21 States Sue to Block Federal Order Targeting Gender-Affirming Care for Minors
California Attorney General Rob Bonta led a multistate lawsuit on Thursday challenging recent federal directives from the Trump administration that seek to limit access to gender-affirming healthcare for transgender, intersex, and nonbinary minors.
Filed in U.S. District Court in Massachusetts, the complaint targets Executive Order 14187 and related guidance issued by the U.S. Department of Justice, which direct federal agencies to investigate and potentially prosecute providers offering gender-affirming care to patients under 19 years old, including in states where such care is lawful.
The executive order, signed in early 2025, mandates federal recognition of only two sexes and describes gender-affirming medical treatments as “chemical and surgical mutilation.” The DOJ subsequently issued memoranda directing civil division attorneys to prioritize enforcement actions against healthcare providers, pharmaceutical companies, and clinics involved in administering such care. In a June press release, the DOJ revealed it had issued more than 20 subpoenas nationwide, including in California.
The coalition argues that the Trump administration’s measures are unconstitutional, exceed federal authority, and interfere with states’ rights to regulate healthcare within their own borders. California law, for example, recognizes gender-affirming care as medically necessary and prohibits discrimination on the basis of gender identity or transgender status in the delivery of healthcare services.
Medical associations, including the American Academy of Pediatrics and the American Medical Association, support gender-affirming care as a standard treatment for gender dysphoria and warn that denying such care can result in increased mental health risks, including depression and suicidal ideation.
The suit also alleges that threats of prosecution have already created widespread uncertainty among providers and patients. Clinics in several states have reportedly reduced or halted services, while families report canceled appointments and disruptions in ongoing treatment plans.
Bonta was joined in the legal action by attorneys general from New York, Massachusetts, Illinois, Connecticut, and more than a dozen other states and jurisdictions, including Washington, D.C., and the Governor of Pennsylvania. The lawsuit seeks a court injunction to halt enforcement of the executive order and related directives.
