Federal judge pauses President Trump's order restricting gender-affirming care for trans youth

[February 14, 2025]  By LEA SKENE

BALTIMORE (AP) — A federal judge on Thursday temporarily blocked President Donald Trump’s recent executive order aimed at restricting gender-affirming health care for transgender people under age 19.

The judge’s ruling came after a lawsuit was filed earlier this month on behalf of families with transgender or nonbinary children who allege their health care has already been compromised. A national group for family of LGBTQ+ people and a doctors organization are also plaintiffs in the court challenge, one of many lawsuits opposing a slew of executive orders Trump has issued as he seeks to reverse the policies of former President Joe Biden.

Judge Brendan Hurson, who was nominated by Biden, granted the plaintiffs’ request for a temporary restraining order following a hearing in federal court in Baltimore. The restraining order, which lasts 14 days but could be extended, essentially puts Trump’s directive on hold while the case proceeds.

That means medical institutions can’t have their federal funding pulled because they provide gender-affirming care services.

The restraining order is nationwide in scope and will apply to institutions across the country. Attorneys for the government didn’t indicate whether they plan to appeal it.

Shortly after taking office, Trump signed an executive order directing federally run insurance programs to exclude coverage for such services. That includes Medicaid, which covers gender-affirming care in some states, and TRICARE for military families. Trump also signed an earlier executive order that narrowly defined the sexes as male and female while commanding that federal funds “shall not be used to promote gender ideology.”

The lawsuit includes several accounts from families of appointments being canceled as medical institutions react to the new directive. Some hospitals immediately paused gender-affirming care, including prescriptions for puberty blockers and hormone therapy.

Those immediate impacts were a main focus of the hearing Thursday afternoon, when Hurson repeatedly asked attorneys on both sides to discuss the risks associated with allowing Trump’s orders to take full effect and continue limiting health care access. Hurson directly challenged the assertion that the president’s goal is to protect transgender youth.

“The order seems to deny that this population even exists, or deserves to exist,” Hurson said, noting that transgender people already face a statistically elevated risk of suicide, poverty, addiction and other hardships.

Disrupting their health care out of the blue could cause them “irreparable harm,” the judge said in announcing his ruling.

Attorneys for the government argued that Trump, through his orders, was simply directing federal agencies to take lawful steps to carry out his policy preferences. They said the orders weren’t aimed at restricting health care access for transgender youth, but rather a decision from the president on how his administration would distribute federal funding.

But the plaintiffs’ attorneys said the orders are “unlawful and unconstitutional” because they violate antidiscrimination laws while infringing on the rights of parents.

Dozens of transgender people and advocates rallied outside the courthouse in downtown Baltimore before the hearing, holding signs and waving pride flags while upbeat music played from a nearby speaker.

People wave signs to passing cars during a pro-transgender rights protest outside of Seattle Children's Hospital after the institution postponed some gender-affirming surgeries for minors following an executive order by President Donald Trump, Sunday, Feb. 9, 2025, in Seattle. (AP Photo/Lindsey Wasson, File)

“We will not be erased,” said Iya Dammons, executive director of the nonprofit Baltimore Safe Haven, which provides services to trans people. “We’ve been here before and we’re not going back.”

Shortly before the hearing began, the group filed slowly into the courtroom, filling its large gallery and listening attentively as the attorneys delivered their arguments.

Lee Binder of Trans Maryland said some of the transgender community’s most vulnerable members are being used as political pawns, so it’s important to show solidarity.

Trump’s approach on the issue represents an abrupt change from the Biden administration, which sought to explicitly extend civil rights protections to transgender people. Trump has used strong language in opposing gender-affirming care, asserting falsely 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.”

Major medical groups such as the American Medical Association and the American Academy of Pediatrics support access to gender-affirming care.

Young people who persistently identify as a gender that differs from their sex assigned at birth are first evaluated by a team of professionals. Some may try a social transition, involving changing a hairstyle or pronouns. Some may later also receive puberty blockers or hormones. Surgery is extremely rare for minors.

Like legal challenges to state bans on gender-affirming care, the recent lawsuit alleges the policy is discriminatory because it allows federal funds to cover the same treatments when they’re not used for gender transition. The suit also says Trump is overstepping his presidential authority by seeking to withhold federal funds previously authorized by Congress.

The judge’s ruling was a victory for transgender youth and their parents, said Omar Gonzalez-Pagan, an attorney for Lambda Legal representing the plaintiffs. He said hopefully hospitals that canceled appointments will start rescheduling them in light of the temporary restraining order that protects their funding.

“I hope that this is bringing the joy and the sense of security that these families need right now,” he said in remarks to reporters after the hearing. He said the next step is to keep fighting.

“Across the country, this unlawful order from the president has sown fear among transgender youth and confusion among their providers,” Joshua Block, an attorney for the American Civil Liberties Union who also represents the plaintiffs, said in a written statement after the hearing. “But today’s decision should restore both their access to healthcare and protections under the Constitution.” ___

Associated Press reporters Geoff Mulvihill in Cherry Hill, New Jersey; and Lindsay Whitehurst in Washington contributed to this report.

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