UPDATE: A coalition of 19 states and the District of Columbia has just filed a significant lawsuit against the U.S. Department of Health and Human Services (HHS), its secretary, Robert F. Kennedy Jr., and its inspector general. This urgent legal action challenges a controversial declaration that threatens to restrict access to essential gender-affirming care for youth across the United States.
The lawsuit, filed on October 24, 2025, in the U.S. District Court in Eugene, Oregon, arises from HHS’s declaration issued last Thursday, which labeled treatments such as puberty blockers, hormone therapy, and surgeries as unsafe and ineffective for children and adolescents experiencing gender dysphoria. This declaration also carries serious implications for healthcare providers—warning that they could face exclusion from federal health programs like Medicare and Medicaid if they continue to provide these necessary services.
This latest development comes amid ongoing tensions between the Biden administration, which has been criticized for its restrictive policies on transgender healthcare for minors, and advocates who argue that such care is vital and medically necessary. New York Attorney General Letitia James, who spearheaded the lawsuit, stated,
“Secretary Kennedy cannot unilaterally change medical standards by posting 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.”
The lawsuit asserts that the HHS declaration is not only inaccurate but also unlawful, seeking to prevent its implementation. It argues that federal law mandates public notification and an opportunity for public comment before any substantial changes to health policy, which the lawsuit claims were bypassed in this case.
HHS based its declaration on a peer-reviewed report that recommended a shift towards behavioral therapy instead of broad gender-affirming care for youth. Critics, including major medical organizations like the American Medical Association, have condemned the report as flawed and inaccurate, asserting that it undermines established standards for treating transgender youth.
In tandem with this declaration, the HHS unveiled two proposed federal rules aimed at limiting federal funding for hospitals that provide gender-affirming care to minors. These proposed rules are not yet final and will undergo a lengthy public comment period, but they have already raised alarms among healthcare providers. Reports indicate that several major medical institutions have started scaling back their services in response to these developments, even in states where gender-affirming care is legally protected.
The implications are profound: currently, less than half of U.S. states provide Medicaid coverage for gender-affirming care, with 27 states having enacted laws that restrict or ban such treatments. The recent Supreme Court ruling upholding Tennessee’s ban further solidifies the precarious landscape for transgender youth seeking care.
Joining Attorney General James in the lawsuit are a diverse group of Democratic attorneys general from states including California, Colorado, Illinois, Massachusetts, and Washington. This coalition represents a significant challenge to the federal government’s stance on transgender health care for minors, highlighting a growing divide in the nation over how to approach these critical medical issues.
As this story continues to develop, the outcome of this lawsuit could have lasting ramifications on the availability of gender-affirming care for youth in the United States. Advocates are closely monitoring the situation, emphasizing that access to such care is not merely a matter of policy but a vital aspect of health and well-being for countless young individuals.
Stay tuned for more updates on this critical legal battle as it unfolds.
