Oregon’s attorney general is joining a lawsuit against the Trump administration over an executive order that aims to block access to gender-affirming care for children and young adults.
The order, which was signed by President Donald Trump on Jan. 28, seeks to cut off federal funding from institutions that provide hormone therapy, puberty blockers and surgical treatment for people under 19.
The suit was filed by Washington state Attorney General Nick Brown in the Western District of Washington, and is joined by Oregon and Minnesota.
The White House’s executive order, according to the three states, particularly targets medical care that is recommended for gender dysphoria, when a person’s internal sense of gender identity conflicts with their sex assigned at birth.
The lawsuit calls the order “cruel and baseless,” and accuses the executive branch of “attempts to dictate medical care by executive fiat.” The states argue the order violates the Fifth Amendment’s equal protection guarantee by singling out transgender individuals for discrimination.
The three states filing suit require Medicaid and privately-offered health plans to cover gender affirming care, including treatment for gender dysphoria, and have adopted protections for gender-affirming care in state law.
“Families should work directly with their providers, not politicians, to make decisions about personal healthcare,” said Oregon Attorney General Dan Rayfield. “We will not stand by as the President tries to unilaterally impose his harmful political agenda on Oregonians.”
The order also takes aim at medical institutions who provide gender-affirming care and receive federal funding.
The lawsuit alleges that hospitals and medical schools in Oregon, Washington and Minnesota stand to immediately lose more than $1 billion in federal funding for research and treatment of conditions that are unrelated to gender-affirming care. That includes more than $400 million at OHSU, grants that it uses to research critical subjects like cancer, vaccines and ADHD.
The states argue that the president cannot legally claw back research funding that has been authorized by the U.S. Congress for medical institutions.
In Trump’s order, he argues that medical transition, a process that some transgender people choose to align their physical appearance with their gender identity, amounts to mutilation and is based on junk science.
The lawsuit comes on the heels of another executive order aimed at transgender people. Earlier this week, Trump signed an executive order that aims to keep trans women out of women’s sports. Oregon House Minority Leader Christine Drazan, R-Canby, said she’d soon introduce a bill to align the state’s high school athletics with the order.
Meanwhile, Senate Minority Leader Daniel Bonham, R-The Dalles, who attended the signing of that executive order Wednesday, has introduced a bill requiring Oregon school districts to ensure that “every athletic competition or extracurricular sport is expressly designated by the biological sex of the students who participate in the competition or sport.”
Bonham did not immediately respond to a request for comment on the attorney general’s lawsuit.
An ‘impossible choice’
Three unnamed physicians affiliated with the University of Washington are also plaintiffs in the suit. The lawsuit argues that the executive order is forcing health care providers to make an “impossible choice” between providing necessary, legal treatment to their patients and risking criminal prosecution.
In the executive order, the White House accuses medical providers of harming children under the guise of medical necessity.
OHSU, the University of Washington School of Medicine, and Seattle Childrens’ Hospital all provide gender-affirming care and treatment for gender dysphoria, following standards recommended by the Endocrine Society – a medical association for endocrinology clinicians – and the World Professional Association for Transgender Health, according to the suit. The executive order has called that guidance into question, saying it “lacks scientific integrity.”
For people under 18, gender-affirming care can include treatment with hormones, drugs that delay the onset of puberty, and in a limited number of cases, chest surgery.
The executive order, the lawsuit argues, seeks to redefine treatment with puberty blockers and hormone therapy as “chemical mutilation.” It also directs the U.S. Department of justice to enforce an existing criminal law against female genital mutilation for those 18 and under.
That part of the executive order, the states suggest, is not meant to target providers who provide genital surgery to transgender patients, a rare procedure available only for patients 18 and over.
Instead, the states suggest the executive branch intends to use the criminal law against female genital mutilation to prosecute people prescribing puberty blocking medications and hormones, and parents of children on those medications.
This interpretation is frivolous, the states argue, noting that the federal statute against female genital mutilation specifically excludes medical procedures. According to providers, the therapies they prescribe are medically necessary and, in some cases, lifesaving by bringing transgender patients relief from depression, anxiety, anorexia, and suicidality.
The anonymous providers are also suing on behalf of their adolescent transgender patients. They argue those patients cannot sue on their own behalf, due to fear they could be outed at school and that their families could be targeted for criminal prosecution.
In a statement, Basic Rights Oregon, an LGBTQ+ advocacy group, applauded Rayfield’s decision to join the suit, saying the group “hears on a regular basis from families of transgender young people about how life-changing and even life-saving gender-affirming care can be for them.”
The group added that the federal government should “let patients and families make their own private decisions.”