SEATTLE — The future of federal funding for some health care providers was debated Thursday at the Ninth Circuit Court of Appeals in Seattle, where the Washington attorney general’s office defended gender-affirming care against what it called “unconstitutional” actions by the Trump administration.
Gender-affirming care for minors and adults remains legal in Washington state. The court is considering whether the federal government can withhold funding from providers that offer such care.
Joanne Levy, who works at the Rainbow Center in Tacoma, an LGBTQ advocacy group, said the organization has been overwhelmed with questions from people uncertain about the future of gender-affirming care in Washington.
“We are trying to protect these very valuable health care providers,” Levy told KOMO News.
“The executive orders that we challenge in this case are profoundly harmful and hateful, but for today’s purposes, what matters most is that they’re unconstitutional,” Washington Solicitor General Noah Purcell said during Thursday’s hearing.
The case stems from executive orders issued in early 2025 that threaten to block federal funding for hospitals and clinics that provide gender-affirming care to minors.
“To limit federal funding of medical institutions that perform sex transition procedures on minors and to ensure that federal funds are not used to promote gender ideology,” said Eric MacArthur, deputy assistant attorney general for the Justice Department’s Civil Division, describing the administration’s position.
Washington Attorney General Nick Brown sued the Trump administration in 2025, and a federal district court judge issued an injunction blocking enforcement of the policies in the state while the lawsuit proceeds. On Thursday, Justice Department attorneys argued the lawsuit is premature because it does not demonstrate how specific federal agencies have acted in response to the executive orders.
“He is, in effect, telling the agencies, ‘I want you to do the analysis. Here’s the general policy I’m setting forth,” MacArthur said.
In January, Mary Bridge Children’s Hospital in Tacoma announced it had closed its clinic that treated gender dysphoria, saying it did so “to avoid being penalized or investigated by the federal government.”
“We are trying to fill the holes in terms of finding health care providers and work with the families to provide lifesaving measures, not only from a health perspective but a mental health perspective,” Levy said.
Federal officials are asking the appeals court to overturn the injunction and allow the administration’s policies to take effect. Washington state argues the executive orders are unconstitutional and interfere with state-regulated medical care.
“The president has no authority to apply these provisions,” Purcell said.
A written ruling from the Ninth Circuit Court of Appeals is expected in the coming weeks or months. In a news release, Brown said his office is confident the courts will continue to side with Washington and the Constitution.