A federal judge overturned the Trump administration\u2019s ban on gender-affirming care for children on Saturday, decrying Robert F Kennedy Jr\u2019s \u201cwanton disregard\u201d for the law that \u201ccauses very real harm to very real people\u201d.<\/p>\n
It\u2019s another loss for Kennedy\u2019s agenda as secretary for the US Department of Health and Human Services (HHS) under the second Trump administration \u2013 an agenda that has focused on restricting healthcare, including vaccines, abortion and gender-affirming care.<\/p>\n
A different legal decision recently halted<\/a> the agency\u2019s attempt to raze vaccine recommendations, and new research<\/a> and regulatory decisions<\/a> have undermined controversial announcements by Trump and Kennedy on autism.<\/p>\n \u201cUnserious leaders are unsafe,\u201d Mustafa T Kasubhai, a US district judge in Oregon wrote in the opening to his final judgment<\/a> on the gender-affirming care case, a 49-page decision that excoriated the administration for disregarding the law and overreach in its regulations. The judge also barred the administration from implementing similar policies under any other names to restrict care nationally by withholding funding.<\/p>\n Shannon Minter, legal director of the National Center for LGBTQ Rights, called the ruling \u201cincredibly powerful\u201d and \u201cfar-reaching\u201d.<\/p>\n \u201cIt enjoins them from doing anything to interfere with the authority of states to regulate medical practice,\u201d Minter said.<\/p>\n For healthcare providers and families who have been in limbo for months, \u201cthis is a huge, huge step forward\u201d, said Jan Oosting, an associate professor of nursing at City University of New York (Cuny).<\/p>\n Khadijah Silver, director of gender justice and health equity at Lawyers for Good Government, who uses they and them pronouns, said they were \u201cso overwhelmingly ecstatic\u201d and \u201ccouldn\u2019t actually process\u201d that the ruling \u201cwas real life\u201d.<\/p>\n In December, Kennedy announced that any health system providing pediatric gender-affirming care would be suspended from receiving Medicaid and Medicare funding. Medicaid and Medicare would also be banned from paying for any gender-affirming care, he said.<\/p>\n As nearly all major hospitals and health systems rely on Medicaid and Medicare, the proposed rule amounted to a ban on gender-affirming care for children, setting a precedent for the government limiting healthcare for any patients.<\/p>\n At the same time, Kennedy issued a declaration<\/a> invoking a regulation to allow the HHS to exclude healthcare providers from Medicaid and Medicare when the providers no longer \u201cmeet professionally recognized standards of healthcare\u201d. Unusually, the new rule was enforced immediately, without going through the usual rule-making process, including public comment.<\/p>\n Gender-affirming care often includes puberty blockers and hormones, but can also involve psychosocial support and, very rarely and after extensive medical consultation, surgery. It is widely agreed<\/a> to be essential to the health of gender-expansive individuals. The Kennedy declaration claimed pediatric gender-affirming care for minors was \u201cneither safe nor effective\u201d and therefore fell below these standards.<\/p>\n Declarations like these are meant to be used for emergencies when the HHS needs to communicate the steps it\u2019s taking to protect public health, Silver said, who added: \u201cThey have never once been abused in such a fashion to go against standards of medical care that are widely accepted \u2026 let alone to override the state\u2019s primary authority in the regulation of medicine.\u201d<\/p>\n Minter said: \u201cThis was an attempt by the federal government to impose a national ban and usurp the authority of states to regulate medical practice within their borders.\u201d<\/p>\n Within eight days, the HHS general counsel, Mike Stuart, began referring health systems to the HHS office of inspector general for violating the new policy. The decision included several screenshots of posts from Stuart celebrating referrals of health systems for violating the rule.<\/p>\n