Federal Judge Strikes Down HHS Declaration on Gender-Affirming Care for Minors
A federal judge in Oregon delivered a significant ruling on Thursday, determining that Health Secretary Robert F. Kennedy Jr. exceeded his legal authority when he issued a declaration stating that gender-affirming care for minors is neither "safe nor effective" and fails to meet "professionally recognized standards of health care." U.S. District Court Judge Mustafa Kasubhai sided with 21 Democrat-led states that had challenged Kennedy's attempt to establish a national standard opposing such care for transgender and gender-nonconforming youth.
Legal Challenge and Ruling Details
The states argued that the guidance from the Department of Health and Human Services, issued on December 18 last year, violated their rights to regulate medical practices. Kennedy's 12-page declaration asserted that it "supersedes" statewide or national standards of care, casting doubt on the positions of major medical organizations like the American Medical Association, American Academy of Pediatrics, and American Psychiatric Association, which endorse gender-affirming care as safe and effective.
Judge Kasubhai agreed with the plaintiffs, noting that the declaration "effectively eliminated" options for health care providers to treat patients seeking gender-affirming care. He criticized the approach during the six-hour hearing in Eugene, Oregon, stating, "There's a theme of 'Break it and see what others will do,' and that's not a system or method committed to the rule of law."
Broader Context and Implications
The HHS declaration coincided with three proposed rules aimed at preventing medical providers from receiving Medicaid and Medicare reimbursements if they offered transition care for youth. Subsequently, HHS referred 13 medical institutions providing such care to the department inspector general's office for investigation, as per court documents.
This ruling represents the latest setback to the Trump administration's efforts to restrict access to gender-affirming treatments, such as puberty blockers and hormone replacement therapy, for minors. Since President Donald Trump signed an executive order targeting youth transition care, over 40 hospitals have paused or stopped offering these treatments, even in states where they are legally protected.
Reactions from Advocates and Officials
LGBTQ+ advocates celebrated the decision, which offers temporary relief to health care providers and families of trans youth. Kelley Robinson, president of the Human Rights Campaign, emphasized, "Politicians, including RFK Jr., do not get to tell doctors how to do their jobs or families what decisions are best for their children. Health care for transgender people is just that — health care — and that care must continue — full stop."
New York Attorney General Letitia James, a plaintiff in the suit, applauded the ruling in a press release, stating, "Today's win breaks through the noise and gives some needed clarity to patients, families, and providers. Health care services for transgender young people remain legal, and the federal government cannot intimidate or punish the providers who offer them."
Legal and Political Background
The Democrat-led states, including Oregon, California, New York, Colorado, and the District of Columbia, contended that Kennedy's declaration violated the Administrative Procedure Act, which mandates federal agencies to follow specific rulemaking standards delegated by Congress. In contrast, the Trump administration argued the declaration was "non-binding" and claimed states failed to demonstrate harm to individual providers, as none had been blocked from Medicare and Medicaid reimbursements at that point.
Legal experts anticipate the government will likely appeal the ruling. HHS did not immediately respond to requests for comment. Meanwhile, 27 Republican-led states have banned access to gender-affirming care since 2020, and the Supreme Court last June allowed states to decide on administering such care to minors.
