More than a dozen Democratic state attorneys general on Wednesday affirmed their support for gender-affirming health care for transgender youth after an executive order issued late last week by President Trump threatened federal support for treatments such as puberty blockers, hormones and surgery for young people.
“As state attorneys general, we stand firmly in support of healthcare policies that respect the dignity and rights of all people. Health care decisions should be made by patients, families, and doctors, not by a politician trying to use his power to restrict your freedoms,” 14 attorneys general said Wednesday in a joint statement led by Massachusetts Attorney General Andrea Joy Campbell.
The statement was signed by the attorneys general of California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, New Jersey, New York, Nevada, Rhode Island, Vermont and Wisconsin.
“Gender-affirming care is essential, life-saving medical treatment that supports individuals in living as their authentic selves,” they wrote, adding that Trump’s order “is wrong on the science and the law.”
“Despite what the Trump Administration has suggested, there is no connection between ‘female genital mutilation’ and gender-affirming care,” they wrote, referencing a piece of the order that directs the Justice Department to use laws against consumer fraud and female genital mutilation to enforce it. “And no federal law makes gender-affirming care unlawful. President Trump cannot change that by Executive Order.”
Trump’s Jan. 28 order aims to broadly restrict access to transition-related care for minors, which it says includes 19-year-olds. It calls for the federal government to stop funding care through government-run insurance programs including Medicaid, Medicare and TRICARE.
A handful of medical centers across the country said they would suspend gender-affirming care because of the order, which directs agencies to block funding for medical institutions, including medical schools and hospitals, that provide transgender health care to youth.
Gender-affirming health care for transgender adults and minors is considered medically necessary by major medical organizations, though not every trans person chooses to medically transition or has adequate access to care. A recent study published in JAMA Pediatrics, a peer-reviewed medical journal affiliated with the American Medical Association, found that just a small number of transgender children and adolescents — less than 1 in 1,000 — with private insurance were prescribed puberty blockers and hormones between 2018 and 2022.
More than half the nation has passed laws prohibiting doctors from providing gender-affirming care to minors, sometimes at the risk of criminal penalties. The Supreme Court could rule this summer on whether such bans are constitutional.
The White House, responding to reports that hospitals were pausing care this week, said Trump’s executive order is “already having its intended effect.”
In a letter sent Monday to health care providers and organizations that receive federal funds, New York Attorney General Letitia James (D), who also signed Wednesday’s joint statement, warned that denying care to transgender residents violates state laws that protect against discrimination based on sex and gender identity.
California Attorney General Rob Bonta (D) told state hospitals and clinics on Wednesday that they are obligated under the state’s antidiscrimination law to continue providing care. “Let me be clear: California law has not changed, and hospitals and clinics have a legal obligation to provide equal access to healthcare services,” he said in a statement.
Seven families with transgender children and teens sued the Trump administration Tuesday, arguing the order is “unlawful and unconstitutional,” in part because it seeks to withhold funds that Congress previously authorized.
“Under our Constitution, it is Congress, not the President, who is vested with the power of the purse,” the families, represented by the American Civil Liberties Union, Lambda Legal and the law firms Hogan Lovells and Jenner & Block, wrote in the lawsuit.
State attorneys general on Wednesday touted a recent victory from a federal court that directed the government to resume funding that had been frozen by the Trump administration. The Justice Department in a Jan. 31 notice said, “Federal agencies cannot pause, freeze, impede, block, cancel, or terminate any awards or obligations on the basis of the OMB [Office of Management and Budget] memo, or on the basis of the President’s recently issued Executive Orders.”
The Justice Department is meanwhile asking the judge to clarify that his ruling only blocks the Office of Management and Budget memo, and that the administration can resume funding changes directed by Trump’s executive orders.
“This means that federal funding to institutions that provide gender-affirming care continues to be available, irrespective of President Trump’s recent Executive Order,” the attorneys general said Wednesday. “If the federal administration takes additional action to impede this critical funding, we will not hesitate to take further legal action.”
“State attorneys general will continue to enforce state laws that provide access to gender-affirming care, in states where such enforcement authority exists, and we will challenge any unlawful effort by the Trump Administration to restrict access to it in our jurisdictions,” they added.
