California Attorney General Rob Bonta has filed a lawsuit in the U.S. District Court for the District of Massachusetts, leading a coalition of states to challenge recent federal actions by the Trump Administration that seek to restrict access to gender-affirming healthcare for transgender, intersex, and nonbinary youth. The lawsuit targets President Trump’s Executive Order 14187 and subsequent memoranda from the U.S. Department of Justice (DOJ), which direct enforcement efforts against providers offering such care to individuals under 19 years old.
Attorney General Bonta stated, “The President and his Administration’s relentless attacks on gender-affirming care endanger already vulnerable adolescents whose health and well-being are at risk; their demands that our healthcare providers discriminate against transgender individuals and deny them access to medically-necessary healthcare is cruel and irresponsible. The Trump Administration’s unlawful threats have not only undermined State rights but have directly contributed to diminishing access to gender-affirming care. These actions have created a chilling effect in which providers are pressured to scale back on their care for fear of prosecution, leaving countless individuals without the critical care they need and are entitled to under law. Today’s lawsuit aims to address the root cause of this problem and hold the Trump Administration accountable, ensuring that we continue to safeguard and uphold the healthcare rights and freedoms of our transgender community.”
President Trump signed an executive order on his first day in office declaring recognition of only two sexes at the federal level, calling for an end to support for what was described as “gender ideology.” Executive Order 14187 specifically sought restrictions on healthcare for youth under 19—defining everyone below this age as a child—even though some states consider 18-year-olds legal adults. The order also directed DOJ enforcement actions related to gender-affirming care, including memoranda issued by U.S. Attorney General Pam Bondi in April 2025 and Assistant Attorney General Brett Shumate in June 2025 instructing DOJ staff to prioritize investigations into entities providing such medical treatments.
On July 9, 2025, DOJ announced it had issued more than 20 subpoenas targeting doctors and clinics providing gender-affirming care for adolescents. In its press release, Attorney General Bondi said: “[m]edical professionals and organizations that mutilated children in the service of a warped ideology will be held accountable by this Department of Justice,” signaling potential prosecution under federal statutes unrelated directly to medical practice.
The coalition argues these federal actions lack legal basis, undermine state authority over healthcare regulation—including California’s protections for gender-affirming care—and intimidate providers with threats of civil or criminal prosecution even when services comply with state law. California recognizes gender-affirming care as medically necessary treatment protected by anti-discrimination laws covering gender identity or expression.
According to major national medical associations, denying medically necessary gender-affirming treatment can worsen mental health outcomes among affected youth—including higher rates of depression, anxiety, and suicidal ideation.
State officials report that following these federal directives some providers have reduced or eliminated services due to concerns about professional risks; patients have experienced canceled appointments or uncertainty regarding continued access.
The lawsuit contends that these executive orders violate constitutional principles by exceeding federal authority while conflicting with state laws requiring equal access to medical treatment. It seeks court intervention blocking further enforcement action by the administration.
Attorneys general from New York, Massachusetts, Illinois, Connecticut joined Bonta in leading the suit alongside counterparts from Delaware, Hawai’i, Maine, Maryland, Michigan, Nevada, New Jersey, New Mexico, Rhode Island, Wisconsin; also participating is the Governor of Pennsylvania.
A copy of the complaint is available online.
