Federal judge temporarily blocks Trump’s restrictions on youth gender-affirming care

In response to a lawsuit filed by trans youth and their families, a federal judge on Feb. 13 temporarily blocked enforcement of President Donald Trump’s executive orders seeking to ban gender-affirming care for individuals under the age of 19 and deny the existence of trans and non-binary individuals.

The ruling by Judge Brendan Hurson of the US District Court for the District of Maryland bars the Department of Health and Human Services (HHS) from “conditioning or withholding federal funding based on the fact that a healthcare entity or health professional provides gender-affirming medical care to a patient under the age of 19,” according to the temporary restraining order, which is in effect for at least 14 days but can be extended. 

The judge ordered the federal government to provide written notice of the order to “all agencies to which the executive orders were addressed” and prohibited the government from taking any steps to implement or reinstate the policy, including reshaping it under a different name. The judge, nominated by former President Joe Biden, also ordered that any funds paused due to the executive orders must be released.

The trans youth and their families are represented in the case by the American Civil Liberties Union (ACLU), Lambda Legal, the ACLU of Maryland, and law firms Jenner & Block and Hogan Lovells. PFLAG National, which encompasses families of LGBTQ individuals, and GLMA, an organization of LGBTQ and allied health professionals, also joined the lawsuit.

“In this situation, it is clear that these plaintiffs have received phone calls stopping their care, stopping their appointments, stopping their everything,” Judge Hurson said during a Feb. 13 hearing about the case, according to NBC News. “I don’t know how you can credibly argue that this is not demanding the cessation of funding for gender-affirming care.”

Hurson said Trump’s executive order “seems to deny that this population even exists, or deserves to exist,” according to the Associated Press.

The temporary ruling follows an avalanche of executive orders by the Trump administration attacking transgender and non-binary individuals. The two most consequential executive orders in this case are Executive Order 14168, entitled “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” which only recognized male and female genders as assigned at birth and attempted to erase transgender and non-binary people; and Executive Order 14187, entitled “Protecting Children from Chemical and Surgical Mutilation,” which called not only called to ban federal funding for gender-affirming care for individuals under the age of 19, but also directed the HHS secretary to “take all appropriate actions to end” gender-affirming care, “including regulatory and sub-regulatory actions.” 

Both of those executive orders were cited in the judge’s ruling.

The initial executive order targeting gender-affirming care prompted many hospitals around the country to cancel appointments for gender-affirming care for youth. In New York City alone, reports indicated NYU Langone, Mount Sinai, and New York Presbyterian were among the providers pulling back on gender-affirming care for individuals under the age of 19.

That prompted New York Attorney General Letitia James to warn providers of their obligation under state law to serve patients without discriminating on the basis of sex or gender identity. In a Feb. 3 letter to providers, James also cited a ruling by Judge John J. McConnell of the US District Court for the District of Rhode Island approving a temporary restraining order to block the administration’s effort to freeze federal funding. That order, she argued, also barred implementation of a memorandum from the Office of Management and Budget calling on each federal agency to “review all agency programs, contracts, and grants, and terminate any that promote or inculcate gender ideology.”

James also joined attorneys general in 14 other states in issuing a joint statement on Feb. 5 vowing to continue to enforce state laws allowing gender-affirming care. Pressure continued to mount in the following days, with officials gathering outside of NYU Langone on Feb. 6 to blast providers and urge them to restore gender-affirming care.

Councilmembers Erik Bottcher and Tiffany Cabán, who are co-chairs of the LGBTQIA+ Caucus, and Health Committee Chair Lynn Schulman, also a member of the LGBTQIA+ Caucus, issued a written statement immediately after the Feb. 13 ruling and again called on hospitals to restore all care.

“In line with Judge Hurson’s ruling and guidance from New York State Attorney General Letitia James, New York hospitals must immediately resume providing gender affirming care for patients of all ages,” the three out lawmakers said. “The Trump administration cannot erase transgender people from existence. Transgender lives are not up for debate. Gender-affirming care is lifesaving care that is supported by all major medical associations, and New York’s hospitals must provide it to all patients who need it.”

They added: “Trump’s attempts to pressure hospitals into canceling lifesaving treatments by withholding federal funding are both cruel and discriminatory. We will always support the transgender community. We will not back down because the Trump administration wants to set them up as scapegoats. We will not let members of our community be villainized and demonized for who they are. We will always defend our transgender and gender non-conforming neighbors.”

Legal groups representing the plaintiffs welcomed the judge’s ruling and denounced the Trump administration’s attacks on trans Americans.

“The president’s orders sought to take away from transgender young people the very care that they, their families, and their medical providers all agree is best for them — medical care that is evidence-based and well-established,” Omar Gonzalez-Pagan, senior counsel and health care strategist for Lambda Legal, said in a written statement. “But these decisions are for patients, their families, and their doctors to make, not for politicians or Washington bureaucrats. As today’s decision makes clear, the president does not have the power to unilaterally condition federal funding by requiring discrimination. To the contrary, our laws and Constitution forbid it.”

Brian K. Bond, the CEO of PFLAG National, also praised the ruling, saying, “Good and decent parents of transgender kids should never be in the frightening position of having their child’s prescribed, medically necessary care canceled at the whim and threat of a politician. But that’s exactly what President Trump’s executive order did to PFLAG families with trans youth and young adults nationwide. Today’s decision rights a grievous wrong to our nation’s families and children, and PFLAG families will be vigilant to ensure our transgender loved ones receive the healthcare they need — as this legal ruling demands.”