States sue HHS over a move that could curtail youth gender-affirming care
NEW YORK– A coalition of 19 states and the District of Columbia sued the U.S. Department of Health and Human Services, its secretary, Robert F. Kennedy Jr., and its inspector general on Tuesday over a statement that could make it harder for young people to access gender-affirming care.
The statement released last Thursday called treatments such as puberty blockers, hormone therapy and surgical procedures dangerous and ineffective for children and adolescents suffering from gender dysphoria, or distress when a person’s gender expression does not match the sex they were assigned at birth. He also warned doctors that they could be excluded from federal health programs like Medicare and Medicaid if they provided this type of care.
The statement comes as HHS also announced proposed rules intended to further restrict gender-affirming care for young people, although the lawsuit does not address them because they are not final.
Tuesday’s lawsuit, filed in U.S. District Court in Eugene, Oregon, alleges the declaration is inaccurate and illegal and asks the court to block its enforcement. It’s the latest in a series of clashes between an administration that is cracking down on health care for transgender children, arguing it can harm them, and advocates who say the care is medically necessary and should not be inhibited.
“Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because his federal government attempted to interfere in decisions that belong to doctors’ offices,” New York Attorney General Letitia James, who led the lawsuit, said in a statement Tuesday.
The lawsuit alleges that the HHS statement seeks to coerce providers to stop providing gender-affirming care and circumvent legal requirements for policy changes. It says federal law requires the public to be informed and given an opportunity to comment before making any substantial changes to health policy — which the suit says was not done before the statement was issued.
An HHS spokesperson declined to comment.
The HHS statement based its findings on a peer-reviewed report the department completed earlier this year, which called for greater use of behavioral therapy rather than widespread gender-affirming care for young people with gender dysphoria.
The report questions standards for treating transgender youth issued by the World Professional Association for Transgender Health and raises concerns that adolescents may be too young to consent to life-changing treatments that could lead to future infertility.
Major medical groups and those who treat transgender youth have sharply criticized the report as inaccurate, and most major U.S. medical organizations, including the American Medical Association, continue to oppose restrictions on transgender care and services for youth.
The declaration was announced as part of a multifaceted effort to limit gender-affirming health care for children and adolescents — and builds on other Trump administration efforts to target the rights of transgender people nationwide.
HHS also unveiled two proposed federal rules Thursday — one to cut off federal Medicaid and Medicare funding for hospitals that provide gender-affirming care to children, and another to prohibit the use of federal Medicaid dollars for such procedures.
The proposals are not yet final or legally binding and must go through a lengthy process of rulemaking and public comment before becoming permanent. But they will likely nonetheless further discourage health care providers from offering gender-affirming care to children.
Several major medical providers have already opted out of gender-affirming care for young patients since Trump returned to office — even in states where the care is legal and protected by state law.
Medicaid programs in just under half of states currently cover gender-affirming care. At least 27 states have passed laws restricting or banning this care. The Supreme Court’s recent decision upholding Tennessee’s ban means most other state laws will likely remain in effect.
Democratic attorneys general 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 joined James in Tuesday’s lawsuit. The Democratic governor of Pennsylvania also joined us.
