States, including Michigan, reject HHS plan to block gender-affirming care for minors

Attendees of a Transgender Day of Visibility rally at the Michigan Capitol in Lansing, Mich., on March 30, 2025. (Photo by Andrew Roth/Michigan Advance)

Maryland joined 18 states and the District of Columbia Tuesday in a lawsuit challenging a Health and Human Services declaration last week that health care facilities offering gender-affirming care to minors would be barred from Medicare and Medicaid.

The lawsuit, filed Tuesday in U.S. District Court in Oregon, claims that HHS Secretary Robert F. Kennedy Jr. exceeded his authority with the Dec. 18 declaration, which would “effectively ban, by fiat, an entire caregory of healthcare.” It also failed to follow proper procedures for promulgating new rules, would  interfere with states’ rights to run their Medicaid programs and regulate health care and deny care to youth that need it.

“Healthcare decisions should be made by doctors and patients – not by politicians in Washington threatening to destroy providers’ careers and spreading fear among transgender youth and their families,” Maryland Attorney General Anthony Brown said in a statement late Tuesday night.

“This isn’t just about following the law – though HHS is clearly violating it. This is about protecting vulnerable young people who deserve the same dignity, respect, and access to medical care as anyone else,” Brown’s statement said.

For many of the 20 Democrat-led jurisdictions on Tuesday’s lawsuit, like Maryland, it was the second day in a row they had gone to an Oregon federal court to challenge Trump administration policy: A total of 22 jurisdictions sued Monday in an attempt to block the administration’s attempt to defund the Consumer Financial Protection Bureau.

Many of the states are now veterans of lawsuit against President Donald Trump and his administration. For Brown, this week’s lawsuits were the 47th and 48th against the administration and its policies since January, when Trump returned to office.

The latest lawsuit is a response to Kennedy’s declaration on the “Safety, Effectiveness, and Professional Standards of Care for Sex-Rejecting Procedures on Children and Adolescents.” That document declared that health care facilities would be barred from participating in Medicare, Medicaid and other federal programs if they provided gender-affirming care — including puberty blockers, hormonal treatments or surgery — to anyone under age 18.

Part of the declaration states that the methods “for children and adolescents are neither safe nor effective as a treatment modality for gender dysphoria, gender incongruence, or other related disorders in minors.” The declaration also says it supersedes “statewide or national standards of care.”

In a news release with the announcement, Kennedy said it was made in line with Trump’s Jan. 28 executive order “protecting children from chemical and surgical mutilation.” The release also notes that the Food and Drug Administration has issued warning letters to 12 manufacturers and retailers it says are marketing breast binders to children for treatment of gender dysphoria, and that HHS’ Office for Civil Rights is working to reverse a Biden administration policy that categorized gender dysphoria as a disability.

Tuesday’s suit claims that Kennedy’s declaration would negatively impact transgender youth, affect thousands of hospitals that offer Medicare and Medicaid programs and harm medical profession that provide necessary health care.

“The Kennedy Declaration also purports to establish a standard of care and supersede other standards of care, despite the Medicare statute’s clear prohibition against any Federal interference,” according to the suit.

The 41-page suit also discusses policies and protections for transgender youth in each of the state suing. In Maryland, it noted, the Trans Health Equity Act became law in 2023, stating that the state’s Medicaid program “shall” cover gender-affirming care that grants lower-income residents access to those procedures. The law also ensures the state provides the care with or without federal funding.

The state Department of Health reports that in 2024, Maryland Medicaid spent $1.7 million to fund more than 1,600 unique office visits for gender-affirming care services. That figure currently includes about $900,000 in federal funding.

“We’re standing up against this cruel and unlawful action because every Marylander, regardless of who they are, deserves compassionate, evidence-based healthcare from providers who won’t be punished for doing what’s right,” Brown said in his statement.

Besides the District and Maryland, other states in Tuesday’s suit include California, Colorado, Connecticut, Delaware, Illinois, Maine, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, North Carolina, Oregon, Pennsylvanis, Rhode Island, Vermont and Wisconsin.

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