Attorney General James Sues to Block Trump Administration’s Unlawful Attacks on Gender-Affirming Care

NEW YORK – New York Attorney General Letitia James today 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.

“Transgender and nonbinary youth deserve the freedom to access the health care they need without fear, shame, or government interference,” said Dr. Carla Smith, CEO of The NYC LGBT Community Center. “The Trump administration’s actions endanger the lives of young people who already face disproportionate rates of depression and suicide. We applaud Attorney General James and this coalition of attorneys general for standing up to these attacks and defending the right to gender-affirming care that is clearly recognized, supported, and protected by law. We also call on healthcare providers to demonstrate courage and integrity, and to follow our state’s laws.”

“This attack on gender-affirming care is not just a policy dispute—it is a deliberate act of violence against transgender and nonbinary youth and the providers who care for them,” said Tandra R. LaGrone, CEO of In Our Own Voices, Inc. “At In Our Own Voices, we serve LGBTQ+ communities of color who already face overwhelming barriers to healthcare, dignity, and survival. These federal threats are reckless, cruel, and unconstitutional. We stand with Attorney General James and this multistate coalition in saying clearly: we will not be intimidated, we will not back down, and we will fight to ensure that every young person has access to the lifesaving care they need and deserve.”

“The threat of attacking the health care of young people and adults has already caused harm here in New York state and beyond,” said The Sylvia Rivera Law Project. “This intimidation is causing confusion to medical providers and threatening criminalization, when providers have been following WPATH standards of care for decades since it was founded in 1978. We support the autonomy and decision-making of youth and their supportive families and communities in our healthcare access. We want to affirm parents and families who are supporting trans youth in accessing the necessary care that is needed to meet our survival and self-determination.”

“Access to gender-affirming care saves lives. ACT UP NY will continue to fight alongside trans youth, families with trans people, and for anyone seeking to protect their bodily autonomy and the bodily autonomy of others,” said Gwen Appenfeller and Mattie Beaton, AIDS Coalition to Unleash Power (ACT UP) NY. “This federal administration’s attempt to ban access to care for children based on their gender identity is a continued direct attack, and an attempt at control and erasure, not just of trans people, but the bodily autonomy of every person living in the United States. This illegal ban claims that the government knows better than doctors, parents, trans youth, and their community when it comes to the healthcare and well-being of all children. This is simply untrue. Trans people deserve to live. Trans children deserve to grow into healthy adults. Whether this ridiculous ban stands or not, the Trans Working Group of ACT UP NY and our coalition partners will continue our work to make sure that trans children are safe, which includes having access to the life-saving Gender-Affirming Care they need and deserve. Since 1987, ACT UP has fought AIDS, demanded justice for health and housing, and built radical systems of care. We will continue this legacy. We stand in unwavering solidarity with New York State Attorney General Letitia James as she continues to lead the legal fight to protect LGBTQI+ people—particularly transgender individuals—against systemic attacks on our rights, health, and existence. ACT UP!  FIGHT BACK! FIGHT AIDS!”

“To deny a transgender child the right to gender-affirming care is the truest form of cruel and unusual punishment,” said Yaetza Maria Martinez, WAVE Women. “Imagine being denied necessary medical treatment that will help you not only survive but thrive! Medical transitions must only be guided by the individual who is transitioning and their chosen medical providers.”

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.