WASHINGTON — A coalition of Democratic-led states and the District of Columbia has sued the federal health department, calling a declaration that rejected gender-affirming care signed by health secretary Robert F. Kennedy Jr. an overreach of his authority.
The lawsuit, filed by 19 states and D.C., says the declaration — which claims that gender-affirming care including hormones and surgeries do not meet medical standards of care — sidesteps public notice and comment periods required of regulations. It also argues that Kennedy exceeded powers Congress had granted the Department of Health and Human Services by attempting to define standards of care.
“The Kennedy Declaration has immediate, significant, and harmful impacts on the Plaintiff States as administrators of state Medicaid programs and as regulators of the practice of medicine,” the suit reads.
The Trump administration last week announced a crackdown on care given to transgender youth in the U.S. In addition to the declaration, HHS also issued two proposed rules that would withhold federal funds in connection with gender-affirming care and another that would bar facilities that offer this type of care from receiving Medicare or Medicaid funding.
Kyle Faget, a lawyer with Foley & Lardner LLP, told STAT the scope of the declaration issued by Kennedy is “enormous.”
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“It essentially says to the medical community … you can’t, without significant risk, provide gender-affirming care even if you believe that is an appropriate standard of care,” she said. She added it would essentially exclude those providers from practicing within entities that accept federal funding — even if they provide gender-affirming services in a private practice.
“We’ve never seen a declaration issued like this before. Declarations tend to be issued in public health emergencies. That’s not what they chose to do here,” she said.
At a press conference last week, Kennedy dismissed the threat of legal challenges, declaring that the department would win any such court battle. HHS did not immediately return a request for comment. Major medical organizations and providers that work with trans children, along with their families, reject Kennedy’s conclusions on gender-affirming care, calling such care evidence-based and, at times, lifesaving. A number of those organizations, including the American Academy of Pediatrics, the Children’s Hospital Association and Physicians for Reproductive Health, condemned the crackdown.
