Judge Voids ‘Kennedy Declaration’ Targeting Trans Youth Care
Court says Robert F. Kennedy Jr. overstepped his authority and violated federal law targeting transgender youth care.
A federal judge in Oregon issued a blistering ruling against the U.S. Department of Health and Human Services and Secretary Robert F. Kennedy Jr., blocking their efforts to yank federal funding from providers of gender-affirming care for minors.
At the center of the case is the so-called “Kennedy Declaration,” in which the HHS secretary claimed that gender-affirming care does not meet accepted medical guidelines, lacks evidence of benefit for treating gender dysphoria, and may cause long-term harm.
At the time, critics said Kennedy based the declaration on an HHS review of gender-affirming care that was anonymously produced and rushed through in 90 days without peer review, in order to comply with President Trump’s executive order limiting minors’ access to such treatments.
Alongside the declaration, HHS proposed two rules restricting gender-affirming care for transgender minors — one barring Medicaid from covering transition-related care for people under 19, and another threatening to strip federal funding, including Medicare and Medicaid dollars, from hospitals or clinics that recommend such treatments.
In a 49-page ruling issued April 18, U.S. District Judge Mustafa Kasubhai of the District of Oregon vacated the Kennedy Declaration in its entirety, finding it unlawful and in violation of federal law.
Kasubhai also ruled that HHS lacks authority to unilaterally set standards of care that override state standards, and permanently blocked the agency and its Office of Inspector General from implementing the Kennedy Declaration or any “materially similar policy” that threatens to deny federal funding to providers treating transgender youth.
By vacating the declaration and blocking its reinstatement, Kasubhai granted relief to providers treating transgender youth in 21 states and the District of Columbia, whose attorneys general sued to challenge the crackdown. Providers in those jurisdictions can continue treating patients without fear of losing federal funding.
HHS’s Office of Inspector General used the declaration as a pretext to investigate hospitals and clinics in states without bans on gender-affirming care. As a result, many providers preemptively ended services for trans youth out of fear of losing federal funding, which could jeopardize care for all patients, as reported by Erin Reed in her Erin in the Morning Substack.
“Unserious leaders are unsafe,” Kasubhai wrote in his opinion. “There is nothing more serious than our leaders’ dedication to the rule of law so that we might maintain the integrity of our constitutional democracy. This case highlights a leader’s unserious regard for the rule of law…. This case is one of a long list of examples of how a leader’s wanton disregard for the rule of law causes very real harm to very real people.”
The judge also elaborated on an initial ruling last month finding that Kennedy overstepped his authority as HHS secretary and that the agency violated federal medical funding rules and the Administrative Procedure Act, which requires the government to publish proposed rule changes, allow public comment, and issue a final version at least 30 days before taking effect.
Kasubhai wrote that Kennedy’s “utter failure” to follow proper administrative procedures before attempting to unilaterally ban gender-affirming care ultimately “harmed children,” whose care was halted when hospitals and clinics stopped offering services to transgender youth rather than risk losing federal funding.
HHS previously argued that the states’ lawsuit should be dismissed and that the declaration was a “non-binding policy view” without “concrete legal consequences.” But Kasubhai called that reasoning a “bald-faced lie” and a “disingenuous” attempt to “gaslight” the court about its true aims.
Kasubhai noted that judicial precedent establishes that states, not the federal government, are the primary regulators of medical conduct, citing a 2025 U.S. Supreme Court decision allowing Tennessee and other states to enforce laws barring gender-affirming care. As such, states without bans — including the 22 that sued — should be left to regulate such care.
HHS is likely to appeal the decision, meaning the issue could eventually reach the Supreme Court and remains unresolved. Some proponents of gender-affirming care worry the court’s conservative majority may ultimately side with Kennedy and the Trump administration, regardless of the facts or alleged APA violations.
Erin Reed said the ruling means hospitals and clinics have “lost the primary justification they have cited for ending gender-affirming care for trans youth,” and urged state attorneys general to enforce local nondiscrimination laws if providers continue refusing treatment.
“The ruling does not merely block the Declaration — it permanently enjoins any ‘materially similar policy,’ meaning the administration cannot simply rename the Declaration and try again,” Reed wrote. “For hospitals that continue to refuse care, the legal calculus has shifted dramatically. Many of the states in this lawsuit — including New York, California, Colorado, and Illinois — have state or local nondiscrimination laws that explicitly protect transgender people…. It remains to be seen if elected officials now push for a return to trans youth care in alignment with those laws.”
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