California and a coalition of other liberal-led states sued the Trump administration Friday over efforts to end gender-affirming care for transgender, intersex and nonbinary children and young adults nationwide — calling them an unconstitutional attack on LGBTQ+ patients, healthcare providers and states’ rights.
The lawsuit was brought by California Atty. Gen. Rob Bonta and officials from 15 other states and the District of Columbia. It challenges a Jan. 28 executive order by President Trump that denounced gender-affirming care as “mutilation” and called on U.S. Justice Department officials to effectively enforce a ban, including by launching investigations into healthcare providers.
The lawsuit notes the Justice Department last month sent more than 20 subpoenas to doctors and clinics that have provided such care nationwide, with justice officials suggesting they may face criminal prosecution.
Bonta’s office, in a statement, said such efforts “have no legal basis and are intended to discourage providers from offering lifesaving healthcare that is lawful under state law.” The lawsuit asks a federal court in Massachusetts to vacate Trump’s order in its entirety for exceeding federal authority and undermining state laws that guarantee equal access to healthcare.
In a statement to The Times, a Justice Department spokesperson said that, as U.S. Atty. Gen. Pam Bondi “has made clear, this Department of Justice will use every legal and law enforcement tool available to protect innocent children from being mutilated under the guise of ‘care.’”
Trump made reining in transgender rights a key promise of his presidential campaign. Upon taking office, he moved swiftly to do so through executive orders, funding cuts and litigation. And in many ways, it has worked — particularly when it comes to gender-affirming care for minors.
Clinics across the country that had provided such care have closed their doors in response to the threats and funding cuts. That includes the renowned Center for Transyouth Health and Development at Children’s Hospital Los Angeles, one of the largest and oldest pediatric gender clinics in the United States.
The clinic told thousands of its patients and their families that it was shuttering last month. Other clinics have similarly closed nationwide, radically reducing the availability of such care in the country.
Republicans and other Trump supporters have cheered the closures as a major win, and they praised the president for protecting impressionable and confused children from so-called woke medical professionals pushing what they allege to be dangerous and irreversible treatments.
Bonta said in the Friday statement that Trump and his administration’s “relentless attacks” on such care were “cruel and irresponsible” and endangered “already vulnerable adolescents whose health and well-being are at risk.”
“These actions have created a chilling effect in which providers are pressured to scale back on their care for fear of prosecution, leaving countless individuals without the critical care they need and are entitled to under law,” Bonta said.
Mainstream U.S. medical associations have supported gender-affirming care for minors experiencing gender dysphoria for years. They and LGBTQ+ rights organizations have accused Trump and his supporters of mischaracterizing that care, which includes therapy, counseling and support for social transitioning, and can include puberty blockers, hormone treatment and, in rarer circumstances, mastectomies.
Queer advocates, many patients and their families say such care is life-saving, alleviating intense distress — and suicidal thoughts — in transgender and other gender-nonconforming youth. They and many mainstream medical experts acknowledge that gender-affirming care for young people is still a developing field, but say it is also based on decades of solid research by medical professionals who are far better equipped than politicians to help families make difficult medical decisions.
However, as the number of children who identify as transgender or nonbinary has rapidly increased in recent years, that argument has failed to take hold in many parts of the country. Conservatives and Republican leaders have grown increasingly alarmed by such care, pointing to young people who changed their minds about transitioning and now regret the care they received.
Some of those young people, including Chloe Cole, a prominent “detransitioner” from California, are among the administration’s most vocal supporters. In a post on X last month, Cole praised the closure of the Children’s Hospital clinic in L.A. as the beginning of the end to gender-affirming care in liberal states, writing: “Let’s finish the job!”
The battle has played out in the courts, in part as a state’s rights issue. In June, the Supreme Court ruled that conservative states may ban puberty blockers and hormone treatments for transgender teens, with the court’s conservative majority finding that states are generally free to set their own standards of medical care.
The Trump administration, however, has not taken the same view. Instead, it has aggressively tried to eradicate gender-affirming care nationwide, regardless of state laws — like those in California — that protect it.
Trump’s Jan. 28 executive order, titled “Protecting Children from Chemical and Surgical Mutilation,” claimed that “medical professionals are maiming and sterilizing a growing number of impressionable children under the radical and false claim that adults can change a child’s sex through a series of irreversible medical interventions.”
It defined children as anyone under the age of 19, and said that moving forward, the U.S. wouldn’t “fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another,” but would “rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”
The states’ lawsuit focuses on one particular section of that order, which directed Bondi to convene state attorneys general and other law enforcement officials nationwide to begin investigating gender-affirming care providers and other groups that “may be misleading the public about long-term side effects of chemical and surgical mutilation.”
The section suggested those investigations could be based on laws against “female genital mutilation,” or even around a 1938 law known as the Food, Drug, and Cosmetic Act, which authorizes the Food and Drug Administration to regulate food, drugs, medical devices and cosmetics.
On July 9, Bondi announced the Justice Department’s subpoenas to healthcare providers, saying doctors and hospitals “that mutilated children in the service of a warped ideology will be held accountable.”
On July 25, The Times reported that Bill Essayli, the Trump administration’s controversial pick for U.S. attorney in L.A., had floated the idea of criminally charging doctors and hospitals for providing gender-affirming care, according to two federal law enforcement sources who spoke on the condition of anonymity for fear of reprisal.
The targeting of gender-affirming care is part of a wider effort by the administration to eliminate transgender rights more broadly, in part on the premise that transgender people do not exist. On his first day in office, Trump issued another executive order declaring there are only two sexes.
His administration has sought to limit the options transgender people have to get passports that reflect their identities, and the Justice Department has sued California over its policies allowing transgender girls to compete against other girls in youth sports. Many transgender Americans are looking for ways to flee the country.
Still, many in the LGBTQ+ community fear the attacks are only going to get worse. Among those who are most scared are the parents of transgender children — including those who believe their health records may have been collected under the Justice Department’s subpoenas.
One mother of a Children’s Hospital patient told The Times last month that she is terrified the Justice Department is “going to come after parents and use the female genital mutilation law … to prosecute parents and separate me from my child.”
Bonta said his office has not heard of any parents being targeted, but he hasn’t ruled it out as a possibility, given the Trump administration’s actions to date.
“If they’re willing to use nonexistent law to attack providers, what would stop them from going after parents as well, as they wage these cultural wars?” Bonta said during a Friday morning news conference.
Bonta is leading the lawsuit along with the attorneys general of Connecticut, Illinois, Massachusetts and New York. Joining them are Pennsylvania Gov. Josh Shapiro and the attorneys general of Delaware, the District of Columbia, Hawaii, Maine, Maryland, Michigan, Nevada, New Jersey, New Mexico, Rhode Island and Wisconsin.
