A coalition of state attorneys general, led by New York, has filed a lawsuit challenging the Trump administration’s nationwide efforts to restrict gender-affirming care, arguing the federal government is circumventing state laws through a campaign of legal intimidation.
The lawsuit, filed Friday in U.S. District Court in Massachusetts, accuses the Department of Justice of threatening providers with civil and criminal penalties in an attempt to halt care for transgender minors, even in states where such care is explicitly protected.
“The administration’s actions put providers in an impossible position: either comply with unlawful federal threats or violate state laws that require nondiscriminatory access to medical care,” said the office of New York Attorney General Letitia James, who is leading the challenge.
Hospitals in states like California, Connecticut, Illinois, Colorado, and Washington, D.C. have recently shut down or paused gender-affirming care programs for minors. Many cite pressure from federal investigations and executive orders signed by President Donald Trump. Among those affected are the Yale health system and Denver Health.
The Trump administration has publicly praised these closures as a victory, claiming they result from recent executive actions aimed at curbing gender-transition procedures for minors.
Attorneys general argue that no federal law bans gender-affirming care—and that these actions represent an unlawful use of federal power to override state protections. The lawsuit points to violations of the Tenth Amendment, which reserves powers not delegated to the federal government to the states.
Federal enforcement has escalated in recent months. In July, Justice Department Chief of Staff Chad Mizelle revealed that at least 20 subpoenas had been issued to clinics, drug manufacturers, and hospitals involved in gender-affirming care. Some of those subpoenas reportedly sought confidential patient information, according to The New York Times.
The lawsuit also challenges FBI investigations into three children’s hospitals that currently provide—or previously offered—gender-affirming care. It further cites a Federal Trade Commission-hosted event earlier this year, titled “The Dangers of Gender-Affirming Care for Minors,” where DOJ officials first revealed plans to investigate and subpoena providers.
Medical experts and national organizations, including the American Medical Association, the American Academy of Pediatrics, and the American Psychological Association, continue to support gender-affirming care for youth as safe, effective, and medically necessary. Global health leaders have warned that restricting access will likely force the care underground, increasing risks to transgender patients.
The lawsuit’s plaintiffs include attorneys general from states where clinics have recently closed, along with Pennsylvania Governor Josh Shapiro. Their legal challenge seeks to stop what they call a politically motivated campaign that endangers patients and infringes on states’ rights.
For many transgender people and families, the federal crackdown represents a dramatic shift. While gender-affirming care has already been restricted in numerous Republican-led states, the Biden-era protections in blue states are now under threat as well—placing care out of reach for many who previously relied on it.
