A coalition of 19 states on Tuesday sued to block the Trump administration’s plan to strip federal funding from hospitals providing gender-related care for minors, a policy that would effectively shut down any health care providers that failed to comply.
That plan, announced on Thursday by Health Secretary Robert F. Kennedy Jr., would cut off all Medicaid and Medicare payments — which make up a major share of hospital revenue — to any facility that provides minors with gender-related treatments in the country.
Part of the underpinning of that plan is a declaration by Mr. Kennedy that gender-related treatments for minors “fail to meet professional recognized standards of health care.” In the suit, the states argue that the declaration is unlawful and a government overreach.
“Secretary Kennedy cannot unilaterally change medical standards by posting a document online,” Letitia James, attorney general of New York, one of the states in the lawsuit, said in a statement on Tuesday. “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.”
Gender-related treatments for minors — which can include puberty-blocking drugs, hormone therapies and, in rarer cases, surgeries — have been fiercely debated in other countries but are endorsed by most medical groups in the United States. Mr. Kennedy, in his announcement last week, referred to such treatments as “malpractice.”
Mr. Kennedy drew on a report issued by his agency last month that concluded that the benefits of medical intervention were uncertain and that the risks, which could include irreversible changes, were more known. Authors argued that psychotherapy, an intervention that is also supported by little evidence, had fewer risks.
More than two dozen states have passed laws banning or limiting gender-related treatments for minors in the last several years. But the Trump administration’s new plan could sharply limit treatment options for transgender youth nationwide.
The suit, which asks that the court strike down Mr. Kennedy’s declaration, was filed in federal court in Oregon by the attorney general of that state, Dan Rayfield. Defendants named in the lawsuit include Mr. Kennedy and the Department of Health and Human Services.
The suit was joined by California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, Wisconsin and Washington, as well as the District of Columbia. All of the states have Democratic-controlled legislatures or a Democratic governor, or both.
Health and Human Services asserted that Mr. Kennedy’s declaration supersedes previously established standards of care and that the agency had a right to exclude providers from federal health care programs for failing to meet new standards. The agency could not be reached on Tuesday for additional comment.
The attorneys general argue that the job of regulating the practice of medicine belongs to the states, not the federal government.
“By attempting to impose a single nationwide standard and threatening to punish providers who adhere to well-established, evidence-based care, HHS is unlawfully interfering in decisions that should be made by doctors and their patients,” Ms. James’s office said in a statement on Tuesday.
In addition to the declaration last week, Health and Human Services proposed two new rules changing the requirements for hospitals to participate in Medicare and Medicaid. Those rules, which would prohibit gender-related care for minors, cannot be finalized until a 60-day period allowing for public comment has passed.
The effort was the latest sign that the federal government under the Trump administration does not recognize the existence of people whose gender identity does not match their sex at birth.
Earlier actions have included a sweeping ban on transgender people serving in the military and the reversal of a policy that allowed Americans to choose the gender displayed on their passports.
At the news conference last week where Mr. Kennedy announced the plan, Jim O’Neill, the deputy secretary of the Health Department, said: “Men are men. Men can never become women. Women are women. Women can never become men.”
A day prior, the House of Representatives approved legislation that would criminalize gender transition treatments. Another House measure, which passed on Thursday, would bar Medicaid payments for gender-related treatments for minors.
Neither bill was expected to pass in the Senate.
Azeen Ghorayshi, Amy Harmon and Reed Abelson contributed reporting.
Orlando Mayorquín is a Times reporter covering California. He is based in Los Angeles.
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