A coalition of Democratic-led states and the District of Columbia has taken legal action against the federal health department, challenging a declaration signed by health secretary Robert F. Kennedy Jr. that rejected gender-affirming care. The lawsuit, filed by 19 states and D.C., argues that the declaration, which claims that gender-affirming care does not meet medical standards of care, bypassed required public notice and comment periods for regulations. It also contends that Kennedy exceeded his authority by trying to define standards of care.
The Trump administration recently announced a crackdown on care for transgender youth in the U.S., accompanied by the declaration and two proposed rules. These rules would withhold federal funds related to gender-affirming care and prevent facilities offering such care from receiving Medicare or Medicaid funding. Kyle Faget, a lawyer with Foley & Lardner LLP, highlighted the broad implications of Kennedy’s declaration, stating that it restricts medical providers from offering gender-affirming care, even in private practice.
The declaration has sparked backlash from major medical organizations and providers working with transgender children, who view gender-affirming care as evidence-based and potentially life-saving. Organizations like the American Academy of Pediatrics, the Children’s Hospital Association, and Physicians for Reproductive Health have condemned the crackdown. Despite the legal challenges, Kennedy asserted that the department would prevail in any court battle.
The lawsuit underscores the importance of access to gender-affirming care for transgender individuals and the need to uphold evidence-based medical practices. The controversy surrounding the declaration highlights the ongoing challenges faced by the transgender community in accessing appropriate healthcare services.

