A significant legal challenge has been launched against the U.S. federal government's recent move to restrict healthcare access for transgender youth. On Tuesday, a coalition of 19 states and the District of Columbia filed a lawsuit against the U.S. Department of Health and Human Services (HHS), its secretary, Robert F. Kennedy Jr., and its inspector general.
The Controversial Declaration at the Heart of the Lawsuit
The legal action targets a declaration issued by HHS just last Thursday. That document labelled treatments such as puberty blockers, hormone therapy, and surgeries as unsafe and ineffective for children and adolescents experiencing gender dysphoria. The declaration also warned medical professionals that providing such care could lead to their exclusion from major federal health programs, namely Medicare and Medicaid.
The lawsuit, filed in the U.S. District Court in Eugene, Oregon, argues the declaration is both inaccurate and unlawful. It requests the court to block its enforcement. This clash pits an administration cracking down on transgender healthcare for minors against advocates who insist the treatments are medically necessary.
Legal Arguments and Broader Policy Push
Leading the lawsuit, New York Attorney General Letitia James stated, "Secretary Kennedy cannot unilaterally change medical standards by posting a document online." The suit alleges HHS is attempting to coerce providers and circumvent standard legal procedures, which require public notice and comment before substantive health policy changes.
This declaration was part of a broader initiative. Simultaneously, HHS unveiled two proposed rules: one to cut off federal Medicaid and Medicare funding from hospitals providing gender-affirming care to children, and another to prohibit federal Medicaid dollars from being used for such procedures. These proposals are not yet final and must undergo a lengthy rulemaking process.
Medical Community Reaction and National Landscape
The HHS declaration relied on a peer-reviewed department report from earlier this year, which advocated for greater reliance on behavioral therapy over broad gender-affirming care for youth. The report questioned existing treatment standards and raised concerns about adolescent consent and potential future infertility.
However, this stance has been sharply criticized by major U.S. medical organizations, including the American Medical Association, which continue to oppose restrictions on transgender care for young people. The legal and policy environment is already fragmented across the country. While Medicaid in slightly less than half of the states covers this care, at least 27 states have laws restricting or banning it, a situation solidified by a recent Supreme Court decision.
The lawsuit was joined by 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. Pennsylvania's Democratic governor also joined the action.
