Maine is joining a coalition of 19 states and the District of Columbia in a lawsuit challenging the U.S. Department of Health and Human Services (HHS) over a controversial declaration regarding youth gender-affirming care. The lawsuit, filed on December 18, claims that the declaration could significantly limit access to critical medical treatments for young people experiencing gender dysphoria.
The declaration categorizes treatments such as puberty blockers, hormone therapy, and surgeries as unsafe and ineffective for children and adolescents. It also includes warnings for healthcare providers, stating that those who offer such treatments may risk exclusion from federal health programs including Medicare and Medicaid.
Legal Action Against HHS
The lawsuit was filed in the U.S. District Court in Eugene, Oregon, and argues that the HHS declaration is both inaccurate and unlawful. It seeks to block the enforcement of the declaration, which the plaintiffs allege is an attempt to coerce healthcare providers into ceasing gender-affirming care.
New York Attorney General Letitia James, who leads the lawsuit, emphasized that Secretary Robert F. Kennedy Jr. cannot unilaterally alter established medical standards through a public announcement. “No one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices,” she stated.
The lawsuit contends that the HHS declaration violates federal law, which mandates that the public be given notice and a chance to comment before any substantial changes to health policy are made. According to the lawsuit, these procedural requirements were not adhered to prior to the issuance of the declaration.
Implications for Youth Care
On the same day, HHS introduced two proposed federal rules aimed at tightening regulations around gender-affirming care for minors. One proposal seeks to cut federal funding from hospitals that provide gender-affirming treatments to children, while the other aims to prohibit the use of federal Medicaid dollars for such procedures. These proposals are still in the preliminary stage and must undergo a lengthy rulemaking process before they become final.
Despite the proposals not being legally binding yet, they are expected to further deter healthcare providers from offering gender-affirming care to young patients. Several major medical institutions have already begun to scale back such services since the Trump administration resumed office, even in states where these treatments are legally protected.
Currently, Medicaid programs in just under half of the states cover gender-affirming care, while at least 27 states have instituted laws that restrict or ban such care. The recent Supreme Court decision upholding Tennessee’s ban on gender-affirming treatments indicates that many similar state laws are likely to remain in effect.
Alongside Maine, the lawsuit includes Democratic attorneys general from states such as California, Colorado, Connecticut, Delaware, Illinois, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Rhode Island, Vermont, Wisconsin, and Washington, as well as the District of Columbia. Additionally, the Democratic governor of Pennsylvania has joined the coalition.
This legal challenge reflects ongoing tensions between government policies aimed at regulating transgender healthcare for minors and advocates who argue that such care is essential for the well-being of affected youth. As the situation develops, the impact on access to gender-affirming care remains a critical concern for many families and healthcare providers across the country.