AG James Leads Multistate Coalition Challenging Federal Threats Against Providers in States Where Care is Legal and Protected
New York Attorney General Letitia James led a coalition of 15 other states and the District of Columbia in suing the Trump administration for attacking access to gender-affirming health care for transgender and nonbinary youth. Attorney General James and the coalition are challenging a coordinated federal campaign to intimidate health care providers into halting medically necessary treatment for individuals under age 19, even in states where such care is legal and protected by law, such as New York. The attorneys general argue that the administration is unlawfully seeking to impose a nationwide ban on gender-affirming care by threatening providers with baseless criminal charges and investigations. The attorneys general are asking the court to halt this unconstitutional pressure campaign and ensure transgender youth can continue to access legally protected health care without fear.
“The federal government is running a cruel and targeted harassment campaign against providers who offer lawful, lifesaving care to children,” said Attorney General James. “This administration is ruthlessly targeting young people who already face immense barriers just to be seen and heard, and are putting countless lives at risk in the process. In New York and nationwide, we will never stop fighting for the dignity, safety, and basic rights of the transgender community.”
On his first day in office, the president signed an executive order declaring that the United States would only recognize two sexes and seeking to eliminate all federal support for what it calls “gender ideology.” A second executive order signed days later expanded the administration’s focus on eliminating gender-affirming care for youth and young adults, redefining everyone under the age of 19 as “children,” even though, in states like New York, 18-year-olds are legal adults with full medical autonomy. The order also erroneously characterized standard, evidence-based medical care as “chemical and surgical mutilation” and directed the U.S. Attorney General to prioritize enforcement actions against providers of gender-affirming care nationwide.
Attorney General James and the coalition assert that the Department of Justice (DOJ) has taken aggressive action to implement the president’s directives. In the months since the orders were signed, DOJ has issued guidance threatening criminal prosecution of providers, launched civil and criminal investigations into major hospitals, made broad and illegal demands for private patient data, and issued subpoenas targeting providers across the country. The attorneys general argue these actions are not based in law, as no federal statute prohibits gender-affirming care, and instead are designed to intimidate and suppress care through illegal threats and coercion.
In the complaint, the attorneys general emphasize that medical experts overwhelmingly agree that gender-affirming care is safe, necessary, and in many cases, lifesaving care. Every major medical association in the United States, including the American Academy of Pediatrics, the American Medical Association, and the American Psychiatric Association, recognizes gender-affirming care as the appropriate treatment for gender dysphoria. Denying access to such care has been shown to significantly increase rates of depression, anxiety, and suicidality in transgender youth.
Attorney General James and the coalition argue that the administration’s campaign of intimidation is already working. Some providers are even scaling back or eliminating services entirely. In New York, several major health systems reportedly canceled young patients’ gender-affirming care appointments abruptly in the wake of the president’s executive orders, leaving families without care or guidance. Denying access to that care, the attorneys general warn, will cost lives.
The attorneys general assert that gender-affirming care is legally protected in all of their states and that federal attempts to block such care represent a blatant assault on state sovereignty in violation of the Tenth Amendment. The attorneys general assert that 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. In New York, for example, providers are legally obligated to offer care without discrimination based on gender identity or expression. The attorneys general contend that these actions violate the Constitution, exceed the government’s statutory authority, and run afoul of the Administrative Procedure Act. They are asking the court to declare the implementation of the executive orders and associated DOJ directives illegal.
Joining Attorney General James in filing this lawsuit are the attorneys general of California, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, Rhode Island, Wisconsin, and the District of Columbia, as well as the governor of Pennsylvania.
For more information on gender-affirming care protections in New York, visit the Office of the Attorney General’s website.
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