A coalition of state attorneys general, led by New York, has filed a lawsuit accusing the Trump administration of waging an unconstitutional campaign to undermine gender-affirming care for transgender youth. The case, filed Friday in the U.S. District Court in Massachusetts, challenges Justice Department efforts to investigate and restrict such care nationwide.
The lawsuit contends that the administration is using a “backdoor” approach — leveraging threats of criminal and civil penalties — to impose federal limits while sidestepping state laws that explicitly protect this care.
Federal probes and funding threats have prompted hospitals across the U.S. to shut down their gender-affirming care programs for minors, even in states where access remains legal. Facilities in California, Connecticut, Colorado, Illinois, and Washington, D.C., have closed or paused services. Several hospitals, including the Yale health system and Denver Health, have linked their decisions directly to executive orders and administrative actions by President Donald Trump.
The White House has publicly touted these closures as victories stemming from Trump’s directives.
“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 a statement from New York Attorney General Letitia James’ office.
The attorneys general argue that no federal statute bans gender-affirming care in the U.S., and that the administration’s tactics are intended to intimidate providers rather than enforce legitimate laws. Through the courts, they seek to block the Justice Department from continuing these actions.
Plaintiffs include attorneys general from states where clinics have recently shuttered, along with Pennsylvania Gov. Josh Shapiro. They assert that their states’ protections for gender-affirming care are guaranteed under the 10th Amendment and that federal interference violates those rights.
In recent months, federal agencies have ramped up enforcement of Trump’s executive orders. In July, Justice Department Chief of Staff Chad Mizelle announced at least 20 subpoenas targeting clinics, drug manufacturers, and hospitals providing gender transition services. According to The New York Times, doctors have been ordered to hand over private patient information. The administration’s directives have also drawn criticism for conflating gender-affirming care with female genital mutilation — a claim medical experts have rejected.
The lawsuit also challenges FBI criminal investigations into three children’s hospitals that either currently provide or previously offered gender-affirming care. It cites other federal agency actions, including a Federal Trade Commission event titled “The dangers of ‘gender-affirming care’ for minors” where Justice Department officials first announced their subpoenas for confidential patient data.
Major medical organizations — including the American Medical Association, American Psychological Association, and American Academy of Pediatrics — have endorsed gender-affirming care for transgender youth. The president of the World Professional Association for Transgender Health, which sets global standards for transgender care, has warned that banning such services will likely push them underground, increasing risks for patients.
For many transgender people, and the parents of transgender youth, the administration’s actions have heightened fears for their health care and safety. While restrictions have long been concentrated in Republican-led states, the lawsuit warns that a national crackdown now threatens patients in traditionally protective states as well.
