A Trump order targets gender-affirming care for youth. California is suing to block it

Trump administration restrictions on gender-affirming care for transgender and nonbinary youth violate the Constitution and undermine state laws that require equal access to medical treatment, according to a lawsuit filed today by Attorney General Rob Bonta and 14 other states and the District of Columbia.

The lawsuit, filed in the U.S. District Court for the District of Massachusetts, targets a January executive order that makes it U.S. policy not to “fund, sponsor, promote, assist, or support” gender transition for people under 19. The order threatens to pull federal funding from medical institutions that provide this type of care.

“The result is an atmosphere of fear and intimidation experienced by transgender individuals, their families and caregivers, and the medical professionals who seek only to provide necessary, lawful care to their patients,” the attorneys general wrote in the suit.

This marks the 37th lawsuit California has filed against the Trump administration.

Gender-affirming care is legal and protected for people 18 years old and older in California. Certain treatments are also available to younger people with parental consent. The lawsuit comes as some of the largest medical providers in the state halt gender-affirming services.

The Trump administration has “trampled over state rights, overstepped their constitutional authority and endangered vulnerable minors and 18-year-olds,” Bonta said in a Friday press conference announcing the lawsuit alongside the attorneys general of Illinois and Connecticut.

Providers scale back care

Following Trump’s executive order, the U.S. Department of Justice directed employees to investigate doctors, hospitals and pharmaceutical companies that provided gender-affirming care. In July, U.S. Attorney General Pamela Bondi announced in a statement that her department had issued more than 20 subpoenas to medical providers as it investigates “healthcare fraud, false statements and more.”

Responding to the suit, DOJ spokesperson Natalie Baldassarre said, “As Attorney General Bondi has made clear, this Department of Justice will use every legal and law enforcement tool available to protect innocent children from being mutilated under the guise of ‘care.’”

Bonta said that providers, fearing prosecution, have scaled back on providing gender-affirming care, which has left many patients without critical medical care, Bonta said. The care includes hormone therapy, puberty blockers and surgical procedures. Research shows that gender-affirming care can positively impact the mental health of transgender youth. Forcing young people to wait until they are 19 or older to start care allows symptoms of gender dysphoria to worsen, Bonta said.

The state attorneys general argue that acceding to Trump’s orders puts providers at odds with states’ anti-discrimination and age-of-majority laws. In California, it is illegal to deny care on the basis of gender identity and gender expression. At the same time, many medical providers rely heavily on federal funding in the form of research and education grants, as well as reimbursements from public payer programs like Medi-Cal.

The directives from the Trump administration have already forced several providers to suspend services. Last month, Children’s Hospital Los Angeles closed its gender-affirming care center, forcing about 3,000 patients under 21 to look elsewhere for care.

“The shutdown came despite efforts my office took over recent months to assure (Children’s Hospital Los Angeles) that they were protected and required to provide gender-affirming care,” Bonta said.

Stanford Medicine has also paused surgical procedures for people under 19. And this week, Kaiser Permanente announced that it too would pause gender-affirming surgeries starting Aug. 29, noting that hormone therapies would still be available.

The executive order being challenged is just one of several that Trump has issued targeting transgender people. Others include one that recognizes only two biological sexes, a second that prevents transgender girls and women from participating in women’s sports, and a third that threatens federal funds for schools that support transgender youth.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.