A federal judge in Oregon said the U.S. government overreached when it issued a declaration warning that treatments for young people experiencing gender dysphoria—including puberty blockers, hormone therapy and surgeries—are unsafe and ineffective. In a ruling issued Thursday, the judge said Health Secretary Robert F. Kennedy Jr. did not go through proper administrative procedures when the declaration was issued in December.
Judge Mustafa Kasubhai ruled that the declaration also raised immediate stakes for clinicians because it warned doctors that they could be excluded from federal health programs such as Medicare and Medicaid if they provided the treatments. The judge granted preliminary relief to health professionals who provide the care, and he denied the government’s request to dismiss the lawsuit.
Letitia James, the Democratic New York attorney general who led the lawsuit, said the ruling “breaks through the noise and gives some needed clarity to patients, families, and providers,” adding that “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 the U.S. Department of Health and Human Services did not immediately respond to an email requesting comment. The Associated Press story also said The New York Times reported that the judge discussed broader implications tied to the case and governance, including the rule of law.
In remarks cited by AP, Kasubhai said: “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 lawsuit targeted the administration’s declaration and sought court action to stop its enforcement. A coalition of 21 states and the District of Columbia sued HHS, Kennedy and the inspector general, alleging the declaration was inaccurate and unlawful, and arguing the government should be blocked from enforcing it.
According to the suit, HHS’s declaration was designed to coerce providers to stop offering gender-affirming care and to circumvent legal requirements for policy changes. The states also argued that federal law requires notice and an opportunity for public comment before making substantive changes to health policy, and that those steps were not followed before the declaration was issued.
AP reported that the declaration drew its conclusions from a peer-reviewed report HHS conducted earlier this year. That report urged greater reliance on behavioral therapy rather than broad gender-affirming care for youths with gender dysphoria, and it questioned standards for the treatment of transgender youth issued by the World Professional Association for Transgender Health while raising concerns about whether adolescents are too young to provide consent to life-changing treatments that could lead to future infertility.
Major medical groups and providers who treat transgender young people have criticized the report as inaccurate, and AP reported that most major U.S. medical organizations, including the American Medical Association, continue to oppose restrictions on transgender care for young people.
AP said the judge issued the ruling at the end of an approximately six-hour hearing, and that the decision would be followed by a written opinion. The ruling is also described as the second major legal setback for Kennedy and HHS this week, after another federal judge in Boston temporarily blocked several vaccine-policy changes and said Kennedy likely violated federal procedures in revamping a vaccine advisory committee and adjusting the childhood vaccine schedule without the committee’s input; officials said they plan to appeal that earlier decision.