A consortium of 19 states including Washington, D.C., filed a complaint this week against Health Secretary Robert F. Kennedy, the Department of Health and Human Services and its inspector general over plans that could dramatically limit medical professionals from providing gender transition care to children and teenagers.
Kennedy last week announced he had signed a declaration saying “sex-rejecting procedures” such as puberty-blockers and surgical procedures, are “neither safe nor effective as a treatment” for gender dysphoria in minors. The federal government also proposed two rules — which are not yet finalized and require completing a lengthy rulemaking process — that would exclude medical providers from federal health programs like Medicare and Medicaid if they provide such care.
The lawsuit filed in the U.S. District Court in Eugene, Oregon, alleges a number of legal issues with Kennedy’s declaration, including that it exceeds the secretary’s authority and violates states’ rights to regulate the practice of medicine within their own borders. The plaintiffs allege the declaration is unlawful and asks the court to block its enforcement.
“Secretary Kennedy cannot unilaterally change medical standards by posting a document online,” New York Attorney General Letitia James, who led the lawsuit, said in a news release. “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.”
Kennedy’s declaration was the latest move by the Trump administration to curtail gender transition care for minors.
In January, President Donald Trump issued an executive order that said the U.S. “will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another.” Trump’s order also directed health agencies to enact the restrictions on Medicare and Medicaid funding. Last month, the health department released a report that said more evidence is needed about the long-term effects of gender transition care on minors, and that medical professionals should emphasize counseling over other interventions. The report was largely written by critics of such treatment.
“We are done with junk science driven by ideological pursuits, not the well-being of children,” Kennedy said in a news conference announcing the declaration last week.
HHS did not immediately respond to a request for comment.
If the proposed rules against medical professionals who provide gender transition care are finalized, the restrictions would amount to a massive contraction of the availability of transgender care services for children. Medical professionals rely heavily on reimbursement from Medicare and Medicaid, and the new proposed rules — released by Centers for Medicare & Medicaid Services — would deny them from receive funding for any type of medical visit if they also offer youth transition care.
About half the states have already banned gender transition care for minors. The Supreme Court affirmed the constitutionality of those laws earlier this year when it upheld a Tennessee law that bans young people from transition treatments that include hormones and puberty blockers.
The complaint says the declaration violates states’ rights and names several state laws that protect gender transition care. In Oregon, for example, a law enacted in 2023 guarantees coverage for all medically necessary gender-transition care services under commercial insurance, the Oregon Health Plan and public employee health plans. In California, the Department of Health Care Services requires that its state Medicaid program provide gender-transition care under it’s health plan.
“Untreated gender dysphoria can have devastating impacts to the mental health and wellbeing of those youth and adolescents,” the complaint asserts. “For many patients, medically necessary gender-affirming care is life-saving.”
Joining James in the lawsuit were also 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. Josh Shapiro, Pennsylvania’s Democratic governor, also joined.
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