Sixteen states and Washington, D.C. filed a federal lawsuit in Boston on Friday, August 1, to block the Trump administration from investigating doctors and hospitals that provide gender-affirming care to minors. The coalition argues that federal subpoenas and executive directives unconstitutionally infringe on state powers.
Federal Subpoenas and DOJ Directives Target Youth Care
The legal challenge centers on a series of federal actions aimed at restricting medical gender-affirming care for adolescents. Within days of taking office, President Donald Trump signed an executive order seeking to restrict such care nationwide for individuals under 19 years old. That order directed prosecutors to prioritize investigations and sought to cut off federal funding from medical schools and hospitals offering the procedures.
Following the executive order, several hospitals announced they were pausing transition care for people under 19. Multiple judges subsequently blocked that part of the order, prompting many hospitals to resume care. Despite the injunction, U.S. Attorney General Pam Bondi issued an April memo directing prosecutors to investigate cases involving procedures she argued violated a federal law barring female genital mutilation, while also launching civil investigations into medical providers and pharmaceutical companies manufacturing puberty blockers and hormones. Additionally, Assistant Attorney General Brett Shumate issued a June memo directing the Justice Department’s Civil Division to prioritize investigations into doctors who provide such care. Last month, the Justice Department disclosed that it had sent more than 20 subpoenas to doctors and clinics performing transgender medical procedures on children demanding private patient information.
State Attorneys General Push Back in Boston Federal Court
The complaint, which names Trump, Bondi, and the DOJ as defendants, was filed in the U.S. District Court for the District of Massachusetts by attorneys general from 16 states and the District of Columbia, alongside the governor of Pennsylvania. The participating states include California, Connecticut, Delaware, Hawai’i, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New York, New Mexico, Rhode Island, Wisconsin, and Pennsylvania.
Transition-related care remains legal in all of the jurisdictions participating in the lawsuit. New York Attorney General Letitia James, who is leading the coalition, stated in a statement: “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.” James also stated that: The federal government is running a cruel and targeted harassment campaign against providers who offer lawful, lifesaving care to children.
Constitutional Arguments Over Tenth Amendment Rights
The legal challenge argues that the administration’s actions violate the Tenth Amendment of the U.S. Constitution by trampling on state rights to regulate medicine. According to the state officials, federal authorities are relying on statutes—including the Food, Drug, and Cosmetic Act, the False Claims Act, and the female genital mutilation statute—that were never intended to address pediatric gender-affirming care.
The lawsuit asserts that federal enforcement threats place healthcare providers in an untenable position, forcing them to make an impossible choice
of either defying the federal threats or complying and violating state-level nondiscrimination laws in medical care. The complaint states: “These efforts to chill the provision of healthcare for adolescents — even in states where such care is legal and protected — show that the Agency Defendants have adopted and are engaged in a systematic effort to leverage the threat of criminal and civil enforcement to eliminate medically necessary care for transgender adolescents in the United States.”
White House and Justice Department Defend Executive Actions
Administration officials defended the policies in statements following the filing. Taylor Rogers, a White House spokesperson, stated in a statement that Americans support Trump’s efforts to stop the despicable mutilation and chemical castration of children,
and added: The President has the lawful authority to protect America’s vulnerable children through executive action, and the Administration looks forward to ultimate victory on this issue.
A Department of Justice spokesperson reiterated the administration’s stance when asked to comment on the lawsuit, stating: As Attorney General 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.’
As the DOJ has opened investigations into some providers of transition care for minors, a rising number of hospitals—including those in states without laws that restrict trans health care—have announced that they plan to close their youth gender clinics. Meanwhile, conservative lawmakers in 25 states have in recent years adopted bans on various forms of gender-affirming care for adolescents, and the U.S. Supreme Court in June upheld a Tennessee ban, delivering a major setback for transgender rights advocates.
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