Connecticut joined a lawsuit in December to challenge the federal government’s attempt to discredit and limit gender-affirming care.
The U.S. Department of Health and Human Services released a declaration on Dec. 18, 2025, claiming that gender-affirming care is “neither safe nor effective as a treatment modality for gender dysphoria, gender incongruence, or other related disorders in minors.”
Connecticut Attorney General William Tong joined multiple other states to file a lawsuit against HHS Secretary Robert F. Kennedy Jr. and the declaration, calling it “cruel and lawless” in a press release.
“Trump and RFK Jr. are forcing a radical political agenda on doctors and families and weaponizing Medicare and Medicaid funding to deny healthcare to kids,” Tong said. “These extreme actions threaten to decimate medical providers nationwide unless they end gender-affirming care, supplanting medical expertise and parental choice with MAGA ideology.”
HHS proposed two rules related to gender-affirming care the day after it released the declaration. One rule would prohibit the use of state and federal Medicaid and Children’s Health Insurance Program money for “sex-rejecting procedures.”
The second rule would take away hospitals’ Medicare and Medicaid certification if they did not prohibit “sex-rejecting procedures” on children. Both proposed rules are open for public comment until Feb. 17.
The complaint filed by the states alleged that the HHS declaration is “procedurally defective” and “contrary to law.”
“The Secretary has no legal authority to substantively alter the standards of care and effectively ban, by fiat, an entire category of healthcare,” the complaint stated. “Nor does the Secretary have authority to threaten providers’ participation in federal programs, including reimbursement by Medicare and Medicaid, by fiat.”
Gender-affirming care is defined by the World Health Organization as “interventions designed to support and affirm an individual’s gender identity.” It includes social and psychological care, such as talk therapy, as well as medical treatments like hormone therapy or surgery.
The practices that Kennedy refers to as “sex-rejecting procedures” in his declaration include “puberty-suppressing hormones, cross-sex hormones, and surgical procedures.”
Kennedy’s declaration stated that these procedures have “an unfavorable risk-benefit profile” for minors. However, it also acknowledged that “systematic reviews provide limited direct evidence of harms from sex rejecting procedures in minors.”
The declaration cited a lack of strong evidence in favor of hormone therapy and surgery and other countries’ movement away from these methods as a first resort for gender-affirming care. The declaration said it was based on the “best available scientific evidence and aims to promote the health, safety, and well-being of children and adolescents.”
The lawsuit claimed decisions about gender-affirming care belong to the state governments, making it unlawful for the federal government to withhold certification like Medicaid and Medicare based on those decisions. The complaint asked that the court “declare and hold unlawful the Kennedy Declaration.”
From the beginning of Donald Trump’s second term, he and his administration have targeted transgender identity, referring to it as “gender ideology extremism.” Trump signed an executive order declaring there were only two genders based on biological sex the same day as his 2025 inauguration. He went on to sign other executive orders banning transgender people from the military and women’s sports, garnering lawsuits and challenges from states and advocacy groups.
The attorneys general of New York, Oregon and Washington are leading this lawsuit. Fifteen other states, the District of Columbia and the governor of Pennsylvania have joined as plaintiffs.