Dive Brief:
- A coalition of 16 states and Washington, D.C. are suing the Trump administration to halt what they say is an “unconstitutional pressure campaign” on providers of youth gender-affirming care.
- The complaint, filed last week in the U.S. District Court in Massachusetts, follows months of escalating federal scrutiny of gender-affirming care for minors, including threats of civil and criminal penalties against providers and drug manufacturers.
- The states argue the government is attempting to ban the practice without going through the proper legal channels. The lawsuit asks the court to block the administration’s actions restricting gender-affirming care and to stop the enforcement of relevant executive orders and agency directives.
Dive Insight:
On President Donald Trump’s first day in office, he signed an executive order commanding federal agencies to only recognize two sexes, ending support for so-called “gender ideology.”
He then moved to further focus on transgender youth, issuing a second order in January that sought to restrict gender-affirming care for those under 19, including by ordering the Department of Justice to pursue enforcement actions against providers.
Since then, the administration has deployed the CMS, the Justice Department, the Federal Trade Commission, the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration and the Office of the Assistant Secretary for Health in its efforts to curtail access to care.
For example, the DOJ issued a memorandum in June, authored by Assistant Attorney General Brett Shumate, directing civil division attorneys to use all available resources to “prioritize investigations of doctors, hospitals, pharmaceutical companies, and other appropriate entities.”
Last month, the administration said it had issued more than 20 subpoenas to doctors and clinics that provide gender-affirming care to children.
The states say that such actions have had a chilling effect on medical care. While some providers initially sought to push back against the administration’s crackdown on gender-affirming care this winter, more recently major health systems including the Cleveland Clinic, Kaiser Permanente, Mount Sinai and University of Pittsburgh Medical Center have elected to pause youth gender-affirming care services, citing political pressure. Many of these closures are happening in states where gender-affirming care is protected by state law.
The White House celebrated health systems ending services in a statement last month as a sign their policies were working as intended.
However, the states say that the Trump administration’s policies violate the 10th Amendment, which says that powers or rights not explicitly belonging to the federal government belong to states or individuals, because transgender healthcare is legally protected in their states. They argue that Congress has passed no law banning gender-affirming care for minors and the Trump administration is attempting to go through back channels to effectuate a de factor ban.
“The attorneys general assert that the administration’s actions put providers in an impossible position: either comply with unlawful federal threats or violate state laws that require nondiscriminatory access to medical care,” New York Attorney General Letitia James’ office said in a statement.
Plaintiffs are asking the court to declare unconstitutional Trump’s executive order banning hospitals that provide youth gender-affirming care from receiving federal funds. They also ask the court to bar the DOJ from penalizing providers who provide the care.
The states included in the lawsuit are New York, California, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, Rhode Island, Wisconsin, Washington, D.C. and Pennsylvania.
