A coalition of nineteen states, led by Democratic attorneys general, and Washington, D.C., have launched a legal challenge against the federal government. The dispute centers on a recent declaration aiming to significantly restrict access to gender transition care for minors.
The lawsuit targets the U.S. Department of Health and Human Services, its secretary, and the inspector general, following the release of a statement deeming treatments like puberty blockers, hormone therapy, and gender-affirming surgeries as potentially unsafe and ineffective for children experiencing gender dysphoria. This declaration carries the weight of potential exclusion from vital federal healthcare programs like Medicare and Medicaid for providers offering these services.
The federal action builds upon a January executive order from President Trump, framing gender transition treatments as harmful “chemical and surgical mutilation.” Secretary Kennedy publicly stated the administration’s intent to protect children based on what they consider “gold standard science.”
While the lawsuit focuses on the initial declaration, the Department of Health and Human Services has also proposed new rules designed to further curtail gender transition care for minors. These proposed rules, still under development, haven’t been included in the current legal action.
The states argue the declaration is both inaccurate and exceeds legal authority, seeking a court order to prevent its enforcement. New York Attorney General Letitia James, spearheading the lawsuit, emphasized that medical standards cannot be unilaterally altered by online postings and access to necessary healthcare should not be jeopardized by federal interference.
The complaint alleges the declaration attempts to coerce healthcare providers into halting gender transition treatments and bypasses established legal procedures for policy changes. Federal law mandates public notice and comment periods before significant alterations to health policy, requirements the states claim were ignored.
The declaration’s conclusions were based on a departmental report advocating for increased reliance on behavioral therapy over medical interventions for minors with gender dysphoria. This report questioned the standards set by the World Professional Association for Transgender Health and raised concerns about the capacity of young people to provide informed consent for potentially irreversible treatments.
However, major medical organizations and physicians specializing in transgender care have strongly criticized the report, labeling its findings inaccurate and unsupported. Their expertise directly challenges the foundation of the federal government’s stance.
Further escalating the situation, the Department of Health and Human Services proposed rules that could cut off federal funding to hospitals offering gender transition care to children and block Medicaid funds for these procedures. These proposals remain subject to a lengthy rulemaking process and public feedback before becoming legally binding.
Even before these rules are finalized, some major healthcare providers have already begun to limit gender transition services for young people, even in states where such care remains legally protected. This preemptive shift highlights the chilling effect of the federal government’s actions.
Currently, Medicaid programs in nearly half of the states cover gender transition treatment. However, at least twenty-seven states have enacted laws restricting or outright banning these treatments, and a recent Supreme Court decision upholding a Tennessee ban suggests these restrictions will likely persist.
The states joining the lawsuit represent a broad coalition, including California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Wisconsin, Washington state, Washington, D.C., and Pennsylvania.
This legal battle underscores a deepening divide over the rights of transgender youth and the role of the federal government in regulating medical care. The outcome will have far-reaching consequences for access to gender-affirming care across the nation.
