19 States and D.C. Sue HHS Over Policy on Youth Gender-Affirming Care

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THE BARE STORY

A coalition of 19 states and the District of Columbia filed a lawsuit on Tuesday against the U.S. Department of Health and Human Services (HHS), its secretary, and its inspector general. The legal action, filed in a federal court in Oregon, seeks to block an HHS declaration issued last week that described gender-affirming care for minors, such as puberty blockers and hormone therapy, as unsafe and ineffective.

The HHS declaration warned that medical providers offering such care could be excluded from federal programs, including Medicare and Medicaid. According to the states’ lawsuit, led by New York’s attorney general, the HHS declaration is “inaccurate, unlawful, and an attempt to coerce medical providers.” The suit also alleges that HHS failed to follow federal law requiring a public notice and comment period before changing health policy. An HHS spokesperson declined to comment on the litigation.

In its declaration, HHS stated its conclusions were based on a peer-reviewed departmental report that questioned standards for treating transgender youth and raised concerns about their ability to consent to treatments that could lead to infertility. The report recommended a greater focus on behavioral therapy. Last week, HHS also unveiled two proposed rules, which are not yet final, to cut federal funding from hospitals and Medicaid programs that provide this care to children.

Major U.S. medical organizations, including the American Medical Association, have criticized the HHS report as inaccurate and continue to oppose restrictions on this type of care for minors. The lawsuit comes as at least 27 states have laws restricting or banning such treatments. Recently, the Supreme Court upheld Tennessee's ban in a 6-3 decision, the first time it had ruled on the issue for youth, finding the state's law did not violate the Fourteenth Amendment's equal protection guarantee.

Same Facts. Different Perspectives.

Two AI models. Two viewpoints. One factual foundation.

• The federal health agency's declaration is considered unlawful and coercive. The coalition of states argues in its lawsuit that the Department of Health and Human Services (HHS) is attempting to coerce medical providers. Their legal action contends that the department's declaration describing gender-affirming care for minors as unsafe is not only inaccurate but also represents an unlawful overreach of authority.

• The agency allegedly violated federal procedure in issuing its new policy. According to the lawsuit, HHS failed to follow the legally required process for changing health policy. The states claim that federal law mandates a public notice and comment period before such a significant change is implemented, a step they allege the department skipped.

• The basis for the HHS policy is factually inaccurate, according to medical experts. Major U.S. medical organizations, such as the American Medical Association, have criticized the departmental report that HHS used to justify its declaration. These groups, which support access to gender-affirming care for minors, have characterized the report as inaccurate.

How it may affect me

As a U.S. reader:

• Access to gender-affirming care for minors may be reduced, as providers could lose federal Medicare and Medicaid funding if they offer these services.

• The lawsuit creates legal uncertainty for hospitals and families over whether this specific medical care can be provided without risking federal penalties.

• Some hospitals and state Medicaid programs may face cuts to federal funding, which could potentially affect their overall budgets and the services they can offer.

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