December 23, 2025

NEW YORK - New York Attorney General Letitia James today led a coalition of 18 other states and the District of Columbia in filing a lawsuit to stop the U.S. Health and Human Services (HHS) Secretary from threatening providers with an arbitrary "declaration" that baselessly attempts to limit access to gender-affirming care for young people. The unlawful and unprecedented document, which Secretary Robert F. Kennedy Jr. announced last week, falsely claims that certain forms of gender-affirming care are "unsafe and ineffective" and threatens to punish any doctors, hospitals, and clinics that continue to provide it with exclusion from the federal Medicare and Medicaid programs. Attorney General James and the coalition argue that this is a feeble attempt by the federal government to ignore legal requirements in an effort to dictate medical standards, intimidate providers, and strip states of their long-standing authority to regulate medicine. The coalition is asking the court to intervene and set aside the unlawful and arbitrary declaration.

"At the core of this so-called declaration are real people: young people who need care, parents trying to support their children, and doctors who are simply following the best medical evidence available," said Attorney General James. "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. My office will always stand up for New Yorkers' health, dignity, and right to make medical decisions free from intimidation."

On December 18, HHS unveiled a multipronged effort to restrict access to gender-affirming care for youth, including a so-called "declaration" that certain forms of gender-affirming care are "unsafe and ineffective." In the declaration, Secretary Kennedy claimed to give HHS the power to exclude health care providers and institutions from the Medicare and Medicaid programs simply for providing health care for transgender adolescents. The agency also announced two proposed rules that would completely bar gender-affirming care providers and associated hospitals from participating in Medicare and Medicaid and ban federal reimbursements for transgender health care. These rules have not yet gone into effect, and HHS has given the public until February 17, 2026 to submit comments on the proposals.

Attorney General James and the coalition argue that HHS is attempting to use the declaration to circumvent basic legal requirements for policy changes. Federal law requires agencies to provide the public with notice and an opportunity to comment before making significant changes to health care policy. Instead, HHS issued what it arbitrarily called a declaration and attempted to make it effective nationwide immediately, without consulting doctors, patients, or states. The coalition contends that this is a clear overreach by the federal government, given that HHS does not have the authority to dictate medical practices. For generations, states, not the federal government, have been responsible for regulating the practice of medicine. By attempting to impose a single nationwide standard and threatening to punish providers who adhere to well-established, evidence-based care, HHS is unlawfully interfering in decisions that should be made by doctors and their patients.

The coalition warns that HHS will attempt to use this unlawful action to enact immediate and widespread consequences. For transgender youth and their families, it creates fear and uncertainty about whether ongoing care could suddenly be taken away. For doctors and hospitals, it threatens severe penalties simply for treating their patients with evidence-based, medically necessary care. For states, it puts Medicaid programs at risk - programs that millions of people depend on for everyday and lifesaving care. States rely on broad networks of providers to deliver essential health services. By threatening to disqualify providers who offer gender-affirming care, the federal government is forcing doctors to choose between abandoning their patients or risking their livelihoods. This pressure would reduce access to care, worsen provider shortages, and harm Medicaid patients far beyond those seeking gender-affirming care.

Attorney General James and the coalition are asking the court to rule the HHS declaration unlawful and block its enforcement.

"Every family deserves the freedom and privacy to make informed choices about their medical care with their providers," said Sarah Kate Ellis, President and CEO of GLAAD. "Any politician working to interfere with that access, and take away choices, is endangering people's lives. Attorney General James is once again taking a stand for all New Yorkers, and making sure every young person has healthcare that they need."

"The Trevor Project's counselors regularly hear from transgender and nonbinary youth who contact our 24/7 crisis services to express fear about anti-transgender laws and policies they hear about in the news - including threats to essential health care they rely on," said Casey Pick, Senior Director of Law and Policy at The Trevor Project. "This type of care is nothing new; it is steeped in decades of scientific research, and supported by all of our country's leading medical and mental health associations. All young people deserve access to the medical care they need to lead healthy, happy lives. These personal decisions ought to be made by individual patients, their families, and their doctors - not through a sweeping federal mandate. We firmly support any effort to challenge the federal government's proposed restrictions on this best-practice care for transgender and nonbinary youth."

"This latest decision by the US Department of Health & Human Services to attempt to end gender affirming care for TGNC youth across the country is a dangerous escalation against our community. Health care decisions should be made by patients, families, and doctors - not dictated by political declarations designed to terrorize and exclude," said Dr. Carla Smith, CEO of The Lesbian, Gay, Bisexual & Transgender Community Center. "This lawsuit is about protecting young people's access to necessary, life-saving medical care. We thank Attorney General James for her continued leadership on this critically important issue."

"At a time when the federal government is once again trying to deny essential health care to transgender people for political gain, we are grateful to the Attorney General for standing with the trans community and upholding the rule of law," said Allie Bohm, senior policy counsel at the New York Civil Liberties Union. "Gender-affirming care is evidence-based and can be lifesaving. We will continue to defend the rights of transgender people to live safely as their authentic selves, free from harm and discrimination, and we are proud to have Attorney General James as a staunch ally in that fight."

Joining Attorney General James in this lawsuit are the attorneys general of 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, as well as the governor of Pennsylvania.