President Donald Trump suffered a legal setback Thursday when a federal judge in Baltimore issued a temporary restraining order blocking enforcement of his executive order on medical care for trans people under 19.
The decision, while preliminary, is national in scope and was hailed by LGBTQ legal advocacy groups and their clients. The decision was made by U.S. District Judge Brendan A. Hurson, who was appointed in 2023 by President Joe Biden. A judge is set to hold a hearing Friday in Seattle on a similar challenge.
The nationwide restraining order prohibits federal agencies from conditioning or withholding federal funding based on the fact that a health care entity or health professional provides gender-affirming medical care to a patient under 19, according to Lambda Legal Defense and Education Fund, which is a party in the lawsuit, along with PFLAG, a national group for friends and families of LGBTQ people.
"Good and decent parents of transgender kids should never be in the frightening position of having their child's prescribed, medically necessary care canceled at the whim and threat of a politician. But that's exactly what President Trump's executive order did to PFLAG families with trans youth and young adults nationwide," stated Brian K. Bond, chief executive officer of PFLAG National. "Today's decision rights a grievous wrong to our nation's families and children, and PFLAG families will be vigilant to ensure our transgender loved ones receive the healthcare they need – as this legal ruling demands."
Trump issued the executive order January 28. Titled, "Protecting Children from Chemical and Surgical Mutilation." It stated, "Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding.
"Moreover, these vulnerable youths' medical bills may rise throughout their lifetimes, as they are often trapped with lifelong medical complications, a losing war with their own bodies, and, tragically, sterilization," the order continued.
The executive order declared that it is the policy of the United States not to "fund, sponsor, promote, assist, or support" gender transition for people under 19, which includes 18-year-olds who are legal adults in the states where they reside, Lambda Legal's release stated. The mandates in the order specifically focus on gender-affirming medical care, including hormones and puberty blockers. The order cross-references the definitions and other directives in a separate executive order signed by President Trump on January 20, requiring discrimination against transgender people across much of the federal government.
On February 4, a lawsuit was filed by Lambda Legal, the American Civil Liberties Union, the ACLU of Maryland, and law firms Jenner & Block and Hogan Lovells on behalf of seven anonymous transgender young adults and adolescents and their families whose health care has been disrupted by Trump's order, the release stated. Also joining the case as plaintiffs are PFLAG National, the nation's largest organization supporting LGBTQ+ people and their families, with over 550,000 members and supporters and nearly 350 chapters across the country; and GLMA (formerly known as the Gay and Lesbian Medical Association), the country's largest organization of LGBTQ and allied health professionals.
During the hearing, Justice Department attorney Harry S. Graver said the transgender patients' arguments were "too abstract" because Trump was not imposing a nationwide ban on gender-affirming care or instituting a freeze on all federal funding for such procedures.
But Hurson disagreed. The government is expected to appeal.
LGBTQ organizations said the issue is one of people accessing care.
"Forcing providers to withhold medically necessary, evidence-based care not only threatens patient health and well-being, but also undermines the integrity of our health care system in its entirety," stated Alex Sheldon, a nonbinary person who is GLMA's executive director. "Today's intervention by the court underscores the cruelty and recklessness that is embedded in this order and affirms our commitment to resist the administration's extremist agenda that targets trans and nonbinary young people and privileges political ideology over medical expertise. We are hopeful that this decision is a critical step toward restoring safety, trust, and stability in our healthcare institutions."
In the first week after the order was signed, some hospitals across the country – in Massachusetts, Maryland, Washington, Colorado, and Virginia at least – abruptly halted medical care for transgender people under age 19, canceling appointments and turning away patients, including some who had been receiving this care for most of their life. This prompted protests of support for transgender youth and in opposition to the order nationwide.
In California, Children's Hospital Los Angeles also paused the initiation of gender-affirming hormonal care for trans patients under the age of 19 because officials stated they needed to assess Trump's executive order.
LGBTQ advocates maintained Trump's order causes harm to young people.
"The president's orders sought to take away from transgender young people the very care that they, their families, and their medical providers all agree is best for them – medical care that is evidence-based and well-established. But these decisions are for patients, their families, and their doctors to make, not for politicians or Washington bureaucrats," stated Omar Gonzalez-Pagan, senior counsel and health care strategist for Lambda Legal. "As today's decision makes clear, the president does not have the power to unilaterally condition federal funding by requiring discrimination. To the contrary, our laws and Constitution forbid it. We hope that with today's decision, healthcare entities can go back to caring for their patients instead of abandoning them over fears of losing admittedly critical federal funding."
Others involved in the lawsuit noted Trump's order has given way to fear among trans people and their families.
"Across the country, this unlawful order from the president has sown fear among transgender youth and confusion among their providers," stated Joshua Block, senior staff attorney for the ACLU's LGBTQ & HIV Project. "But today's decision should restore both their access to health care and protections under the Constitution. Providers who've suspended health care for their transgender patients should be left with no doubt that they can lift those suspensions and continue to provide healthcare and act in their best medical judgment without risking their funding or worse."
"The ACLU of Maryland supports the right of every Marylander and families nationwide to make personal and very private decisions about healthcare with their medical providers, without harmful government interference," stated Dana Vickers Shelley, executive director of the ACLU of Maryland. "We are relieved that the courts have recognized the damage caused by the president's unlawful executive order. This decision puts the president on notice that the ACLU of Maryland and our coalition partners will not rest while the Constitution is under siege."
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