RFK Jr. Loss on Gender Care Sets Stage for More Trump Setbacks

The Trump administration’s mission to block minors from receiving gender-affirming care is facing a significant hurdle following a court order that legal observers say hinders an array of government efforts.

US Health and Human Services Secretary Robert F. Kennedy Jr.'s declaration that gender-affirming care for minors is harmful to children is one among a suite of Trump administration actions in peril following Judge Mustafa T. Kasubhai’s April 18 order.

The outcome is a major victory for states and hospitals pressured by the federal government to stop providing surgery and other treatments, with Kasubhai granting a request from California, Illinois, and other states to block not only the declaration but any similar policy as well.

“This decision removes the shadow of the Kennedy declaration and reinforces what we know: regulating the practice of medicine is a power reserved to the states, not the President or Secretary Kennedy,” said Omar Gonzalez-Pagan, senior counsel and health-care strategist at Lambda Legal.

HHS spokesperson Emily G. Hilliard said the agency “will continue to fight to protect our nation’s children,” accusing Kasubhai for putting “radical ideology ahead of their safety.”

Federal Overreach

Since the start of his second term in office, President Donald Trump has overseen an effort across federal agencies to cut off services for transgender people, including a series of Department of Justice probes into hospitals providing gender-affirming care for minors.

Kennedy has played a critical role in the effort. In December, the HHS announced, along with the Kennedy declaration, a handful of efforts to crack down on care, including Centers for Medicare & Medicaid Services rulemaking that would cut off funds to hospitals providing gender-affirming care to minors.

However, those pending rules may be in danger as Kasubhai’s ruling is both “broad enough and specific enough to prevent enforcement,” said Shannon Minter, legal director at the National Center for LGBTQ Rights.

Kasubhai “did not simply enjoin enforcement of the Kennedy directive. He issued a permanent injunction preventing HHS from interfering with state-based medical providers who are providing medical care to transgender young people,” Minter said.

Trump administration actions have created a chilling effect across hospitals reluctant to provide services in fear of federal retribution.

Kasubhai’s order “should help give health-care providers in the plaintiff states the assurances they are looking for in offering or resuming this care that many young people and their families rely on,” said Katie Keith, who served as deputy director of the White House Gender Policy Council under former President Joe Biden.

What’s more, “the court resoundingly rejected the administration’s arguments on both process and substance,” said Keith, also founding director of the Center for Health Policy and the Law at Georgetown Law. That means that “going forward, the Trump administration and other courts will have to grapple with this court’s reasoning.”

Others, however, view the decision as biased and overreaching, and take issue with the judge’s analysis and outcome.

“The opinion’s gratuitous disparaging remarks only reinforce political bias, to say nothing of the flawed legal analysis,” said Lindsay Killen, chief strategy officer at Do No Harm, a group that opposes gender-affirming care for minors.

“Secretary Kennedy was well within his authority to issue an opinion that relies on evidence-based research and science rather than talking points from gender ideologues,” Killen said.