Nearly 20 states sue HHS over declaration to restrict gender transition treatment for minors
19 Democratic‑leaning states and Washington, D.C. sue the Trump administration over a new HHS declaration that limits gender‑transition care for minors
A coalition of 19 states that run under Democratic leadership, along with the District of Columbia, filed a federal lawsuit on Tuesday in a federal court in Eugene, Oregon. The complaint targets the U.S. Department of Health and Human Services, its secretary, Robert F. Kennedy Jr., and the agency’s inspector general. It challenges a declaration issued last week that labels various gender‑transition procedures—including puberty blockers, hormone therapy, and surgeries—as unsafe and ineffective for children experiencing gender dysphoria.
The declaration warns doctors that providing these treatments to minors could lead to exclusion from federal health programs such as Medicare and Medicaid. It also ties the ban to President Donald Trump’s January executive order that called on HHS to guard children from “chemical and surgical mutilation.”
“Our six decisive actions are guided by gold‑standard science and the first‑week executive order from President Trump to protect children from chemical and surgical mutilation,” Secretary Kennedy said during a news conference last week.
HHS has announced two rules that would tighten the restrictions: one would deny federal Medicaid and Medicare funding to hospitals that offer gender‑transition services to children, while the other would prohibit the use of Medicaid dollars for these procedures. The rules are still in the early advisory stages and are not enforceable until the public comment process and final rulemaking are completed.
The lawsuit argues that Kennedy’s decree is both factually incorrect and unconstitutional. New York Attorney General Letitia James, who led the lawsuit, said, “Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because the federal government tried to interfere in decisions that belong in doctors’ offices.”
According to the complaint, the declaration was drafted without the required public notice and comment, violating federal law that mandates transparency for substantive policy changes. The plaintiffs claim the document pressures healthcare providers to stop gender‑transition treatments for youth and sidesteps legal procedures for altering policy.
The statement of facts behind the declaration references a peer‑reviewed report issued by HHS earlier this year. That report called for greater emphasis on behavioral therapy rather than broad gender‑transition treatment for minors with gender dysphoria. The report also raised doubts about the ability of young patients to give informed consent for life‑changing procedures that could affect future fertility.
Medical associations and physicians who treat transgender children have denounced the report as inaccurate. Even in states that permit gender‑transition care for minors, several major hospitals have reduced or halted such services since the Trump administration’s return.
Less than half of the states currently provide Medicaid coverage for gender‑transition treatments. At least 27 states have enacted bans or restrictions, and the Supreme Court’s recent decision upholding Tennessee’s ban suggests those laws will likely remain enforceable.
The coalition includes attorney generals from California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Wisconsin, Washington, and the District of Columbia, as well as the Democratic governor of Pennsylvania. The Associated Press contributed to this report.
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