Judge rules US government overreached with transgender health care declaration

PORTLAND, Ore. (AP) — A federal judge said the government overreached by issuing a declaration that called treatments like puberty blockers and surgeries unsafe and ineffective for young people experiencing gender dysphoria, according to a ruling Thursday in Oregon.

Judge Mustafa Kasubhai’s ruling was centered on Secretary Robert F. Kennedy Jr. not going through the proper administrative procedures when issuing the declaration in December. The declaration also warned doctors that they could be excluded from federal health programs like Medicare and Medicaid if they provide these treatments.

The judge also denied the defendants’ motion to dismiss the case.

The judge’s ruling was at the end of a roughly 6-hour hearing and will be followed by a written decision.

“Today’s win breaks through the noise and gives some needed clarity to patients, families, and providers,” the Democratic New York Attorney General Letitia James, who led the lawsuit, said in a statement Thursday. “Health care services for transgender young people remain legal, and the federal government cannot intimidate or punish the providers who offer them.”

A spokesperson for HHS did not immediately respond to an email requesting comment.

The New York Times reported that the judge spoke about the broader implications associated with this case, especially as it relates to democracy.

“The notion that ‘I will go forward and issue a declaration and see if we can get away with it’ is not a principle of governance that adheres to the overarching commitment to a democratic republic that requires the rule of law to be regarded and respected and honored as a sacred,” the judge said.

The decision is the second major legal setback for Kennedy and the U.S. Department of Health and Human Services this week. Another federal judge in Boston on Monday temporarily blocked several of Kennedy’s vaccine policy changes. The judge ruled Kennedy likely violated federal procedures in revamping a key vaccine advisory committee and slimming down the childhood vaccine schedule without the committee’s input. Federal officials have indicated they plan to appeal that ruling.

A coalition of 19 states and the District of Columbia in December sued HHS, Kennedy and its inspector general over the declaration, alleging that it is inaccurate and unlawful and asking the court to block its enforcement.

The lawsuit says that HHS’s declaration seeks to coerce providers to stop providing gender-affirming care and circumvent legal requirements for policy changes. It also says federal law requires the public to be given notice and an opportunity to comment before substantively changing health policy — neither of which, the suit says, was done before the declaration was issued.

HHS’s declaration based its conclusions on a peer-reviewed report that the department conducted earlier this year that urged greater reliance on behavioral therapy rather than broad gender-affirming care for youths with gender dysphoria.

The report questioned standards for the treatment of transgender youth issued by the World Professional Association for Transgender Health and raised concerns that adolescents may be too young to give consent to life-changing treatments that could result in future infertility.

Major medical groups and those who treat transgender young people have sharply criticized the report as inaccurate, and most major U.S. medical organizations, including the American Medical Association, continue to oppose restrictions on transgender care and services for young people.