CA AG Bonta, multistate coalition sue Trump over trans youth health care 

The attorneys general of 15 states, including California, and the District of Columbia are suing the Trump administration after several health care providers cited one of President Donald Trump’s executive orders as a reason they will no longer be providing gender-affirming surgeries for trans youth. The federal lawsuit was filed August 1.

Executive Order 14187, titled “Protecting Children from Chemical and Surgical Mutilation,” interprets federal law to prevent the procedures at health providers that are recipients of Medicare or Medicaid coverage. The lawsuit refers to the executive order as the “denial of care” order.

On August 1, California Attorney General Rob Bonta said the Trump administration’s actions in pressuring health care companies and hospitals to stop gender-affirming surgeries was unlawful.

“The president and his administration’s relentless attacks on gender-affirming care endanger already vulnerable adolescents whose health and well-being are at risk; their demands that our health care providers discriminate against transgender individuals and deny them access to medically-necessary healthcare is cruel and irresponsible,” Bonta stated in a news release. “The Trump administration’s unlawful threats have not only undermined state rights but have directly contributed to diminishing access to gender-affirming care. 

“These actions have created a chilling effect in which providers are pressured to scale back on their care for fear of prosecution, leaving countless individuals without the critical care they need and are entitled to under law,” he added.

With this latest court filing, there are now four lawsuits challenging the legality of the executive order, including PFLAG v. Trump; Washington v. Trump; and EK v. Department of Defense Education Activity. A national injunction was given in the PFLAG case; however, this was before the U.S. Supreme Court in June upheld Tennessee’s ban on gender-affirming care for trans minors in United States v. Skrmetti.

Last week, Oakland-based Kaiser Permanente became the latest health care provider to pause gender-affirming surgeries for patients under 19, effective August 29, as the Bay Area Reporter previously reported.  

Kaiser’s decision came after the federal justice department recently sent subpoenas to 20 unnamed doctors and clinics, which itself came on the heels of a Federal Trade Commission workshop on the “dangers of gender-affirming care,” which Andrew Ferguson, the chair of the commission, says are deceptive under federal trade laws. 

Kaiser followed Children’s Hospital LA, which stopped providing gender-affirming care July 22. Stanford stopped providing gender-affirming surgeries to patients under 19 in June.

Speakers at a July 25 rally outside of Kaiser’s San Francisco hospital on Geary Boulevard had decried Kaiser’s decision.

“Kaiser’s own foundation has put out research on the efficacy of this care. The evidence is there that this care is safe and effective,” noted Sydney Simpson, a registered nurse in interventional radiology at Kaiser San Francisco.

Simpson, who is trans and nonbinary and co-founded the trans caucus at the Harvey Milk LGBTQ Democratic Club, told the B.A.R. that it had been an emotional several days for them and their colleagues. But their main focus has been, and will continue to be, on the trans youth in their care.

Simpson predicted that the pause on their surgical procedures is only the first in several steps to come. They aren’t confident “at all” about not seeing the Trump administration target such health care for trans adults and demand an end to all gender-affirming care no matter a person’s age.

“They want to roll back not just surgical procedures but medical services also,” said Simpson, adding those entail mental health care, hormones, and puberty blockers.

Attendees of the protest had told the B.A.R. that they hoped Bonta would file a lawsuit to force the California health providers to undue either their pausing or ending care for trans youth. They noted it is against state law to discriminate against trans individuals of any age.

Bonta’s lawsuit doesn’t name any health care providers among the plaintiffs, solely Trump, U.S. Attorney General Pam Bondi, and the federal Department of Justice. In addition to California and Washington, D.C., the suit Bonta filed is joined by Massachusetts, New York, Connecticut, Illinois, Delaware, Hawaii, Maine, Maryland, Michigan, Nevada, New Jersey, New Mexico, Rhode Island, and Pennsylvania Governor Josh Shapiro (D). It was filed Friday in the United States District Court for the District of Massachusetts.

The civil complaint states that the age limit of 19 is arbitrary and violates the civil rights of adults. 

It’s “a category that includes not only minors, but also eighteen-year-olds who have reached the age of majority,” the complaint states.

It also states that the federal government is intruding on what is traditionally a state concern.

“The regulation of medicine is a core traditional police power belonging to the States and protected by the Tenth Amendment,” the complaint states. “Yet through the challenged actions, the Defendants seek to trammel on State power and eliminate this care, even in those States where such care is supported, and indeed protected, by law.”

The 10th Amendment to the U.S. Constitution reserves those powers not specifically enumerated in the document to the states, or to the people.

The complaint also discusses the health provider pull-outs.

“The administration has explicitly threatened civil and criminal prosecution of providers of this care and launched criminal investigations into children’s hospitals that provide this care in California, Colorado, and Massachusetts, and demanded extensive data – including patient medical records – regarding the provision of this care from hospitals across the country, without any reason to believe those hospitals have violated the statutes being invoked,” the complaint states. “Facing threats to their licenses, livelihoods, and liberty, some providers in Plaintiff States have announced that they will cease providing this longstanding, medically necessary, often lifesaving care to their patients.”

The causes of action are an “arbitrary and capricious” agency action as proscribed by the Administrative Procedure Act, an act “in excess of statutory authority” under the act, and 10th Amendment violations.

Bonta stated, “Today’s lawsuit aims to address the root cause of this problem and hold the Trump Administration accountable, ensuring that we continue to safeguard and uphold the healthcare rights and freedoms of our transgender community.”

Equality California, the statewide LGBTQ rights organization, issued a statement in support of the lawsuit.

“No young person should be denied medically necessary care because of a hate-fueled political agenda. Donald Trump and his administration have no business interfering with personal health care decisions made between parents, doctors, and patients.” stated EQCA Executive Director Tony Hoang, a gay man.

Hoang continued that Bonta is defending California law, which guarantees equal rights for transgender people.

“In California, transgender health care is not only legal – it’s recognized as medically necessary health care and a fundamental right,” Hoang stated. “The Trump administration’s attempt to criminalize this care and intimidate providers undermines these longstanding state protections, violates anti-discrimination laws, and places doctors and hospitals at risk of prosecution for delivering lawful care.”

The B.A.R. asked gay state Senator Scott Wiener (D-San Francisco) at last week’s rally if Bonta should file a lawsuit. Wiener demurred, saying he did not want to speak for the attorney general, but he did note that California law is clear about trans people not being discriminated against.

“The law needs to be enforced,” said Wiener.

Reached for comment August 1, Wiener stated, “Trump’s war on trans people — trying to eliminate them entirely — is destructive and un-American. Criminalizing doctors for providing health care to trans young people is particularly vile. It’s none of Trump’s damn business what health care trans kids receive with the support of their parents and health care providers. I’m grateful that Attorney General Bonta is joining with other states to put a stop to this civil rights violation.”

Updated, 8/1/25: This article has been updated with comments from state Senator Scott Wiener.