19 Democratic states challenge HHS policy restricting transgender care for minors
WASHINGTON, DC: A coalition of 19 Democratic-led states, including the District of Columbia, filed a lawsuit on Tuesday, December 23, challenging a Trump administration policy aimed at restricting gender-affirming medical care for transgender minors.
The legal action targets a recent declaration by the Department of Health and Human Services (HHS) that could bar hospitals providing such care from participating in federal health programs.
State officials argue the move exceeds federal authority and could sharply limit access to care nationwide. The lawsuit marks the latest escalation in an ongoing national dispute over transgender health policy.
BREAKING NEWS: We’re leading a lawsuit challenging federal attacks on gender-affirming care. Healthcare decisions belong w/families & providers, not the government – and the gov't can't use a “declaration” to circumvent legal requirements for policy change. #orpol #breakingnews pic.twitter.com/bthvYPgwgm
— Attorney General Dan Rayfield (@AGDanRayfield) December 24, 2025
Lawsuit challenges HHS authority
The lawsuit filed in federal court in Oregon focuses on a December 18 declaration issued by the Department of Health and Human Services Secretary Robert F Kennedy Jr.
The declaration asserts that certain medical treatments for transgender minors, including puberty blockers and hormones, do not "meet professionally recognized standards of care."
It further signals that hospitals and providers offering such care could lose eligibility for federal funding through Medicare and Medicaid.
The States contend that the declaration violates the 'Administrative Procedure Act' by bypassing required notice-and-comment procedures and attempting to impose immediate nationwide policy changes.
They also argue that the federal government lacks authority to regulate the practice of medicine, a power traditionally reserved for states.
According to the complaint, the policy would interfere with states' administration of Medicaid programs and disrupt established healthcare systems.
“Health care decisions should be made by patients, families, and their providers – not by politicians making false claims about the safety of care,” Massachusetts Attorney General Andrea Joy Campbell said in a statement.
The suit also states that "the secretary has no legal authority to substantively alter the standards of care and effectively ban, by fiat, an entire category of healthcare."
Broader policy shift and the national impact
The lawsuit comes amid a broader set of actions by the Trump administration affecting transgender-related healthcare.
In addition to the HHS declaration, the department has proposed new rules that would revoke federal funding from providers offering certain treatments to minors.
Administration officials have described these steps as part of a wider effort to reshape federal health policy.
Health and Human Services Deputy Secretary Jim O’Neill said during a press conference announcing the policies, “Men are men. Men can never become women. Women are women. Women can never become men. Children are innocent and need our protection."
Kennedy has said the administration is taking multiple "decisive actions" based on science and executive authority.
The Democratic-led states argue that these measures would pressure providers to abandon patients or risk losing federal support.
In a joint statement, they said, “By threatening to disqualify providers who offer gender-affirming care, the federal government is forcing doctors to choose between abandoning their patients or risking their livelihoods."
"This pressure would reduce access to care, worsen provider shortages, and harm Medicaid patients far beyond those seeking gender-affirming care," they added.
