A federal judge in Oregon last week permanently blocked a Trump administration effort to restrict gender-affirming care for minors by threatening providers’ access to Medicare and Medicaid funding.
U.S. District Judge Mustafa Kasubhai’s ruling stems from a lawsuit led by Washington Attorney General Nick Brown and joined by more than 20 other states, challenging a 2025 declaration by U.S. Department of Health and Human Services Secretary Robert F. Kennedy, Jr. That declaration labeled certain gender-affirming care for minors “unsafe” and warned of financial penalties and potential government funding withdrawal for providers who continued to offer care.
Gender-affirming care for minors typically includes puberty blockers, hormone treatment, and mental health support services widely endorsed by major U.S. medical organizations.
Kennedy’s Dec. 18 directive stated: “Sex-rejecting procedures for children and adolescents are neither safe nor effective as a treatment modality for gender dysphoria, gender incongruence, or other related disorders in minors, and therefore, fail to meet professional [sic] recognized standards of health care.” During a news conference, the Secretary said he was sending “a clear directive to providers to follow the science and the overwhelming body of evidence that these procedures hurt — not help — children” and that anyone providing such care would be “out of compliance with these standards of healthcare.”
In his scorching April 18 opinion, Judge Kasubhai found that the federal government, through Kennedy’s directive, overstepped its authority, concluding the policy bypassed required rule making procedures and interfered with states’ ability to regulate medical care.
“The Kennedy Declaration exceeded statutory authority, flouted applicable notice and comment rule-making procedures, and impeded Plaintiffs’ rights to regulate the medical profession and their discretion to design their own statutorily-compliant Medicaid plans,” the judge wrote.
“This case highlights a leader’s unserious regard for the rule of law,” wrote Kasubhai. “Tragically, this case is one of a long list of examples of how a leader’s wanton disregard for the rule of law causes very real harm to very real people.”
The judge added: “This case illustrates that when a leader acts without authority and in the absence of the rule of law, he acts with cruelty.”
The decision affirms an earlier oral ruling and prevents the administration from enforcing the policy. Attorneys representing the 21 states who filed the suit were jubilant.
“This is a resounding win for the rights of youth, their families, and the rule of law when it comes to medical care,” Brown said. “The court agrees that the administration ignored the law in its rush to deprive transgender youth of the health care they are legally entitled to.”
“When families and doctors make healthcare decisions together, no federal official should be able to use threats and intimidation to get in the way,” Oregon Attorney General Dan Rayfield said in a statement. “That’s what Secretary Kennedy tried to do — force hospitals and providers to abandon their patients. Oregon will always stand up for the dignity and wellbeing of every person.”
The ruling keeps existing care in place for now and underscores the ongoing legal and political fight over how, and by whom, these medical decisions are governed. Read the full opinion.
