NEW YORK (AP) — A coalition of 19 states and the District of Columbia on Tuesday sued the U.S. Department of Health and Human Services, its secretary, Robert F. Kennedy Jr., and its inspector general over a statement that could complicate access to gender-affirming care for young people.
The statement issued last Thursday called treatments such as puberty blockers, hormone therapy and surgeries unsafe and ineffective for children and teenagers who experience gender dysphoria, or the distress when someone’s gender expression does not match their assigned sex at birth. It also warned doctors that they could be excluded from federal health programs like Medicare and Medicaid if they provide those types of care.
The statement came as HHS also announced proposed rules designed to further curtail gender-affirming care for youth, although the lawsuit does not address those as they are not final.
Tuesday’s lawsuit, filed in US District Court in Eugene, Oregon, alleges that the statement is inaccurate and illegal and asks the court to block its enforcement. It is the latest in a series of clashes between an administration that is cracking down on transgender health care for children, arguing it could be harmful to them, and advocates who say the care is medically necessary and should not be withheld.
“Secretary Kennedy cannot unilaterally change medical standards by publishing a document online, 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,” said New York Attorney General Letitia James, who led the case, in a statement Tuesday.
The lawsuit alleges that the HHS statement seeks to force providers to stop providing gender-affirming care and avoid legal requirements for policy changes. It says federal law requires that the public be given notice and an opportunity to comment before health policy is substantially changed – neither of which, the lawsuit says, was done before the statement was issued.
A spokesman for HHS declined to comment.
The HHS statement based its conclusions on a peer-reviewed report the department commissioned earlier this year that urged greater reliance on behavioral therapy rather than broad gender-affirming care for youth with gender dysphoria.
The report questioned the standards for the treatment of transgender youth issued by the World Professional Association for Transgender Health and raised concerns that teenagers may be too young to consent to life-changing treatments that could result in future infertility.
Major medical groups and those who treat transgender youth have strongly criticized the report as inaccurate, and most major US medical organizations, including the American Medical Association, continue to oppose restrictions on transgender care and services for youth.
The statement was announced as part of a multifaceted effort to limit gender-affirming health care for children and teens — and builds on other Trump administration efforts to target the rights of transgender people nationwide.
On Thursday HHS also unveiled two proposed federal rules – one to cut federal Medicaid and Medicare funding from hospitals that provide gender-affirming care to children, and another to prohibit federal Medicaid dollars from being used for such procedures.
The proposals are not yet final or legally binding and must go through a lengthy rulemaking process and public comment before they become permanent. But they will still likely continue to discourage health care providers from offering gender-affirming care to children.
Several major medical providers have already withdrawn gender-affirming care for young patients since Trump returned to office — even in states where the care is legal and protected by state law.
Medicaid programs in just under half of the states currently cover gender-affirming care. At least 27 states have adopted laws restricting or banning the treatment. The recent Supreme Court decision upholding Tennessee’s ban means that most other state laws are likely to remain in place.
Joining James in Tuesday’s lawsuit were 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. The Democratic governor of Pennsylvania also joined.