Attorneys general in more than a dozen blue states warned hospitals and health care providers to continue providing gender-affirming care to transgender minors in spite of an executive order President Trump issued last week demanding an end to care for minors.
In letters and statements, the Democratic attorneys general said Trump had no authority to order a halt to gender-affirming care, which is legal under federal law. In some states, they said hospitals that abide by Trump’s order would find themselves in violation of state-level anti-discrimination laws.
“California supports the rights of transgender youth to live their lives as their authentic selves,” Attorney General Rob Bonta (D) said in a statement. “We will not let the president turn back the clock or deter us from upholding California values.”
“I understand that the president’s executive order on gender affirming care has created some confusion. Let me be clear: California law has not changed, and hospitals and clinics have a legal obligation to provide equal access to health care services,” he said.
Trump’s order, issued last Tuesday, bars the use of federal dollars to assist with gender-affirming care and puts Medicare and Medicaid funding at risk for hospitals that provide such care. The order requires department and agency heads to end research into gender-affirming care.
Bonta issued a letter to Children’s Hospital Los Angeles alerting the provider of its responsibility under state law, after the hospital paused the initiation of hormonal therapies for transgender minors.
In a letter to hospitals in her state on Monday, New York Attorney General Letitia James (D) said those facilities would be violating state law if they stop offering gender-affirming care to minors. James said such a refusal would violate anti-discrimination laws.
In his own statement, Illinois Attorney General Kwame Raoul (D) pointed to the Illinois Human Rights Act, which prohibits health care providers from discriminating on the basis of sex, and specifically gender identity.
Bonta, James, Raoul and the Democratic attorneys general of a dozen other states — Colorado, Connecticut, Delaware, Hawaii, Maine, Maryland, Massachusetts, Nevada, New Jersey, Rhode Island, Vermont and Wisconsin — issued a joint statement Wednesday restating their commitment to defending gender-affirming care.
“The Trump administration’s recent Executive Order is wrong on the science and the law,” the attorneys general wrote. “[N]o federal law makes gender-affirming care unlawful. President Trump cannot change that by Executive Order.
A group of transgender minors and their families sued the Trump administration over the executive order earlier this week in federal court in Maryland. The suit accuses the administration of discrimination based on sex and transgender status.
The tug and pull between Trump’s order, which remains in effect as the federal case begins, and state-level laws puts hospitals and health care providers in an untenable position. The federal government provides a huge amount of funding to health care providers — Medicaid represents nearly 20% of total hospital spending, according to the Kaiser Family Foundation, and Medicare represents another 21%, as of 2021.
Conservative groups and lawmakers have launched a campaign in recent years to limit or outright ban gender-affirming care, beginning with minors. Today, 26 states have enacted laws or policies meant to limit youth access to gender-affirming care, including extremely rare surgeries and more common — but still rare — hormonal therapies.
Those measures have suffered varying fates in front of state and federal courts. Laws approved in Arkansas and Montana have been blocked by courts, while legal cases are still playing out in Alabama, Florida, Georgia, Idaho, Indiana, Kentucky, Louisiana, Missouri, North Carolina, North Dakota, Nebraska, Ohio, Oklahoma, Tennessee and Texas.