A Seattle federal judge has issued a long-term block on former President Donald Trump’s initiative to eliminate federal funds for institutions that provide gender-affirming care to transgender youth. U.S. District Court Judge Lauren King, who had earlier granted a two-week restraining order following a lawsuit by Democratic attorneys general from Washington, Oregon, and Minnesota, extended her decision pending a final ruling. Colorado has since joined the legal action.
The temporary order expired on Friday, leading Judge King to issue a preliminary injunction that halts most aspects of Trump’s plan until the case’s merits are thoroughly examined. She dismissed part of the states’ argument concerning the order’s stance on female genital mutilation, citing insufficient grounds for prosecution threats in such instances.
Two executive orders from Trump are central to the lawsuit. The first, titled “Defending Women from Gender Ideology Extremism,” proposes withdrawing federal funding from programs that endorse gender ideology. The second, “Protecting Children from Chemical and Surgical Mutilation,” seeks to cut research and education grants to institutions, including hospitals and medical schools, that offer gender-affirming care to minors under 19. In response to these orders, several hospitals across the country have ceased providing care like puberty blockers and hormone treatments.
The “Protecting Children” order raises concerns about the future of Medicaid programs in some states that cover gender-affirming care, hinting that such practices might cease. It also suggests that medical professionals might face criminal charges under a law banning unnecessary genital mutilation of underage females, a notion vehemently opposed and legally unsound according to the challenging states.
Transgender youth who identify persistently as a gender different from their birth-assigned sex, a condition known as gender dysphoria, are significantly more prone to severe depression and suicide if not treated. Treatments can include evaluations by medical professionals, social transitions such as changing hairstyles or pronouns, and, in some cases, puberty blockers or hormones. Surgery for minors, however, remains exceedingly rare.
In her Friday ruling, Judge King highlighted that the order is not confined to minors or irreversible treatments. It notably does not address medical procedures for cisgender children. “The order’s inadequate ‘means-end fit’ could prevent federally funded providers from delivering essential medical treatments to transgender youth unrelated to gender identity,” she stated. “For instance, a cisgender teen could receive puberty blockers for cancer treatment from such a provider, whereas a transgender teen with a similar cancer treatment plan could not.”
Washington Assistant Attorney General William McGinty emphasized the vital nature of the issue during Friday’s arguments. “There are young people at risk of losing their lives if this care is unavailable,” he warned. Trump’s executive order employs negative terms like “maiming,” “sterilizing,” and “mutilation,” which contradict mainstream gender-affirming care practices in the U.S. Such care has broad endorsement within the medical community, including from the American Academy of Pediatrics and the American Medical Association.
Judge King questioned Justice Department attorney Vinita Andrapalliyal about Trump’s orders’ scope and impact, probing, “What is gender dysphoria?” Andrapalliyal replied, “Your honor, I am not a medical expert,” prompting King to press further, pointing out, “It’s a thing, correct? A medically acknowledged diagnosis?” “I don’t have an official stance on that,” Andrapalliyal responded, highlighting the quest for a “legitimate government interest” justifying Trump’s directives.
The four Democratic attorneys general pursuing this case in Seattle argue that these orders infringe upon equal rights protections, breach the separation of powers, and impinge on states’ rights to regulate non-delegated federal matters. Conversely, the Trump administration has countered these claims, asserting in court that “the President’s authority to direct subordinate agencies to implement his agenda, subject to their own statutory authorities, is well established.”
Besides health care access orders and classifying sexes as immutable, Trump has enacted orders potentially banning transgender military service members, altered educational rules on gender teachings, and banned transgender athletes from girls’ and women’s sports. These actions have sparked numerous legal challenges.
