Secretary of Well being and Human Providers, Robert F. Kennedy, Jr., speaks throughout an occasion on prescription drug costs within the Roosevelt Room of the White Home, Friday, Dec. 19, 2025, in Washington.
Evan Vucci/AP
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Evan Vucci/AP
NEW YORK — A coalition of 19 states and the District of Columbia on Tuesday sued the U.S. Division of Well being and Human Providers, its secretary, Robert F. Kennedy Jr., and its inspector normal over a declaration that would complicate entry to gender-affirming look after younger folks.

The declaration issued final Thursday known as therapies like puberty blockers, hormone remedy and surgical procedures unsafe and ineffective for youngsters and adolescents experiencing gender dysphoria, or the misery when somebody’s gender expression does not match their intercourse assigned at delivery. It additionally warned docs that they may very well be excluded from federal well being applications like Medicare and Medicaid if they supply these forms of care.
The declaration got here as HHS additionally introduced proposed guidelines meant to additional curtail gender-affirming look after younger folks, though the lawsuit does not tackle these as they aren’t closing.
Tuesday’s lawsuit, filed in U.S. District Courtroom in Eugene, Oregon, alleges that the declaration is inaccurate and illegal and asks the court docket to dam its enforcement. It is the most recent in a collection of clashes between an administration that is cracking down on transgender well being care for youngsters, arguing it may be dangerous to them, and advocates who say the care is medically obligatory and should not be inhibited.
“Secretary Kennedy can’t unilaterally change medical requirements by posting a doc on-line, and nobody ought to lose entry to medically obligatory well being care as a result of their federal authorities tried to intrude in selections that belong in docs’ places of work,” New York Legal professional Common Letitia James, who led the lawsuit, stated in an announcement Tuesday.
The lawsuit alleges that HHS’s declaration seeks to coerce suppliers to cease offering gender-affirming care and circumvent authorized necessities for coverage adjustments. It says federal legislation requires the general public to be given discover and a possibility to remark earlier than substantively altering well being coverage — neither of which, the swimsuit says, was achieved earlier than the declaration was issued.
A spokesperson for HHS declined to remark.
HHS’s declaration primarily based its conclusions on a peer-reviewed report that the division performed earlier this yr that urged larger reliance on behavioral remedy reasonably than broad gender-affirming care for teenagers with gender dysphoria.
The report questioned requirements for the therapy of transgender youth issued by the World Skilled Affiliation for Transgender Well being and raised considerations that adolescents could also be too younger to provide consent to life-changing therapies that would end in future infertility.
Main medical teams and those that deal with transgender younger folks have sharply criticized the report as inaccurate, and most main U.S. medical organizations, together with the American Medical Affiliation, proceed to oppose restrictions on transgender care and providers for younger folks.
The declaration was introduced as a part of a multifaceted effort to restrict gender-affirming well being care for youngsters and youngsters — and constructed on different Trump administration efforts to focus on the rights of transgender folks nationwide.

HHS on Thursday additionally unveiled two proposed federal guidelines — one to chop off federal Medicaid and Medicare funding from hospitals that present gender-affirming care to youngsters, and one other to ban federal Medicaid {dollars} from getting used for such procedures.
The proposals aren’t but closing or legally binding and should undergo a prolonged rulemaking course of and public remark earlier than changing into everlasting. However they may nonetheless probably additional discourage well being care suppliers from providing gender-affirming care to youngsters.
A number of main medical suppliers have already got pulled again on gender-affirming look after younger sufferers since Trump returned to workplace — even in states the place the care is authorized and guarded by state legislation.
Medicaid applications in barely lower than half of states at the moment cowl gender-affirming care. A minimum of 27 states have adopted legal guidelines limiting or banning the care. The Supreme Courtroom’s latest resolution upholding Tennessee’s ban means most different state legal guidelines are prone to stay in place.
Becoming a member of James in Tuesday’s lawsuit had been Democratic attorneys normal 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. Pennsylvania’s Democratic governor additionally joined.