Full Breakdown
States Challenge Trump Administration's Gender-Affirming Care Policy
12/24/2025, 9:03:54 PM
Overview of the Lawsuit
A coalition of 19 states and the District of Columbia has filed a lawsuit against the U.S. Department of Health and Human Services (HHS) and its Secretary, Robert F. Kennedy Jr., in response to a recent declaration that threatens to restrict access to gender-affirming care for minors. This declaration, issued on December 18, 2025, asserts that treatments such as puberty blockers and hormone therapy are "unsafe and ineffective" for children and adolescents experiencing gender dysphoria. The lawsuit, led by New York Attorney General Letitia James, argues that this policy constitutes an unlawful overreach of federal authority.
Key Details of the Declaration
The HHS declaration stipulates that hospitals providing gender-affirming care could be barred from participating in federal health programs like Medicare and Medicaid. This move is seen as a significant threat to healthcare providers, as these programs account for nearly 45% of hospital spending. The states involved in the lawsuit contend that Kennedy's declaration bypasses necessary public notice and comment periods required for policy changes, violating the Administrative Procedure Act.
Coalition of States
The states participating in the lawsuit include California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and Wisconsin. The coalition argues that the declaration undermines their authority to regulate medical practices and interferes with their Medicaid programs, which serve millions of residents.
Criticism of the Policy
Critics of the HHS declaration, including major medical organizations such as the American Medical Association and the American Academy of Pediatrics, have condemned the policy as a harmful intrusion into the patient-physician relationship. They assert that gender-affirming care is evidence-based and essential for the well-being of transgender youth. The lawsuit emphasizes that the declaration could lead to a chilling effect on healthcare providers, forcing them to choose between adhering to established medical practices and risking their participation in federal funding programs.
Official Statements
In a statement, Attorney General Letitia James emphasized, “Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices.” Maryland Attorney General Anthony G. Brown echoed these sentiments, stating that the declaration is a "cruel and unlawful action" that threatens the dignity and access to medical care for vulnerable young people.
Conflicting Reports & Gaps
While the HHS declaration is based on a report suggesting that the risks of gender-affirming treatments outweigh their benefits, this conclusion has been met with significant opposition from medical professionals who argue that such care is critical and lifesaving. The declaration's claims about the safety and effectiveness of these treatments remain contentious, with many in the medical community advocating for their continued availability.
What's Next
The lawsuit has been filed in the U.S. District Court in Oregon, where the coalition seeks to have the court declare the HHS declaration unlawful and block its enforcement. As the legal battle unfolds, the implications for transgender youth and their families, as well as healthcare providers, remain uncertain. The outcome of this case could set a significant precedent regarding the federal government's role in regulating medical care for minors.
