceasefire and a resumption of talks.”

Hundreds of protesters rallied Thursday night in the rain outside Children’s Hospital Los Angeles, calling for the hospital to roll back recent restrictions on gender-affirming care for youth.

Denying such care “goes against every ethical standard we are taught in medicine and nursing. It ignores decades of research, the guidance of every major medical organization and the lived experiences of trans people,” family nurse practitioner Jordan Davis told the crowd packed onto the sidewalk on Sunset Boulevard.

“We are here because we refuse to let fear and politics dictate healthcare.”

In the aftermath of an executive order by President Trump, the L.A. hospital said it was pausing the initiation of hormonal therapy for “gender affirming care patients” younger than 19. CHLA said it had already suspended gender-affirming surgeries for minors.

“We continue to carefully evaluate the executive order to fully understand its implications,” the hospital said in a statement. “The physical and mental health, safety and well-being of all of our patients remains our highest priority.”

The decision came days after Trump issued an executive order aiming to stop the use of puberty blockers, hormones and other gender-affirming care for youth and directing federal officials to “take all appropriate actions to end the chemical and surgical mutilation of children.” Families of transgender youth have sued to try to stop the executive order, arguing it illegally deprives them of medical care on the basis of their transgender identity.

Among the groups that organized the Thursday night protest were the Democratic Socialists of America-Los Angeles and the Committee of Interns and Residents, which is part of the Service Employees International Union and represents resident physicians and medical fellows. Some of its members do rotations at Children’s Hospital L.A.

“For one of the largest and most famous children’s hospitals in the country to be pausing care … it sends the wrong message,” said Dr. Mahima Iyengar, national secretary-treasurer for CIR-SEIU. “It’s sending a message that healthcare decisions are not being made by doctors right now. They’re being made by politicians instead.”

During the protest, Iyengar read testimonies from parents of transgender children who did not want to be publicly identified to protect their kids, describing how such care had helped them. Protesters hoisted signs that said, “Gender-affirming Care Saves Lives” and “Shame on You, CHLA!” and chanted, “Protect trans kids!”

Protesters rally in support of gender-affirming care for transgender youth outside Children’s Hospital Los Angeles on Thursday.

(Jill Connelly / For The Times)

To think that “my child feels threatened, and feels like their life doesn’t matter, feels like their life can be compromised, is more than just infuriating. It’s offensive to me,” parent Juan Carlos Pérez told the crowd.

Among those who attended the Thursday protest were Los Angeles City Councilmembers Ysabel Jurado and Hugo Soto-Martinez. Soto-Martinez, whose district includes the children’s hospital, has urged the facility to “take a stand against these hateful and illegal policies.”

The CHLA decision was celebrated by groups including the California Family Council, which contends that the medical care involved in gender transition is risky and harmful for youth. “This is a long-overdue victory for truth, for medical ethics, and most importantly, for vulnerable children who deserve real help, not experimental treatments with lifelong consequences,” its vice president, Greg Burt, said in a statement.

The American Academy of Pediatrics recommends that transgender youth “have access to comprehensive, gender-affirming, and developmentally appropriate health care.”

Dr. Mahima Iyengar shares stories from parents of transgender children with a crowd of demonstrators outside Children’s Hospital Los Angeles on Thursday.

(Emily Alpert Reyes / Los Angeles Times)

In a policy statement, the academy describes puberty blockers as reversible, noting that hormones have been used since the 1980s to suppress puberty if a child undergoes it at an unusually early age. Some other physical changes from administering testosterone or estrogen are not reversible, the policy statement said.

Iyengar said that “just like with any medication that you prescribe as a doctor, you talk about risks, you talk about benefits, and you make an individual decision based on the patient in front of you. And ultimately, it’s that patient’s decision at the end of the day. … This is a healthcare decision.”

Surgical procedures for transgender youth have been “rare and almost entirely chest-related procedures,” according to a study of insured patients published in the medical journal JAMA Network Open. The vast majority of breast reductions for minors were for cisgender boys, far outnumbering those for transgender youth, it found.

Among the biggest threats to hospitals outlined in Trump’s order on gender-affirming care are possible changes to the rules for the Medicare and Medicaid programs, a major source of healthcare funding.

A protester holds a rainbow flag while joining the rally in support of gender-affirming care for transgender youth outside Children’s Hospital Los Angeles.

(Jill Connelly / For The Times)

But LGBTQ+ advocates have stressed that such sweeping changes rely on federal rulemaking that has yet to be carried out. California Atty. Gen. Rob Bonta said that the executive order did not give federal agencies any basis to yank federal funding from healthcare providers.

In a letter this week to CHLA, his office cautioned the hospital that if services are being offered to other people who are not transgender, withholding them from transgender people based on their gender identity is a prohibited form of discrimination.

The hospital told The Times it was not halting hormonal therapy or puberty blockers for children who are not transgender, who might be prescribed them for other medical purposes. As of Wednesday, CHLA said it was reviewing the letter from Bonta’s office.

Los Angeles LGBT Center Chief Executive Joe Hollendoner told the crowd of protesters Thursday night that the children’s hospital could not “hide behind” Trump’s executive order.

“Just because that orange menace signed something on his desk does not mean it is the law of the land!” Hollendoner declared to cheers and applause.

Parents of transgender children told The Times this week that the news had reached families in confusing and unsettling ways. Some patients already receiving hormonal treatment said they had appointments at CHLA abruptly canceled, then later reinstated.

Linda, a parent who asked to be identified only by her first name to protect the privacy of her child, said her 13-year-old has been receiving periodic shots to prevent the onset of puberty but has been interested in switching to an implant that would be effective for a few years.

Demonstrators gather along Sunset Boulevard ahead of a rally to demand that Children’s Hospital Los Angeles reverse its decision to stop for gender-affirming care for transgender patients under age 19.

(Emily Alpert Reyes / Los Angeles Times)

The mother said a hospital staffer called this week and asked whether she still wanted to order the implant, “because it’s going to cost you a lot of money and they may not insert it.”

A CHLA official said Tuesday that existing patients already receiving hormonal therapy would be able to continue with their course of care but did not promptly clarify what kinds of treatment would continue.

Aldo Anderson, left, Keith Anderson and Michael Chwe rally in support of gender-affirming care for transgender youth outside Children’s Hospital Los Angeles.

(Jill Connelly / For The Times)

In a statement, the hospital said it would “continue to support our patients and their families with access to robust mental health and social support services, ensuring our patients continue to have access to high-quality care and the best possible health outcomes.”

The American Psychological Assn. has opposed bans on gender-affirming care as “contrary to the principles of evidence-based healthcare” and says that obstructing access to gender-affirming care “heightens the risk of negative mental health outcomes.”