Democratic states sue HHS over youth gender-affirming care declaration

Following last week's HHS declaration deeming gender-affirming treatments for minors unsafe, a coalition of 19 states and the District of Columbia filed a federal lawsuit Tuesday challenging the move. Led by New York Attorney General Letitia James in Oregon federal court, the suit argues the declaration unlawfully bypasses medical standards and risks excluding providers from Medicare and Medicaid.

The lawsuit, filed in federal court in Eugene, Oregon, targets an HHS declaration issued last Thursday by Secretary Robert F. Kennedy Jr. labeling puberty blockers, hormone therapy, and surgeries for children and adolescents with gender dysphoria as unsafe and ineffective. As detailed in prior coverage of HHS's related proposed rules to cut federal funding for such care, the declaration warns that providers risk exclusion from programs like Medicare and Medicaid.

New York AG Letitia James, leading the coalition, said: "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 plaintiffs allege the declaration violates the Administrative Procedure Act by skipping public notice and comment, and misrepresents evidence. It references an earlier HHS report favoring behavioral therapy over such interventions due to concerns like infertility and adolescent consent. Major medical groups like the American Medical Association back gender-affirming care despite the report.

Coalition members include attorneys general from California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Wisconsin, Washington, and the District of Columbia, plus Pennsylvania Gov. Josh Shapiro.

The suit comes amid HHS proposals to bar Medicaid and CHIP funding for minors' gender-affirming care, following President Trump's executive order. At least 27 states have restricted it, the Supreme Court upheld Tennessee's ban, and Medicaid covers it in under half of states, with some providers already reducing services post-Trump administration return.

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HHS official announces cuts to federal funding for hospitals offering gender-affirming care to minors.
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The Trump administration has proposed new rules that would strip most federal health funding from hospitals that provide gender-affirming medical procedures to minors. The Department of Health and Human Services (HHS) announced measures that would make such care a violation of conditions for participation in Medicare and Medicaid, and would bar Medicaid and the Children’s Health Insurance Program from covering these services for people under 18, as part of efforts to carry out a recent executive order by President Donald Trump.

A federal judge has struck down portions of a Biden-era regulation interpreting federal health care nondiscrimination law to cover gender identity, siding with Tennessee and 14 other states that sued the U.S. Department of Health and Human Services.

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The U.S. Department of Health and Human Services said it has referred Children’s Hospital Colorado to its inspector general over what it described as noncompliance with newly announced federal standards targeting certain gender-related medical interventions for minors. The hospital is separately asking a federal court to block a Justice Department subpoena seeking records tied to its care for transgender adolescents, as a coalition of Democratic-led states challenges the federal initiative in court.

The American Society of Plastic Surgeons has recommended delaying gender-related surgeries for minors until age 19, citing insufficient evidence of benefits outweighing risks. This policy shift follows a $2 million malpractice award to a detransitioner who underwent a double mastectomy at 16. The statement marks a departure from prior medical consensus on pediatric gender care.

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