Federal Court Permanently Blocks HHS Gender-Affirming Care Declaration
Summary
A federal district court issued a written opinion and judgment permanently blocking HHS Secretary Kennedy's December 18, 2024 declaration that certain forms of gender-affirming care for youth with gender dysphoria are 'unsafe and ineffective.' The court granted summary judgment for the plaintiff states, finding the declaration exceeded federal statutory authority, failed required notice-and-comment rulemaking procedures, and improperly interfered with states' rights to regulate medical practice and design Medicaid plans. Twenty-two state attorneys general led by Washington, Oregon, and New York secured the ruling protecting healthcare providers from threats of exclusion from Medicare and Medicaid programs.
“Secretary Kennedy's attempt to prohibit medical care for youth with gender dysphoria "exceeded [the federal government's] statutory authority, flouted applicable notice and comment rulemaking procedures, and impeded Plaintiffs' rights to regulate the medical profession and their discretion to design their own statutorily-compliant Medicaid plans."”
Healthcare providers offering gender-affirming care to minors should note that the court rejected HHS's assertion that these treatments are 'unsafe and ineffective' for purposes of federal enforcement. While the ruling applies to the named defendant HHS, the court's statutory authority and administrative procedure holdings provide a legal shield that other providers can invoke in similar federal disputes. State Medicaid programs should confirm their coverage policies remain consistent with their own statutory frameworks following this ruling.
What changed
The court permanently enjoined HHS Secretary Kennedy's declaration asserting that certain youth gender-affirming care is 'unsafe and ineffective' and would supersede all state standards of care. The court held the declaration exceeded statutory authority, failed notice-and-comment rulemaking, and unlawfully threatened to exclude providers from Medicare and Medicaid for providing such care.\n\nHealthcare providers, hospitals, and clinics offering gender-affirming care to transgender adolescents in the plaintiff states are protected from federal exclusion threats under this ruling. State Medicaid programs retain authority to design their own statutorily-compliant coverage policies for gender dysphoria treatments. The ruling is binding on the federal defendants but may be subject to appeal.
Archived snapshot
Apr 20, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
FOR IMMEDIATE RELEASE:
Apr 20 2026
AG Brown, along with the Attorneys General of Oregon and New York, lead a coalition of 22 states that secured a federal court order Saturday permanently blocking an unlawful attempt by the Trump administration to threaten healthcare providers for treating youth with gender dysphoria.
A federal district court issued a written opinion and judgment, granting the plaintiff states’ summary judgment motion. The court agreed with every argument made by the Plaintiff States. In the Court’s opinion, Judge Kasubhai held that the Secretary Kennedy’s attempt to prohibit medical care for youth with gender dysphoria “exceeded [the federal government’s] statutory authority, flouted applicable notice and comment rulemaking procedures, and impeded Plaintiffs’ rights to regulate the medical profession and their discretion to design their own statutorily-compliant Medicaid plans.”
“This is a resounding win for the rights of youth, their families, and the rule of law when it comes to medical care,” Washington Attorney General Nick Brown said in March when the court announced it would be granting a written order in favor of the states. “The court agrees that the administration ignored the law in its rush to deprive transgender youth of the health care they are legally entitled to.”
On December 18, the U.S. Department of Health and Human Services (HHS) issued a declaration asserting that certain forms of gender-affirming care are “unsafe and ineffective” and that the declaration would supersede all other state standards of care. In the declaration, HHS Secretary Robert F. Kennedy Jr. attempted to give HHS the power to exclude healthcare providers, including hospitals and clinics, from Medicare and Medicaid programs simply for providing care for transgender adolescents.
AG Brown and the coalition immediately sued in the U.S. District Court for the District of Oregon, arguing that Kennedy lacked the legal authority to issue the declaration; that HHS’s actions were arbitrary and capricious; and that the agency failed to adhere to the necessary procedural requirements for notice-and-comment rulemaking.
At the end of a summary judgment hearing last month, a federal judge agreed with the states and gave an oral ruling stating the court would block the federal government’s threats. The Court’s written opinion and judgment effectuate that prior ruling and protect healthcare providers and hospitals from the devastating effects of HHS’s unlawful actions.
Joining Attorney General Brown in this lawsuit are the attorneys general of Colorado, Connecticut, Delaware, the District of Columbia, Hawai’i, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Wisconsin, and the governor of Pennsylvania.
A copy of the court's opinion and judgment is available here.
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