As clinician‑care maintainers for transgender and gender diverse communities, you’re navigating not only clinical guidelines but political turbulence. The current administration’s policies—including executive orders, DOJ threats, and investigations—are aggressively targeting gender affirming care. But in response, a coalition of states is standing up in court. Let’s break down who, why, and how you can engage through your care context.

State Lawsuits: Who Is Fighting Back

Coalition of States & D.C. Suing the Trump Administration

In August 2025, sixteen states and the District of Columbia, led by California, New York, and Massachusetts, formally sued the Trump administration in federal court. They argue that federal efforts—including Executive Order 14187 and Justice Department directives—are unlawfully intimidating care providers and undermining state sovereignty, violating the 10th Amendment and state anti‑discrimination laws.

The complaint highlights how these federal actions directly discourage or coerce hospitals and clinics from continuing gender‑affirming services—even in areas where state law protects such care.

Hospitals and Clinics Under Pressure

Health systems across California, Colorado, Illinois, Connecticut, and D.C. have reported shelving or halting youth gender‑affirming services in response to DOJ subpoenas and funding threats—despite state protections.

These institutions underscore the chilling effect federal overreach has on care access—even when legal protections are in place.

Legal Arguments on State Rights and Clinical Necessity

State attorneys general assert that gender affirming care is supported by major clinician‑aligned associations—like the AMA, AAP, and APA—and recognized as essential, evidence‑aligned care. They describe federal interventions as unconstitutional oversteps that violate both procedural rights and patients’ health access.

The coalition’s lawsuit is seeking declaratory and injunctive relief to halt enforcement of EO 14187 and related DOJ actions, aiming to protect the safety of clinics and continuity of care California Attorney General's Office.

Why This Matters for Clinician-Care Providers

1. Legal Backing for Individualized Care
   These lawsuits affirm that care decisions should be clinically guided, not legislatively dictated.

2. Support for Hospital Systems under Duress
   Legal victories may empower institutions to reinstate or continue services with reduced fear of prosecution or funding loss.

3. Language for Advocacy and Documentation
   You may use argument language from these cases—such as violations of states’ anti-discrimination laws and the Tenth Amendment—to clarify your care rationale internally and externally.

4. Framework for Collective Resistance
   These cases show how clinicians, institutions, and state systems can unite in resistance. Your documentation, solidarity, and advocacy are part of that collective story.

What You Can Do in Your Care Context

• Update Your Documentation Practices
  Use explicit, values-aligned language affirming that care is evidence-based and supported by both state law and national clinician-aligned consensus.

• Share and Connect
  Keep colleagues, clinic leadership, and patient networks aware of the current litigation landscape. Share updates from attorney general statements or coalition briefs.

• Advocate Within Institutions
  Encourage your institution to publicly align with the legal coalition or issue internal statements supporting clinician-led, gender-affirming care—especially if challenges arise.

The administration’s mounting threats to trans healthcare access—notably under EO 14187—are met with robust legal resistance. States across the country are asserting their rights, protecting clinicians, and defending patient autonomy. As a care provider, being informed about these battles strengthens your ability to advocate, document, and care—with clarity, confidence, and an unwavering commitment to human rights.