President Donald Trump’s plans to pull federal funding from medical institutions that provide gender-affirming care will remain blocked after a federal judge found, for the second time, that Trump lacked the proper executive authority to make such an order.
U.S. District Court Judge Lauren J. King, an appointee of President Joe Biden, initially issued a 14-day pause on Trump’s directive which sought to stop federal funding for research and educational grants to medical schools and hospitals that provide gender affirming care to people under the age of 19.
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The judge said Trump doesn’t care about the wellbeing of patients forced to de-transition under his order.
King initially issued her pause in response to the attorneys general of Washington, Oregon, and Minnesota filing a motion to sue the Trump Administration. The attorneys argued that Trump’s executive order restricting gender-affirming treatment is an unconstitutional violation of a state’s right to govern. Colorado later joined the lawsuit, bringing the total number of plaintiff states to four.
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The judge’s order went into effect on February 14 and was set to expire by February 28. However, King scheduled an injunction hearing for the day the order expired, and she held arguments to determine whether to extend the block. She ruled in favor of approving a preliminary injunction, blocking the order’s enforcement in the four plaintiff states.
During the hearing, the states argued that Trump’s order, by attempting to dictate the medical care that state residents can receive, unconstitutionally violated the Due Process Clause in the Fifth Amendment and the states’ rights guaranteeed by the Tenth Amendment. The plaintiffs further argued that withholding funding appropriated by Congress also violates the Constitution’s separation of powers.
The Department of Justice (DOJ) defended the order, stating that it instructed agencies to act “consistent with applicable law,” which should nullify any claims of its unconstitutionality. The DOJ also claimed that the Equal Protection Clause, which guarantees that all people are treated equally by the law, didn’t apply because the president’s order is “safeguarding children from potentially dangerous, ineffective, and unproven treatments.”
The treatments used in gender-affirming medical care have been safely used on trans people and cisgender children for decades. Major medical associations consider gender-affirming care to be safe, essential, and effective for trans people’s well-being.
However, Judge King pressed DOJ attorney Vinita Andrapalliyal about the terminology in Trump’s order, particularly its definition of gender dysphoria. After a continuous back-and-forth, Andrapalliyal acknowledged that gender dysphoria is a condition and King verified that Andrapalliyal had “no reason to dispute the scientific legitimacy of this diagnosis.”
Washington Assistant Attorney General William McGinty conveyed the issue’s urgency, saying, “The president’s disregard for the Constitution is obvious and intentional. But once again, states and the courts have stepped up to affirm the rule of law and the values that hold us together as a nation.”
Furthermore, Judge King found that the order’s use of disparaging terminology with words such as “maiming,” “sterilizing,” and “mutilation” contradicts what is typical for gender-affirming care in the United States.
Hurting the Administration’s case even more, the judge pointed out that the order was not limited to children or irreversible treatments and doesn’t target medical interventions performed on cisgender children.
“In fact, its inadequate ‘means-end fit’ would prevent federally funded medical providers from providing necessary medical treatments to transgender youth that are completely unrelated to gender identity,” King wrote. “For example, a cisgender teen could obtain puberty blockers from such a provider as a component of cancer treatment, but a transgender teen with the same cancer care plan could not.”
Judge King concluded that Trump’s order served only as a mechanism for the federal government to limit rights and protections for transgender people. As such, she made her decision to impose the injunction.
The only section from the order she didn’t block was the order’s provision against female genital mutilation. Female genital mutilation is already illegal in the four plaintiff states and no evidence indicates that the states plan on performing such procedures.
King’s ruling marks the second time two separate federal judges have issued injunctions against Trump’s order on gender-affirming care. The first, issued by U.S. District Judge Brendan Hurson, an appointee of President Joe Biden, declared that Trump issued his ban without legal authority, making his orders an unconstitutional form of discrimination. Hurson’s ruling blocked Trump’s order nationwide.
King’s injunction will remain in effect until the case is resolved. The DOJ would need to appeal King’s decision to the 9th U.S. Circuit Court of Appeals to have her injunction discontinued. The Circuit Court justices are majority Democrat, making an appeal unlikely until a resolution is reached.
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