A federal judge has dealt a major blow to the Trump administration’s ongoing effort to restrict gender-affirming care for transgender youth, ruling that the Department of Health and Human Services overstepped its authority under Secretary Robert F. Kennedy Jr.
In a decision issued in Oregon, U.S. District Judge Mustafa Kasubhai found that a controversial federal “declaration” targeting transgender healthcare was likely unlawful and could not be enforced. The declaration, released in December 2025, labeled treatments such as puberty blockers and gender-affirming surgeries as unsafe and ineffective for minors and threatened providers with exclusion from federal programs like Medicare and Medicaid.
The court’s ruling marks a significant legal setback for the administration, which has made restricting transgender healthcare a central policy focus.
Judge Kasubhai determined that the federal government bypassed required administrative procedures when issuing the declaration. Federal agencies are typically required to go through a formal rulemaking process, including public input, before implementing sweeping healthcare changes.
Instead, the court found that HHS attempted to impose a nationwide policy shift without that process, raising serious legal concerns about executive overreach.
The judge also signaled he would block the policy from taking effect, siding with a coalition of 19 states and Washington, D.C., who challenged the declaration in court.
At the heart of the case was the administration’s attempt to pressure healthcare providers. The declaration warned that doctors and hospitals offering gender-affirming care to minors could lose access to federal funding programs, including Medicaid and Medicare.
State attorneys general argued that this approach would force providers into an impossible choice: stop offering medically recommended care or risk losing the funding that keeps their practices open.
Advocates also warned that the policy created fear and uncertainty for transgender youth and their families, potentially disrupting ongoing care.
The blocked declaration is part of a wider federal push to restrict transgender healthcare access, particularly for minors. These efforts have included policy proposals to cut funding to hospitals providing care and to redefine federal standards around gender identity and treatment.
Major medical organizations have consistently pushed back on these efforts, arguing that gender-affirming care is evidence-based and medically necessary for many patients.
While the ruling prevents the declaration from being enforced for now, the legal fight is far from over. A full written opinion from the court is expected, and further appeals are likely.
For now, however, the decision provides clarity: gender-affirming care for transgender youth remains legal, and providers cannot be penalized under this federal directive.
For transgender patients, families, and healthcare professionals, the ruling represents a temporary but meaningful safeguard against federal interference in medical decision-making.
