Sixteen states are suing the Trump administration to defend transgender youth healthcare access, which has rapidly eroded across the US due to threats from the federal government.
The Democratic attorneys general of California, New York, Massachusetts, Illinois and Connecticut are leading the lawsuit, announced on Friday, which challenges the president’s efforts to eradicate vital medical treatments for trans youth.
The complaint targets one of the president’s first executive orders issued in January, which described puberty blockers and hormone therapy as “chemical and surgical mutilation”, called for federal funds to be withheld from hospitals that provide the treatments and suggested the US Department of Justice could investigate doctors. Those gender-affirming treatments, which are accessed by a small fraction of youth in the US, have for years been the standard of care endorsed by major US medical associations.
Under intensifying threats that hospitals could lose federal funding, and growing fears that providers could be criminally prosecuted, a number of major institutions have abruptly ended gender-affirming care for trans youth.
The crackdown has sent families scrambling for alternatives, including in blue states long considered sanctuaries for LGBTQ+ rights, where clinics and lawmakers had previously assured youth they would be shielded from Donald Trump’s agenda.
Last month, Children’s Hospital Los Angeles, one of the nation’s largest and most prominent institutions to serve trans kids, shuttered its gender-affirming care center for youth after three decades, citing funding threats from across the federal government.
Other institutions that have recently pulled back gender-affirming care services for trans youth include Phoenix Children’s Hospital in Arizona, Stanford Medicine, Denver Health, the University of Chicago, the University of Pennsylvania and Children’s National Hospital in Washington DC. Some have ceased surgeries for patients under age 19, which are rare, while others have also ended hormone therapy and puberty blockers.
The justice department in July also announced that it had sent subpoenas to more than 20 doctors and clinics that provide gender-affirming care to youth, a move that sent shock waves among providers and raised alarms that patients’ information could be shared with the federal government.
The suit notes the administration has already launched criminal investigations and explicitly threatened providers in California, Colorado and Massachusetts and that officials have “demanded extensive data, including patient medical records”.
The blue states are also challenging a June memo from Brett Shumate, assistant US attorney general, which directed the justice department’s civil division to “use all available resources to prioritize investigations of doctors, hospitals, pharmaceutical companies and other appropriate entities” that provide gender-affirming care.
Republican lawmakers in more than 25 states have moved to restrict trans youth healthcare in recent years. But the treatments remain legal in other parts of the country, and states such as California have anti-discrimination laws that explicitly protect the services.
The plaintiffs argue that Trump’s actions should be declared unlawful, alleging his order exceeds federal authority. California’s attorney general, Rob Bonta, also challenged Trump’s definition of children as people under the age of 19, affecting 18-year-old adults’ access to care, saying the administration’s directives force hospitals to violate state laws.
Bonta said denying this care has been shown to worsen mental health outcomes, including increased rates of depression, anxiety and suicidal ideation. “Trump and Bondi are not trained medical professionals. They aren’t at all qualified to give anyone medical advice. What’s worse, they refuse to listen to the actual experts,” he said at a press conference.
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Citing comments from one parent of a trans child treated at a center that is shutting down, Bonta said: “This closure will be life and death for trans youth who can no longer get the care they need.”
“What would you do if your child was diagnosed with gender dysphoria? I would fight for my kid every single day,” added William Tong, the Connecticut attorney general. “We’re fighting for … parents who just want to do the best for their kids, as we all do, to help them live their best and truest lives.”
Joining the lawsuit are the attorneys general of Delaware, Hawaii, Maine, Maryland, Michigan, Nevada, New Jersey, New Mexico, Rhode Island and Wisconsin, along with the District of Columbia and the Pennsylvania governor.
“On day one, President Trump took decisive action to stop the despicable mutilation and chemical castration of children – which everyday Americans resoundingly support,” said Taylor Rogers, a White House spokesperson, in an email. “The president has the lawful authority to protect America’s vulnerable children through executive action, and the administration looks forward to ultimate victory on this issue.”
The justice department did not immediately respond to an inquiry.
The suit comes after the US supreme court upheld Tennessee’s ban on trans youth healthcare.
“Hormone therapy truly saves lives,” said Eli, a trans 16-year-old who lost his healthcare in Los Angeles, in a recent Guardian interview. “I wish people understood they’re doing so much more harm than they could possibly imagine – that so many lives will be hurt and lost and so many people torn apart.”