A key part of the Trump administration’s approach to transgender healthcare has been dealt a setback, after a federal judge in Oregon ruled that Health Secretary Robert F. Kennedy Jr overstepped his authority in issuing guidance on gender-affirming care.
The decision, handed down on Thursday (19 March), centres on a 12-page statement released by the Department of Health and Human Services in December 2025. The document claimed that “sex-rejecting procedures for children and adolescents are neither safe nor effective” for treating gender dysphoria or related conditions in minors.
According to reporting by The New York Times, the court found that RFK Jr exceeded his legal powers when he asserted that healthcare providers offering gender-transition treatments to minors “do not meet professionally recognized standards.”
The ruling provides relief for hospitals and medical professionals who offer gender-affirming care. Following the December statement, the department had signalled plans to investigate providers continuing to treat trans minors, with the possibility of cutting off access to federal Medicare and Medicaid funding.
The case forms part of a broader wave of policies introduced since Donald Trump returned to office. The administration has enacted a series of executive orders affecting LGBTQ+ rights, many of which directly target transgender people — including declaring there are “only two sexes”, restricting gender-affirming care for those under 19, banning trans people from military service, and dismantling diversity, equity and inclusion (DEI) programmes across federal agencies.
The Oregon ruling follows a lawsuit brought by 21 states, which argued that the federal government had attempted to impose a national medical standard without following proper legal procedures, in violation of the Administrative Procedure Act.
Government lawyers maintained that RFK Jr’s statement was “non-binding” and should be viewed as an expression of opinion rather than enforceable policy.
However, after a six-hour hearing, Judge Mustafa Kasubhai rejected that argument, finding that standard rulemaking processes had not been followed. He also criticised the administration’s approach, warning against bypassing established legal frameworks.
“The notion that ‘I will go forward and issue a declaration and see if we can get away with it’ is not a principle of governance that adheres to the overarching commitment to a democratic republic,” the judge said, emphasising the importance of the rule of law.
Legal experts expect the ruling to face an appeal, but in the meantime, it offers temporary relief to transgender youth, their families and healthcare providers navigating an increasingly complex legal landscape.
