The Trump administration’s nationwide efforts to limit gender-affirming care are being challenged in court by a coalition of state attorneys general, led by New York, who claim the federal government is evading state laws through a campaign of legal intimidation.
The Department of Justice is accused in the case, which was filed Friday in U.S. District Court in Massachusetts, of threatening providers with criminal and civil fines in an effort to stop providing care for transgender youngsters, even in jurisdictions where such care is expressly allowed.
According to the office of New York Attorney General Letitia James, who is spearheading the lawsuit, the administration’s actions place providers in a precarious situation where they must either comply with illegal federal threats or break state laws that mandate nondiscriminatory access to medical treatment.
Gender-affirming care programs for minors have lately been discontinued or suspended by hospitals in jurisdictions such as California, Connecticut, Illinois, Colorado, and Washington, D.C. Many point to pressure from President Donald Trump’s executive orders and criminal probes. Denver Health and Yale Health are among those impacted.
These closures have been publicly hailed as a win by the Trump administration, which says they are the result of recent executive steps intended to limit gender-transition treatments for children.
Attorneys general contend that these acts constitute an illegal use of federal power to supersede state rights and that no federal statute prohibits gender-affirming care. The case identifies violations of the Tenth Amendment, which grants the states authority not specifically granted to the federal government.
In recent months, federal enforcement has increased. Chad Mizelle, the chief of staff at the Justice Department, disclosed in July that at least 20 subpoenas had been sent to hospitals, clinics, and pharmaceutical companies that provide gender-affirming care. According to the New York Times, some of those subpoenas asked for private patient data.
FBI investigations of three children’s hospitals that now or formerly offered gender-affirming care are also contested in the case. It also references an event earlier this year called The Dangers of Gender-Affirming Care for Minors, which was held by the Federal Trade Commission and at which DOJ officials initially announced their intention to look into and subpoena providers.
Gender-affirming care for adolescents is still regarded as safe, effective, and medically required by medical specialists and national organizations such as the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association. Leaders in global health have cautioned that limiting access will probably push care underground, putting transgender patients at greater risk.
Attorneys general from states with recently closed clinics are among the plaintiffs in the action, along with Pennsylvania Governor Josh Shapiro. Their lawsuit aims to halt what they see as a politically driven campaign that violates states’ rights and puts patients at danger.
The federal crackdown is a significant change for many transgender individuals and families. The Biden-era protections in blue states are also under jeopardy, making care inaccessible to people who once depended on it, even though gender-affirming care has already been prohibited in many Republican-led states.
