NEW YORK — Maine is part of a coalition of 19 states and the District of Columbia that on Tuesday sued the U.S. Department of Health and Human Services; its secretary, Robert F. Kennedy Jr.; and its inspector general over a declaration that could complicate access to gender-affirming care for young people.
The declaration issued on Dec. 18 called treatments like puberty blockers, hormone therapy and surgeries unsafe and ineffective for children and adolescents experiencing gender dysphoria, or the distress when someone’s gender expression doesn’t match their sex assigned at birth. It also warned doctors that they could be excluded from federal health programs like Medicare and Medicaid if they provide those types of care.
The declaration came as HHS also announced proposed rules meant to further curtail gender-affirming care for young people, although the lawsuit doesn’t address those as they are not final.
Tuesday’s lawsuit, filed in U.S. District Court in Eugene, Oregon, alleges that the declaration is inaccurate and unlawful and asks the court to block its enforcement. It’s the latest in a series of clashes between an administration that’s cracking down on transgender health care for children, arguing it can be harmful to them, and advocates who say the care is medically necessary and shouldn’t be inhibited.
“Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices,” New York Attorney General Letitia James, who led the lawsuit, said in a statement Tuesday.
The lawsuit alleges that HHS’s declaration seeks to coerce providers to stop providing gender-affirming care and circumvent legal requirements for policy changes. It 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.
“Secretary Kennedy cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices,” New York Attorney General Letitia James, who led the lawsuit, said in a statement Tuesday.
The lawsuit alleges that HHS’s declaration seeks to coerce providers to stop providing gender-affirming care and circumvent legal requirements for policy changes. It 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 on Thursday also unveiled two proposed federal rules — one to cut off federal Medicaid and Medicare funding from hospitals that provide gender-affirming care to children, and another to prohibit federal Medicaid dollars from being used for such procedures.
The proposals are not yet final or legally binding and must go through a lengthy rulemaking process and public comment before becoming permanent. But they will nonetheless likely further discourage health care providers from offering gender-affirming care to children.
Several major medical providers already have pulled back on gender-affirming care for young patients since Trump returned to office — even in states where the care is legal and protected by state law.
Medicaid programs in slightly less than half of states currently cover gender-affirming care. At least 27 states have adopted laws restricting or banning the care. The Supreme Court’s recent decision upholding Tennessee’s ban means most other state laws are likely to remain in place.
Joining James in Tuesday’s lawsuit were Democratic attorneys general from California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Wisconsin, Washington and the District of Columbia. Pennsylvania’s Democratic governor also joined.
Story by Ali Swenson.


