Two transgender young adults and five families of trans minors filed a federal lawsuit Tuesday challenging two executive orders President Donald Trump issued over the last two weeks that aim to prohibit federal funding of transition-related health care for anyone under 19 and define sex as biological, only male and female and unchangeable.
“The Executive Orders were issued for the openly discriminatory purpose of preventing transgender people from expressing a gender identity different from their sex designated at birth—and expressing governmental disapproval of transgender people who, by definition, have a gender identity that does not align with their sex designated at birth,” the lawsuit states. “These Orders are part of a government-wide effort by the Trump Administration to restrict legal protections and essential services for the transgender community.”
One of the plaintiffs, Kristen Chapman, said she and her family moved to Virginia in the summer of 2023 after their home state of Tennessee passed a law banning gender-affirming medical care for trans minors like her 17-year-old daughter, Willow. The family struggled to find a provider in Virginia who would accept Medicaid, which is a government health care program for people with limited income. Chapman said the family paid for Willow’s care out of pocket, but it became “prohibitively expensive.” After trying for a few months, she said they were finally able to schedule an appointment for Jan. 29 at VCU Medical Center in Richmond, which would take Medicaid.
“The day before our appointment, President Trump signed the executive order at issue in this case. The next day, just a few hours before our appointment, VCU told us they would not be able to provide Willow with care,” Chapman said in a statement shared by the ACLU. “I thought Virginia would be a safe place for me and my daughter. Instead, I am heartbroken, tired, and scared.”
The lawsuit, filed in the District Court of the District of Maryland, requests that a judge immediately block the executive orders, which it argues are illegal and unconstitutional because the president does not have the authority to withhold federal funds that have been previously approved by Congress. The suit also argues that the order restricting transition care violates parents’ fundamental rights and the rights of trans people under 19 by discriminating against them based on sex, as the order allows people under 19 who are not trans to continue receiving the same treatments for other medical conditions.
The White House and the Department of Justice did not immediately respond to a request for comment.
The American Civil Liberties Union, Lambda Legal, ACLU of Maryland and private law firms Hogan Lovells and Jenner & Block filed the suit on behalf of the families and young adults who are all members of PFLAG National, a nonprofit that supports the friends and families of LGBTQ people. PFLAG and GLMA, the largest national association of LGBTQ and allied health professionals, some of whom have had federal funds withheld under the orders, are also named as plaintiffs.
Omar Gonzalez-Pagan, senior counsel and health care strategist for Lambda Legal, called the orders “morally reprehensible and patently unlawful.”
“The federal government — particularly, this administration — has no right to insert itself into conversations and decision-making that rightly belongs only to patients, their families, and their medical providers,” he said in a statement. “This broadside condemns transgender young people to extreme and unnecessary pain and suffering, and for minors, it subjects their parents to agonized futility in caring for their child — all while denying them access to the same medically recommended health care that is readily available to their non-transgender peers.”
One of the orders, “Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” declared that the U.S. government will recognize only two sexes, male and female, and that “these sexes are not changeable and are grounded in fundamental and incontrovertible reality.” It prohibits agencies from promoting gender ideology and argues that it will “defend women’s rights and protect freedom of conscience by using clear and accurate language and policies that recognize women are biologically female, and men are biologically male.”
The other order at issue in the lawsuit, titled “Protecting Children From Chemical and Surgical Mutilation,” prohibits federal funding from covering transition-related medical care — including puberty blockers, hormone therapy and surgery — for children, which it defines as those younger than 19. Medical schools and hospitals receiving federal research or education grants also have to “end the chemical and surgical mutilation of children,” the order states.
The sweeping order could affect more than just programs receiving federal funds. For example, it also directs the secretary of Health and Human Services to change section 1557 of the Affordable Care Act, which prohibits health care discrimination and, as a result, has required health insurance plans under the act to cover transition-related care. It also instructs the director of the Office of Personnel Management to bar trans care for minors in the Federal Employee Health Benefits and Postal Service Health Benefits programs for 2026.
The order argues that the country has an obligation to protect children from “irreversible medical interventions.”
“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,” the order states, using inflammatory language to describe transition-related care. It goes on to allege without citing evidence that these 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.”
More than half of states across the U.S. have already enacted measures to restrict transition-related care for minors, but since Trump’s order last week, a number of hospitals in states without these restrictions have stopped such care for patients under 19 or announced that they are reviewing it. The White House announced in a news release Monday that hospitals in New York City, Colorado, Virginia, Illinois, Pennsylvania and Washington, D.C., have either suspended or announced that they are reviewing their transition care programs for minors.
Though Trump’s order seeking to restrict such transition care implies that it is a widespread threat to children, recent research has shown that a small number of minors actually access this type of care. A study published in JAMA Pediatrics in January found that less than 0.1% of adolescents with private insurance in the U.S. are transgender or gender-diverse and are prescribed puberty blockers or gender-affirming hormones.
Most major medical associations, such as the American Medical Association, the American Academy of Pediatrics and the American Psychological Association, support access to transition care for minors and oppose restrictions on it.
Trump issued multiple executive orders during his first two weeks in office that seek to restrict trans rights. In addition to the two mentioned in the lawsuit, he also signed an order prohibiting trans people from enlisting and serving in the military. At least three other lawsuits have been filed against these orders — two from transgender women serving in federal prison who would be denied transition care under the order and transferred to men’s prisons and one from transgender service members and those seeking to enlist. A judge blocked prison officials from transferring one of the trans inmates on Sunday.
