Trump Administration’s Efforts to Cut Funding to Entities Providing Gender Affirming Care Remain Blocked

On February 28, 2025, U.S. District Court Judge Lauren King issued a preliminary injunction in State of Washington et. al. v. U.S. Department of Justice et al related to the Trump Administration’s Executive Orders impacting gender affirming care: Executive Order 14168 (“Defending Women…”) and Executive Order 14187 (“Protecting Children…”). This decision extends the relief granted in a temporary restraining order (“TRO”) the court issued on February 14, 2025. The protections of the preliminary injunction extend only to Washington, Minnesota, Oregon, and Colorado, the four states that together brought the lawsuit against the U.S. Department of Health and Human Services (“HHS”) and other federal agencies responsible for carrying out the Executive Orders.

In granting the preliminary injunction—as to all but Section 8(a) of Executive Order 14187—Judge King found the Plaintiff states adequately demonstrated that the Executive Orders threaten immediate and irreparable injuries including “the loss of hundreds of millions of dollars in federal funding (as well as its devastating consequences for all manner of medical research and treatment) … and dire harms to transgender youth deprived of gender-affirming care.”

Finding the Plaintiffs would likely succeed on the merits of their case, Judge King concluded the Executive Orders likely violate bedrock Constitutional protections and principles, including those guaranteed by the Fifth and Tenth Amendments. In an impermissible “end run around separation of powers,” the Executive Orders “purport to condition congressionally appropriated funds in a manner that effectively rewrites the law and . . . usurps Congress’s legislative role.” Judge King further determined that the Executive Orders “facially discriminate on the basis of transgender status and sex.”

Pending a final decision on the merits of the case, Judge King’s preliminary injunction blocks the United States from:

• taking steps to ensure that institutions receiving Federal funds do not provide gender affirming care to individuals under the age of nineteen.
• conditioning or withholding federal funding based on a health care entity’s or health professional’s provision of gender affirming care.

The court also ordered the United States to:

• provide written notice of the order to all Defendants and agencies and their employees, contractors, and grantees by March 6, 2025.

The nationwide TRO issued by a Maryland federal district court in PFLAG Inc. et al. v. Trump, et al. was extended through March 5, 2025, and can be further extended by the court beyond that date. That TRO restricts the defendants—which include HHS and its component Health Resources and Services Administration (“HRSA”)—“from conditioning or withhold federal funding based on the fact that a healthcare entity or health professional provides gender affirming medical care to a patient under the age of nineteen.”

As we continue to monitor developments in this area, please keep our team posted on your health center’s experience.

For questions concerning Executive Orders impacting gender affirming care, please contact Partners Molly S. Evans, Rosie Dawn Griffin and Dianne K. Pledgie.