19 Democrat-led states sue Trump HHS over federal ban on child sex changes

The legal challenge follows an HHS declaration issued last week stating that child sex changes, including puberty blockers, hormone therapy, and surgeries, are ineffective and unsafe for children and teenagers experiencing gender dysphoria. The declaration warns that doctors who provide these services could be excluded from Medicare and Medicaid.

“Nearly all U.S. hospitals participate in Medicare and Medicaid, and this action is designed to ensure that the U.S. government will not be in business with organizations that intentionally or unintentionally inflict permanent harm on children,” HHS said in a background document regarding the announcement.

According to HHS, the policy is based on a peer-reviewed review conducted this year that supported the use of behavioral therapy over irreversible medical procedures for children with gender dysphoria.

States opposing the policy have characterized it as an attack on what they refer to as “gender affirming care.” Oregon Attorney General Dan Rayfield filed the lawsuit on behalf of the coalition of states.

“By targeting Oregon providers, HHS is putting care at risk and forcing families to choose between their personal health care choices and their doctor’s ability to practice,” Rayfield argued. “Healthcare decisions belong with families and their healthcare providers, not the government.”

Minnesota Attorney General Keith Ellison, who also joined the lawsuit, posted on X, “I’ve said it before and I’ll said it again: Gender-affirming care is healthcare, period. It is evidence-based, backed by the American Medical Association, and helps trans individuals live their lives with the dignity we all deserve. Gender-affirming care saves lives.”

Oregon AG Dan Rayfield said "BREAKING NEWS: We’re leading a lawsuit challenging federal attacks on gender-affirming care. Healthcare decisions belong w/families & providers, not the government – and the gov't can't use a 'declaration' to circumvent legal requirements for policy change."

"I'm suing @HHSGov after they made an unlawful and baseless attempt to limit gender-affirming care for young people. The federal government should not interfere in decisions that belong in doctors’ offices. I'll always stand up for New Yorkers’ health, dignity, and rights," said New York's AG Letitia James.

The 19 states are California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Wisconsin, Washington and the District of Columbia. Pennsylvania's Democrat Governor Josh Shapiro also joined the suit along with the attorneys general.

The lawsuit comes after President Donald Trump signed an executive order after taking office, directing his administration to end federal support and funding for transgender medical procedures performed on minors.