A coalition of 19 Democrat-led states and the District of Columbia has filed a federal lawsuit challenging a recent declaration by the Department of Health and Human Services (HHS) that limits medical interventions for minors experiencing gender dysphoria.
The move, enacted by the Trump admistration, restricts federally funded access to puberty blockers, hormone therapy and surgical procedures for trans-identifying youth, sparking a nationwide legal and medical debate.
The lawsuit contends that HHS Secretary Robert F. Kennedy Jr.’s declaration exceeded federal authority, bypassing the standard rulemaking process that requires public notice and comment.
State attorneys general argue that the policy imposes significant barriers for minors seeking medically supported care and forces providers to choose between compliance with federal guidelines or continued participation in Medicare and Medicaid programs.
HHS defended the action, citing a peer-reviewed review conducted earlier this year indicating that behavioral and therapeutic interventions are safer and more effective for youth than irreversible medical procedures.
A background document from the agency emphasized that nearly all U.S. hospitals rely on Medicare and Medicaid, framing the declaration as a safeguard against procedures that could cause lasting harm to children.
Kennedy criticized professional organizations that have endorsed sex-change treatments for minors.
“Doctors across the country now provide needless and irreversible procedures that violate their sacred Hippocratic oath, endangering the very lives they are sworn to safeguard,” he said, directly challenging the guidance of the American Medical Association and American Academy of Pediatrics.
State leaders have framed the federal action as a threat to patient choice.
New York Attorney General Letitia James warned that minors and their families could lose access to critical healthcare services, according to Breitbart.
“Secretary Kennedy cannot unilaterally change medical standards by posting a document online,” she stated, underscoring concerns over administrative overreach.
Oregon Attorney General Dan Rayfield added that the declaration places families in an untenable position, compelling them to navigate conflicting federal and medical guidance.
Minnesota Attorney General Keith Ellison also defended gender-affirming care, citing its evidence-based benefits and the positive impact on the well-being of trans-identifying youth, according to The Post Millennial.
The states joining the legal action include California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Wisconsin, Washington and the District of Columbia.
Pennsylvania Gov. Josh Shapiro also signed on alongside the attorneys general.
Legal experts note that the case could establish precedent regarding the federal government’s ability to dictate medical care standards without formal rulemaking procedures.
Advocates for pediatric gender care argue that the declaration undermines both the doctor-patient relationship and state oversight of healthcare, while opponents frame it as a necessary step to protect minors from procedures with lifelong consequences.
The dispute represents the latest clash between federal policy initiatives and Democratic state leadership on socially and medically contentious issues.
While HHS frames the declaration as protective, the coalition of states argues that it disrupts access to care, creating both legal and logistical challenges for providers and families across the country.
As the lawsuit moves through the courts, the case is expected to draw national attention, highlighting the ongoing tension between executive authority, medical ethics and the rights of minors seeking healthcare interventions.
The outcome could shape federal involvement in pediatric gender medicine and define how far the government can go in restricting procedures without following established legal procedures.
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