Judge Rules US Government Overreached on Transgender Health Care Declaration

Federal judge says government violated procedures in issuing warning about gender-affirming care for young people

Mar. 20, 2026 at 7:03am

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A federal judge in Oregon has ruled that the U.S. Department of Health and Human Services overreached when it issued a declaration warning doctors that they could be excluded from federal health programs if they provide gender-affirming care to transgender youth. The judge said the government violated administrative procedures in issuing the declaration, which called treatments like puberty blockers and surgeries unsafe and ineffective.

Why it matters

This ruling is a major legal setback for the Biden administration's efforts to restrict access to gender-affirming care for transgender youth. It affirms that the government cannot simply issue declarations to undermine established medical standards without following proper procedures. The decision preserves access to these treatments, which are considered essential by major medical organizations.

The details

Judge Mustafa Kasubhai ruled that Secretary Robert F. Kennedy Jr. and HHS did not go through the proper administrative steps when issuing the declaration in December 2025. The declaration warned doctors they could be excluded from Medicare and Medicaid if they provide gender-affirming treatments. The judge denied the government's motion to dismiss the case brought by a coalition of 19 states and Washington D.C.

  • The judge's ruling came at the end of a roughly 6-hour hearing on March 20, 2026.
  • In December 2025, HHS issued the declaration questioning the safety and efficacy of gender-affirming care for transgender youth.

The players

Judge Mustafa Kasubhai

The federal judge who ruled that the government overreached in issuing the declaration on transgender health care.

Robert F. Kennedy Jr.

The Secretary of the U.S. Department of Health and Human Services who issued the declaration that was ruled unlawful.

Letitia James

The Democratic Attorney General of New York who led the lawsuit against the government's declaration.

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What they’re saying

“Today's win breaks through the noise and gives some needed clarity to patients, families, and providers. Health care services for transgender young people remain legal, and the federal government cannot intimidate or punish the providers who offer them.”

— Letitia James, New York Attorney General

“The notion that 'I will go forward and issue a declaration and see if we can get away with it' is not a principle of governance that adheres to the overarching commitment to a democratic republic that requires the rule of law to be regarded and respected and honored as a sacred.”

— Judge Mustafa Kasubhai

What’s next

The judge's written decision will be issued following the hearing. The federal government has indicated it plans to appeal the separate ruling earlier this week that blocked several of Secretary Kennedy's vaccine policy changes.

The takeaway

This ruling is a significant victory for protecting access to gender-affirming care for transgender youth, affirming that the government cannot bypass proper procedures to undermine established medical standards. It underscores the importance of the rule of law and administrative processes in a democratic society.