Democrat-led states sue HHS over push to defund hospitals that perform sex-change procedures on minors
Nineteen Democrat-led states and the District of Columbia have sued the U.S. Department of Health and Human Services over a series of proposed regulatory actions that would effectively bar hospitals that participate in Medicare and Medicaid programs from performing body-mutilating sex-change procedures on minors.
New York Attorney General Letitia James announced Tuesday that she is leading the states and D.C. in the complaint filed against various HHS officials.
“[HHS Secretary Robert F. Kennedy Jr.] cannot unilaterally change medical standards by posting a document online, and no one should lose access to medically necessary health care because their federal government tried to interfere in decisions that belong in doctors’ offices,” stated James.
“At the core of this so-called declaration are real people: young people who need care, parents trying to support their children, and doctors who are simply following the best medical evidence available.”
Kennedy announced the proposed rules last week that seek to exclude from federal Medicare and Medicaid any medical facility that performs cosmetic sex change operations or provides hormonal interventions for gender dysphoric children. Kennedy signed a declaration that contends that "sex-rejecting treatments on children do not meet professionally recognized standards of health care."
The declaration defines “sex-rejecting procedures” as "pharmaceutical or surgical interventions, including puberty blockers, cross-sex hormones, and surgeries such as mastectomies, vaginoplasties, and other procedures, that attempt to align an individual’s physical appearance or body with an asserted identity that differs from the individual’s sex."
The agency contends that such procedures, which can often involve the removal of healthy reproductive organs or the provision of puberty-blocking drugs and cross-sex hormones, expose children to "irreversible damage, including infertility, impaired sexual function, diminished bone density, altered brain development, and other irreversible physiological effects."
Kennedy's announcement came not long before the U.S. House of Representatives passed legislation banning so-called gender transition procedures for minors, a bill that is unlikely to clear the closely divided U.S. Senate. Twenty-seven states have enacted similar policies that prohibit some or all types of gender transition procedures for minors.
The new lawsuit, which was filed in U.S. District Court for the District of Oregon, Eugene Division, alleges that HHS’ new rules — which are subject to a 60-day comment period — came “without warning," “exceeds the Secretary’s authority" and "violates the Administrative Procedure Act and the Medicare and Medicaid statutes.”
“At minimum, Secretary Kennedy and HHS cannot circumvent statutorily mandated notice and comment requirements by changing substantive legal standards by executive fiat,” alleged the complaint.
“The Kennedy Declaration has immediate, significant, and harmful impacts on the Plaintiff States as administrators of state Medicaid programs and as regulators of the practice of medicine.”
Kennedy's declaration, titled “Safety, Effectiveness, and Professional Standards of Care for Sex-Rejecting Procedures on Children and Adolescents," stated that “current medical evidence does not support a favorable risk/benefit profile for” sex-change surgeries for minors, adding that “existing evidence cannot support effectiveness claims for medical and surgical interventions in ameliorating mental health conditions or reducing gender dysphoria symptoms.”
"So-called 'gender-affirming care' has inflicted lasting physical and psychological damage on vulnerable young people," Kennedy said at a press conference last week. "This is not medicine; it is malpractice."
“Sex-rejecting procedures are neither safe nor effective treatment for children with gender dysphoria.”
In May, HHS released a lengthy report titled "Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices" that concluded that such treatments “carry risk of significant harms including infertility/sterility, sexual dysfunction, impaired bone density accrual, adverse cognitive impacts, cardiovascular disease and metabolic disorders, psychiatric disorders, surgical complications, and regret.”
European medical bodies, such as those in the United Kingdom, Sweden, and Norway, have been reevaluating their approaches to treating children with gender dysphoria in recent years.
Last year, the U.K.'s National Health Service instructed gender clinics to pause first appointments for kids under 18 following the formal review led by Dr. Hilary Cass, the retired former president of the Royal College of Paediatrics and Child Health. Cass's report found there is "no good evidence on the long-term outcomes of interventions to manage gender-related distress."
