RFK Jr. announced a directive on medical care for transgender youth. 19 attorneys general sued to stop it
More than a dozen states led by Democrats and the District of Columbia filed a lawsuit against Trump administration health officials over directives to bar medical professionals from providing gender-affirming care to minors. The coalition, led by Oregon, claimed the directive revoked people’s right to make their own decisions about their health, while Health Secretary Robert F. Kennedy Jr. said it stops an “unsafe, irreversible” practice.
Nineteen attorneys general filed the lawsuit in U.S. District Court, arguing Kennedy circumvented requirements from the Federal Register regarding how new policies are implemented and is outside of his authority. Pennsylvania Democratic Gov. Josh Shapiro marks the 20th plaintiff, though Pennsylvania’s attorney general, Republican Dave Sunday, did not formally join.
“The Secretary has no legal authority to substantively alter the standards of care and effectively ban, by fiat, an entire category of healthcare,” according to court papers. “Nor does the Secretary have authority to threaten providers’ participation in federal programs, including reimbursement by Medicare and Medicaid, by fiat.”
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Several federal health officials, including Kennedy, FDA Commissioner Dr. Martin “Marty” Makary, Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz and others shared snippets from the Dec. 18 press conference about the directives. They said they are in the interest of children and criticized the medical care transgender youth receive.
“Pushing transgender ideology in children is predatory, it’s wrong and it needs to stop,” Makary said, according to HHS’s rapid response X account.
Oregon Attorney General Dan Rayfield said in a Wednesday statement that HHS usurps families’ right to make decisions about their health independent of the government. His office added that HHS actions are an attempt to “intimidate providers.”
“This pressure would reduce access to care, worsen provider shortages, and harm Medicaid patients far beyond those seeking gender-affirming care,” according to the release.
Kennedy issues directive on care for trans youth
The lawsuit challenges the authority Kennedy had to issue such a directive.
Kennedy built on President Donald Trump’s January executive order regarding medical intervention for transgender minors. Kennedy’s directive included medications, surgeries and chest binders.
“Under my leadership, and answering President Trump’s call to action, the federal government will do everything in its power to stop unsafe, irreversible practices that put our children at risk,” Kennedy said in a Dec. 18 release, calling the medical care “sex-rejecting procedures.”
Researchers at Harvard University’s School of Public Health found that in 2019, just two in every 100,000 minors ages 15 to 17 received gender-affirming surgery associated with a transgender and gender-diverse diagnosis. In the study, no children aged 12 and younger received such care. They also learned that of the 151 breast-reduction surgeries for male minors, 146 were for cisgender male minors, which were labeled as gender-affirming care.
A 60-day public comment period is available for the two rules until Feb. 17. The first rule would bar all hospitals that participate in the Medicare and Medicaid programs from providing the care to minors. The second rule would ban states’ Medicaid programs from approving and covering such medical care. According to the Federal Register, the proposals received a combined total of 1,366 comments as of publication time.
Directive builds on MTG’s bill
Kennedy’s order follows a bill by outgoing Rep. Marjorie Taylor Greene, R-Ga., to ban sex reassignment surgery for transgender youth. Her bill passed in the House 216 yays to 211 nays. It’s not immediately known how the bill would stand in the Senate.
“Children are not old enough to vote, drive, or get a tattoo and they are certainly not old enough to be chemically castrated or permanently mutilated,” Greene wrote on Dec. 17 on X.
Greene’s bill would criminalize anyone who performs, or attempts to perform, gender-affirming surgery on a minor. Her bill specifies that it encompasses both genital and bodily mutilations that are not done due to religion or other cultural practices. The bill does leave room for procedures done in the necessity for the child’s health or a necessary step for an impregnated minor.
The bill doesn’t have exemptions for a minor’s mental, behavioral or emotional distress and health, which includes gender dysphoria. The American Psychiatric Association has urged that gender dysphoria and transgender are not one and the same, with the former referring to the “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.”
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“Medical affirmation may include pubertal suppression for younger adolescents with gender dysphoria and gender-affirming hormones like estrogen and testosterone for older adolescents and adults,” the association wrote. “Medical affirmation is never recommended for prepubertal children. Some adults (and less often older adolescents) may undergo various aspects of surgical affirmation.”
Legal, advocacy organizations condemn legislation
More than 150 organizations that focus on the transgender and rest of the LGBTQ+ community, civil rights groups, health and mental health groups and legal advocacy groups signed an open letter to Congress opposing Greene’s bill.
They wrote that the bill doesn’t protect children in persecuting treatment for transgender, intersex and gender-diverse youth and their medical providers.
“If passed, this legislation would expose tens of thousands of transgender and gender diverse youth to immense psychological suffering and increased risk of suicidality,” they wrote.
