A federal judge in Oregon ruled on Thursday that Health Secretary Robert F. Kennedy Jr. overstepped his authority when he declared that gender-affirming care for minors was neither “safe nor effective” and did not meet “professional recognized standards of health care.”
U.S. District Court Judge Mustafa Kasubhai ruled in favor of 21 Democrat-led states who challenged Kennedy’s attempt to create a national standard against gender-affirming care for trans and gender-nonconforming minors, saying that the guidance from the Department of Health and Human Services violated their rights to regulate medical practices. Kennedy had issued the 12-page declaration on Dec. 18 last year, saying the guidance “supersedes” statewide or national standards of care.
The HHS declaration had cast doubt on the standards of care backed by major medical organizations like the American Medical Association, American Academy of Pediatrics and the American Psychiatric Association, which characterize gender-affirming care as safe and effective. It also came at the same time as HHS unveiled three proposed rules that sought to prevent medical providers from receiving Medicaid and Medicare reimbursements if they provided transition care for youth. Soon after, HHS referred 13 medical institutions that provide such care to the department inspector general’s office for investigation, according to court documents.
Legal experts expect the government will likely appeal the ruling. HHS did not immediately respond to JS’s request for comment.
LGBTQ+ advocates celebrated the ruling that, for now, offers some relief to health care providers and families of trans youth.
“Politicians, including RFK Jr., do not get to tell doctors how to do their jobs or families what decisions are best for their children,” Kelley Robinson, the president of the Human Rights Campaign, said in a statement. “Health care for transgender people is just that — health care — and that care must continue — full stop.”
New York Attorney General Letitia James, one of the plaintiffs in the suit, also applauded the judge’s decision in a press release.
“So much of the conversation around transgender health has lost sight of the real people harmed by the federal government’s attacks,” James said in a statement. “Today’s win breaks through the noise and gives some needed clarity to patients, families, and providers. Health care services for transgender young people remain legal, and the federal government cannot intimidate or punish the providers who offer them.”
The Democrat-led states, including Oregon, California, New York, Colorado and the District of Columbia, had argued in their suit that Kennedy’s attempt to establish national standards on gender-affirming care violated the Administrative Procedure Act, a statute that requires federal agencies to follow certain standards for rulemaking as delegated by Congress.
By contrast, the Trump administration argued that the declaration was a “non-binding” policy and said that states failed to show how the declaration harmed individual providers as none had been blocked from receiving Medicare and Medicaid at that point.
Over the course of the six-hour hearing in Eugene, Oregon, Kasubhai agreed with the states, noting that Kennedy’s declaration “effectively eliminated” any options for health care providers to treat patients seeking gender-affirming care.
“There’s a theme of ‘Break it and see what others will do,’ and that’s not a system or method committed to the rule of law,” Kasubhai said during the trial. “That notion that ‘I will go forward, issue a declaration and see if we can get away with it,’ that is not a principle of governance that adheres to the overarching commitment to the democratic public that requires the rule of law to be regarded and respected and honored as sacred.”
The decision is the latest blow to the Trump administration’s sweeping efforts to halt access to gender-affirming treatments such as puberty blockers and hormone replacement therapy for minors.
In the year after President Donald Trump signed his executive order seeking to block access to transition care for youth, numerous hospitals and clinics that receive federal funding axed their services, making access to gender-affirming care more difficult for both youth and adults.
As of January, more than 40 hospitals have paused or stopped offering gender-affirming treatments to young people, including in states where such care is protected under state law.
Major hospitals such as New York University’s Langone and the Children’s Hospital of Los Angeles have all stopped offering treatments.
Additionally, the Justice Department has issued 20 subpoenas to doctors and hospitals it said were involved in “performing transgender medical projects.”
So far, 27 Republican-led states have banned access to gender-affirming care since 2020 — and the Supreme Court last June gave states the green light to decide how and if such care should be administered to minors.
