19 states sue over federal crackdown on gender-affirming care

WASHINGTON — A coalition of Democratic-led states and the District of Columbia have sued the federal Health Department, calling a statement rejecting gender-affirming care signed by Health Secretary Robert F. Kennedy Jr. an overreach of his authority.

The lawsuit, filed by 19 states and D.C., says the declaration — which claims that gender-affirming care, including hormones and surgical procedures, does not meet medical standards of care — circumvents the public notice and comment periods required by the regulations. He also argues that Kennedy overstepped the powers that Congress had granted to the Department of Health and Human Services in attempting to set standards of care.

“The Kennedy Declaration has immediate, significant, and adverse impacts on the plaintiff states as administrators of state Medicaid programs and as regulators of the practice of medicine,” the lawsuit says.

The Trump administration last week announced a crackdown on care for transgender youth in the United States. In addition to this statement, HHS also released two proposed rules that would withhold federal funds related to gender-affirming care and another that would prevent facilities offering this type of care from receiving Medicare or Medicaid funding.

Kyle Faget, an attorney at Foley & Lardner LLP, told STAT that the scope of Kennedy’s statement is “huge.”

“It basically says to the medical community … you cannot, without significant risk, provide gender-affirming care even if you believe it is an appropriate standard of care,” she said. She said it would essentially prevent these providers from practicing within entities that accept federal funding — even if they provide gender-affirming services in private practice.

“We’ve never seen a statement like this before. Statements tend to be issued during a public health emergency. That’s not what they chose to do here,” she said.

At a news conference last week, Kennedy dismissed the threat of legal action, saying the department would win such a legal battle. HHS did not immediately return a request for comment.
Major medical organizations and providers who work with trans children, as well as their families, reject Kennedy’s findings on gender-affirming care, calling such care evidence-based and, sometimes, life-saving. A number of these organizations, including the American Academy of Pediatrics, the Children’s Hospital Association and Physicians for Reproductive Health, have condemned the crackdown.