October 2025 has brought not just escalating political attacks on trans people—but also a growing wave of legal resistance. Across the country, state attorneys general, federal judges, and public advocates are pushing back on unconstitutional attempts to restrict access to medically necessary care for transgender individuals, especially adolescents.

As prescribing clinicians, it’s crucial to stay informed—not only about the medical evidence, but also about the legal landscape shaping your ability to offer care with integrity.

1. Federal Lawsuits: 19 States Say “No” to Criminalizing Care

Attorneys General from 19 states—led by Washington—filed suit against the federal government, challenging an executive order that seeks to criminalize essential healthcare for transgender youth. (The 19th , Alabama Reflector , Washington AG )

The lawsuits assert that the executive order violates:

• The U.S. Constitution’s guarantees of equal protection and due process

• The rights of youth to receive established, evidence-based medical care

• States’ rights to regulate healthcare delivery within their borders

This coordinated legal challenge marks a turning point—state governments are asserting that political interference in gender care is not only unethical, but illegal.

2. Blocking the Feds: Federal Court Quashes DOJ Subpoenas for Trans Health Records

In Boston, a federal judge issued a ruling quashing subpoenas from the U.S. Department of Justice demanding access to patient records from gender clinics. (Lowenstein Sandler )

The ruling explicitly states that:

“The subpoenas pose a clear threat to patient privacy, care access, and First Amendment protections.”

For clinicians, this ruling is a critical shield. It reinforces the importance of maintaining patient confidentiality and pushes back against attempts to criminalize providers through backdoor surveillance.

3. State-Level Pushback Against Program Restrictions

Washington state has filed additional lawsuits challenging the federal government’s attempt to tie funding restrictions to gender-based exclusions in program design. (AG Ferguson )

What’s at stake:

• Community health programs could lose federal funding for affirming LGBTQ+ youth

• Schools and mental health providers would be penalized for offering supportive care

• Local autonomy over evidence-based practice would be overridden by federal ideology

The lawsuits argue these restrictions violate Title IX and multiple federal statutes that prohibit discrimination in federally funded programs.

Why This Matters for Prescribing Clinicians

• Legal advocacy is health advocacy. Clinicians are not lawyers, but we are stakeholders. These cases protect your ability to prescribe safely, ethically, and without fear of legal retaliation.

• Protecting confidentiality is non-negotiable. The DOJ subpoena case reinforces the legal weight of patient privacy—even when the federal government applies pressure.

• Medical care is not criminal. Framing medical care for trans people as controversial or dangerous is political—not clinical. These lawsuits are a direct rejection of those false narratives.

• State alliances are growing. You are not alone. Legal and governmental partners are fighting beside us.

Our Role in the Resistance

Prescribing clinicians are part of a multidisciplinary resistance—one rooted in science, ethics, and respect.

• Stay informed about legal developments in your state.

• Collaborate with institutional leaders to protect your practice.

• Educate lawmakers, patients, and colleagues on the medical necessity of this care.

• Document everything. Create records of consent, benefits, risks, and affirming goals.

• Join or support professional organizations pushing back with data and expertise.

We’re in a legal moment—but also a moral one. These wins show us what’s possible when communities mobilize, when states act boldly, and when clinicians stay grounded in justice.