A coalition of 19 Democratic-led states and the District of Columbia filed a federal lawsuit on Tuesday seeking to block new actions by the Department of Health and Human Services that would restrict access to gender-affirming medical care for transgender youth.
The lawsuit challenges a recent declaration and regulatory push by HHS Secretary Robert F. Kennedy Jr., who has asserted that gender-affirming treatments for minors are unsafe and ineffective. The states argue the federal government lacks the authority to impose such restrictions and that the move violates both federal law and state authority over health care regulation.
Filed in U.S. District Court in Oregon, the complaint names HHS and Kennedy as defendants and asks the court to halt enforcement of the policy. The plaintiffs include states such as California, New York, Illinois, Washington, Massachusetts, and Oregon, along with Washington, D.C.
At issue is a December announcement from HHS that could cut off Medicare and Medicaid funding for hospitals and providers that offer puberty blockers, hormone therapy, or other gender-affirming care to minors. State officials warn that the threat of losing federal funding could force hospitals to discontinue care even in states where it remains legal and supported by medical professionals.
The states argue that HHS bypassed required procedures when issuing the declaration, including public notice and a formal rulemaking process. The lawsuit contends that the agency cannot unilaterally redefine medical standards or penalize providers without following federal administrative law.
In court filings, the states also emphasize that decisions about medical care should remain between patients, families, and licensed health care providers. They argue that the federal policy interferes with established standards of care and injects political considerations into medical decision-making.
Kennedy and HHS officials have defended the policy by framing it as a public health measure. Kennedy has repeatedly described gender-affirming medical care for minors as harmful and has argued that federal funds should not be used to support what he characterizes as experimental treatments.
Medical organizations and transgender advocates strongly dispute that claim. Groups including the American Academy of Pediatrics and the American Medical Association have long supported gender-affirming care as evidence-based and medically appropriate for some transgender youth. Advocates argue that restricting access increases risks to mental health and well-being.
The lawsuit comes amid a broader national conflict over transgender health care, with federal agencies, state governments, and courts increasingly at odds. While some states have enacted bans on gender-affirming care for minors, others have moved to protect access through legislation and executive action.
Legal experts say the case could have wide-reaching consequences, particularly if the federal government succeeds in using funding mechanisms to influence state health care policy. Similar disputes over Medicaid and Medicare conditions have previously reached the Supreme Court.
For now, the lawsuit seeks an injunction to prevent HHS from enforcing the policy while the case proceeds. A ruling could determine whether the federal government can effectively restrict gender-affirming care nationwide through administrative action rather than legislation.
