Trans Youths Halt Trump’s Order to Bar Gender-Affirming Care (1)

US health-care agencies can’t withhold federal money from entities or professionals that provide gender-affirming care for transgender people under 19-years old, pending a trial on the legality of executive orders directing the funding freeze, a federal court said Tuesday.

The plaintiffs—transgender individuals and the advocacy organizations PFLAG Inc. and GLMA— showed they’re likely to win on claims that President Donald Trump’s “gender-identity” and “health-care” executive orders exceeded his authority, are contrary to existing statutes, and infringe the individuals’ equal protection rights, the US District Court for the District of Maryland said.

The plaintiffs also showed that they have been irreparably harmed as result of the orders and that the balance of equities and public interest favor halting the government’s action, the court said in an opinion granting a nationwide preliminary injunction. Trump exceeded his authority by directing agencies to withhold funding on a condition that the US Congress hasn’t authorized.

“Seeking to effectively enact legislation by executive order clearly exceeds the bounds of Article II and thus does not serve the public interest,” Judge Brendan Abell Hurson said.

The lawsuit is part of a wave of litigation challenging the myriad executive orders Trump adopted shortly after his inauguration, including those purporting to end birthright citizenship; eliminate federal diversity, equity, inclusion, and accessibility programs; and freeze foreign aid.

The gender-identity and health-care orders expand on efforts to restrict transgender individuals’ access to gender-affirming care nationwide. Over two dozen states already ban treatments for minors, and several state Medicaid programs refuse to cover it.

The gender identity order, issued on Trump’s first day in office, prohibits using federal money to “promote gender ideology” and directs agencies to assess grants to ensure recipients don’t do so. The health-care order mandates that agencies strip institutions that perform gender-affirming care for children of their federal grants, even if they’re not related to or used to pay for such care.

Hurson said the injunction doesn’t harm the federal government. He further heldthe defendants haven’t produced any evidence supporting harms they may face from temporarily restoring the status quo. Hurson said that the executive orders will harm transgender people receiving treatment and medical professionals doing research.

"[T]he executive orders threaten to harm transgender youth, as well as access to medical care for entire communities if hospitals decide to continue to provide gender-affirming medical care and then lose significant federal funding,” Hurson said.

The plaintiffs sued federal officials Feb. 4, saying Trump didn’t “have unilateral power to withhold federal funds that have been previously authorized by Congress and signed into law” or to “impose his own conditions on the use of funds.”

Hurson granted a temporary restraining order Feb. 13, then issued an opinion explaining his reasoning the following day.

The president has no constitutional authority to refuse to spend money appropriated by Congress to implement his own policy preferences, the judge said.

Temporary restraining orders usually expire in 14 days unless extended. The plaintiffs on Feb. 18 asked Hurson to convert the TRO to a preliminary injunction.

A second federal judge in Washington state mostly blocked the orders’ enforcement on Feb. 28.

Lambda Legal Defense & Education Fund, the American Civil Liberties Union Foundation, American Civil Liberties Union Foundation of Maryland, Jenner & Block LLP, and Hogan Lovells US LLP represent the plaintiffs.

The case is PFLAG, Inc. v. Trump, D. Md., No. 25-cv-337, 3/4/25.