Baltimore, December 27, 2025
Maryland has joined 18 states and the District of Columbia in a lawsuit against federal proposals aimed at restricting children’s access to gender-affirming care. The lawsuit contests a Department of Health and Human Services declaration branding treatments such as hormone therapy and puberty blockers as unsafe for minors. The coalition argues this federal move undermines state authority over medical practices and threatens vital healthcare access for transgender youth.
Maryland Joins Multistate Lawsuit Against Federal Restrictions on Children’s Gender-Affirming Care
Baltimore, MD – Maryland, along with 18 other states and the District of Columbia, has filed a lawsuit against the U.S. Department of Health and Human Services (HHS) to block proposed rules that would limit children’s access to gender-affirming care. The lawsuit challenges a recent HHS declaration labeling treatments like puberty blockers, hormone therapy, and surgeries as unsafe and ineffective for minors experiencing gender dysphoria. The declaration also threatens to exclude healthcare providers offering such services from federal programs like Medicare and Medicaid.
The coalition argues that the HHS declaration unlawfully interferes with state authority to regulate medical practices and violates the Administrative Procedure Act by failing to provide adequate notice and seek public comment before implementing substantial health policy changes. The lawsuit seeks to prevent the enforcement of these proposed rules, asserting that they are both false and procedurally defective.
Joining Maryland in the lawsuit are the attorneys general from California, Colorado, Connecticut, Delaware, Illinois, Maine, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Wisconsin, Washington, and the District of Columbia. Pennsylvania’s Democratic governor has also joined the legal action. The coalition emphasizes the importance of preserving access to gender-affirming care, which is considered medically necessary and life-saving for many transgender youth.
Background on the HHS Declaration and Proposed Rules
On December 18, 2025, HHS issued a declaration stating that certain forms of gender-affirming care are “unsafe and ineffective” for children and adolescents. This declaration also warned that healthcare providers offering such treatments could face exclusion from federal health programs. In addition to the declaration, HHS proposed rules to restrict funding for gender-affirming care, though these rules are not yet finalized. The proposed changes have raised concerns among medical professionals and advocacy groups, who argue that they could lead to reduced access to essential healthcare services for transgender minors.
Implications for Maryland and Other States
Maryland has been proactive in protecting access to gender-affirming care. In June 2023, Governor Wes Moore signed Executive Order 01.01.2023.08, which directed state agencies to protect clinicians, health systems, and patients seeking gender-affirming treatment in Maryland. The executive order also stated that, barring a court order, no state agency would comply with subpoenas from other states seeking information about the provision of gender-affirming care in Maryland. This legal action further reinforces Maryland’s commitment to safeguarding access to gender-affirming healthcare services for its residents.
Legal and Medical Perspectives
The lawsuit underscores the ongoing legal battles over transgender healthcare access in the United States. Major medical organizations, including the American Medical Association and the American Academy of Pediatrics, have consistently supported access to gender-affirming care, citing its importance in reducing depression, substance abuse, and suicide attempts among transgender youth. The coalition of states argues that the federal government’s actions are an overreach and that decisions regarding medical treatments should be made between healthcare providers and patients, without undue interference from federal authorities.
Frequently Asked Questions (FAQ)
What is the purpose of the lawsuit filed by Maryland and other states?
The lawsuit aims to block proposed federal rules that would limit children’s access to gender-affirming care, challenging a recent HHS declaration labeling such treatments as unsafe and ineffective for minors experiencing gender dysphoria.
Which states are involved in the lawsuit?
Maryland, along with California, Colorado, Connecticut, Delaware, Illinois, Maine, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Wisconsin, Washington, and the District of Columbia, are part of the lawsuit. Pennsylvania’s Democratic governor has also joined the legal action.
What does the HHS declaration state about gender-affirming care?
The HHS declaration issued on December 18, 2025, states that certain forms of gender-affirming care are “unsafe and ineffective” for children and adolescents and warns that healthcare providers offering such treatments could face exclusion from federal health programs like Medicare.
What is Maryland’s stance on gender-affirming care?
Maryland has been proactive in protecting access to gender-affirming care. In June 2023, Governor Wes Moore signed Executive Order 01.01.2023.08, directing state agencies to protect clinicians, health systems, and patients seeking gender-affirming treatment in Maryland. The executive order also stated that, barring a court order, no state agency would comply with subpoenas from other states seeking information about the provision of gender-affirming care in Maryland.
What are the concerns raised by medical organizations regarding the federal declaration?
Major medical organizations, including the American Medical Association and the American Academy of Pediatrics, have consistently supported access to gender-affirming care, citing its importance in reducing depression, substance abuse, and suicide attempts among transgender youth. They argue that the federal government’s actions are an overreach and that decisions regarding medical treatments should be made between healthcare providers and patients, without undue interference from federal authorities.
Key Features of the Lawsuit and Its Implications
| Feature | Description |
|---|---|
| Legal Action | Maryland and 18 other states, along with the District of Columbia, have filed a lawsuit against the U.S. Department of Health and Human Services to block proposed rules limiting access to gender-affirming care for minors. |
| HHS Declaration | The declaration issued by HHS on December 18, 2025, labels certain forms of gender-affirming care as “unsafe and ineffective” for children and adolescents and threatens exclusion from federal health programs for providers offering such treatments. |
| Maryland’s Executive Order | In June 2023, Governor Wes Moore signed Executive Order 01.01.2023.08, directing state agencies to protect clinicians, health systems, and patients seeking gender-affirming treatment in Maryland and stating that, barring a court order, no state agency would comply with subpoenas from other states seeking information about the provision of gender-affirming care in Maryland. |
| Medical Community’s Position | Major medical organizations, including the American Medical Association and the American Academy of Pediatrics, support access to gender-affirming care, citing its importance in reducing depression, substance abuse, and suicide attempts among transgender youth, and argue that decisions regarding medical treatments should be made between healthcare providers and patients without undue interference from federal authorities. |
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