21 Democrat-led states sue Trump administration to keep federal funds financing mutilation of transgender minors

A group of 21 states led by Democratic governors filed a lawsuit to block the decision by the Trump administration to cut federal funding for "gender transition" procedures for minors, including surgeries involving genital mutilation and other body parts that clinics perform under the diagnosis of gender dysphoria.

The lawsuit, filed Wednesday in a federal court in Massachusetts, seeks to block a new rule from the Department of Health and Human Services that would prevent Medicaid and the Children's Health Insurance Program (CHIP) from continuing to use taxpayer funds to pay for these types of procedures on adolescents. The measure, announced last month, is scheduled to take effect in October.

According to a report by The New York Times, the attorneys general of these 21 states argue that the White House overstepped its authority by blocking reimbursements for treatments that, they say, some states consider "medically necessary."

The attorney general of California, Rob Bonta, defended the position by explaining that the Trump administration, in his view, is turning its back on the country's transgender people: "We will not stand by as the Trump administration oversteps its authority and twists the facts to justify its bad-faith agenda against transgender Americans. We will continue to fight to secure access to medically necessary care and protect transgender individuals' abilities to prosper as their authentic selves."

The administration, however, is backed by a report of its own published last year by the Department of Health, which concluded that the risks of these treatments — hormones, puberty blockers, and, in rare cases, surgeries — outweigh any medical benefits, and recommended prioritizing psychotherapy for minors who experience a mismatch between their biological sex and their perceived gender.

Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, defended the new rule, which is set to take effect: "Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits."

Most Republican-led states already prohibit these procedures on minors, a stance that aligns with that of several European countries that have restricted or outright banned such interventions after reviewing the available scientific evidence. Despite this, U.S. medical societies such as the American Academy of Pediatrics continue to support these controversial treatments.

This is not the first time the Trump administration has attempted to curb this type of funding. Earlier this year, a similar attempt was blocked by a federal judge, who ruled that the federal government could not deny hospitals offering these treatments access to federal funds for other medical services, based solely on a statement by the Secretary of Health, Robert F. Kennedy Jr. However, that case differs from the new rule, as that attempt appeared to be retaliation against healthcare institutions.

Data from Congressional Budget Office (CBO) data show that, between 2019 and 2023, the government allocated about $100 million to these types of treatments for minors. Surgery, however, still accounts for only a small fraction of these procedures, although other types of treatments, such as puberty blockers, have also become a point of contention.

The plaintiffs contend that the new rule sets a dangerous precedent by allowing the executive branch to replace state medical standards with its own parameters. However, supporters argue that, in this particular case, it is a common-sense measure.