New York Attorney General Letitia James has filed a lawsuit against the Trump administration, leading a coalition of 15 other states and the District of Columbia. The suit challenges recent federal actions aimed at restricting access to gender-affirming health care for transgender and nonbinary youth. According to the coalition, these federal measures are an attempt to pressure health care providers into stopping medically necessary treatments for individuals under 19, even in states where such care is legal.
Attorney General James stated, “The federal government is running a cruel and targeted harassment campaign against providers who offer lawful, lifesaving care to children. This administration is ruthlessly targeting young people who already face immense barriers just to be seen and heard, and are putting countless lives at risk in the process. In New York and nationwide, we will never stop fighting for the dignity, safety, and basic rights of the transgender community.”
The lawsuit comes after executive orders signed by the president that redefined federal recognition of sex categories and directed agencies to end support for what was termed “gender ideology.” One order extended efforts to eliminate gender-affirming care for those under 19, classifying all individuals below this age as “children,” despite state laws like those in New York granting full medical autonomy at 18. The order also instructed the U.S. Attorney General to prioritize enforcement actions against providers offering gender-affirming care.
Following these directives, the Department of Justice (DOJ) issued guidance threatening criminal prosecution of providers and began investigations into hospitals across the country. Subpoenas were issued seeking private patient data from clinics offering gender-affirming services. The attorneys general argue that no federal law prohibits such care and that these actions serve only to intimidate providers through threats not grounded in statute.
Medical experts cited in the complaint maintain that gender-affirming care is recognized as safe and necessary by major associations including the American Academy of Pediatrics, American Medical Association, and American Psychiatric Association. Studies have shown that denying access can increase depression, anxiety, and suicidality among transgender youth.
James’s office reports that some health systems in New York have canceled appointments for young patients seeking gender-affirming care since issuance of the executive orders. Providers are said to be caught between conflicting state obligations—such as New York’s requirement for nondiscriminatory medical access—and new federal threats.
The attorneys general assert these federal actions violate constitutional principles including state sovereignty under the Tenth Amendment as well as exceeding statutory authority under administrative law. They seek a court declaration blocking implementation of both executive orders and related DOJ directives.
Dr. Carla Smith, CEO of The NYC LGBT Community Center, commented: “Transgender and nonbinary youth deserve the freedom to access the health care they need without fear, shame, or government interference. The Trump administration’s actions endanger the lives of young people who already face disproportionate rates of depression and suicide. We applaud Attorney General James and this coalition of attorneys general for standing up to these attacks and defending the right to gender-affirming care that is clearly recognized, supported, and protected by law. We also call on healthcare providers to demonstrate courage and integrity, and to follow our state’s laws.”
Tandra R. LaGrone from In Our Own Voices added: “This attack on gender-affirming care is not just a policy dispute—it is a deliberate act of violence against transgender and nonbinary youth and the providers who care for them. At In Our Own Voices, we serve LGBTQ+ communities of color who already face overwhelming barriers to healthcare, dignity, and survival. These federal threats are reckless, cruel, and unconstitutional. We stand with Attorney General James and this multistate coalition in saying clearly: we will not be intimidated, we will not back down, and we will fight to ensure that every young person has access to the lifesaving care they need and deserve.”
A spokesperson from The Sylvia Rivera Law Project noted confusion among medical providers due to intimidation tactics: “The threat of attacking the health care of young people and adults has already caused harm here in New York state and beyond… This intimidation is causing confusion to medical providers and threatening criminalization when providers have been following WPATH standards of care for decades since it was founded in 1978.”
Gwen Appenfeller and Mattie Beaton from ACT UP NY said: “Access to gender-affirming care saves lives. ACT UP NY will continue to fight alongside trans youth… This federal administration’s attempt to ban access… is a continued direct attack… Whether this ridiculous ban stands or not… we will continue our work… We stand in unwavering solidarity with New York State Attorney General Letitia James as she continues to lead the legal fight…”
Yaetza Maria Martinez from WAVE Women stated: “To deny a transgender child the right to gender-affirming care is the truest form of cruel and unusual punishment… Medical transitions must only be guided by the individual who is transitioning and their chosen medical providers.”
Other states joining New York include California, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan,Nevada, New Jersey,New Mexico, Rhode Island,Wisconsin, District of Columbia,Pennsylvania governor.
For more information about protections for gender-affirming care in New York visit the Office of Attorney General’s website.
