A federal judge in Seattle issued a preliminary injunction blocking the Trump administration from withholding federal funds from hospitals in Washington, Oregon, Minnesota, and Colorado that offer gender-transition treatment to those under 19. Judge Lauren J. King concluded that the administration’s policy likely violates constitutional rights, emphasizing the necessity of checks and balances. The ruling comes amid broader efforts by the administration to restrict transgender recognition and funding for gender-related medical treatments. Judge King noted that the states involved could face significant financial losses without the injunction and emphasized the potential harms to transgender youth denied such treatments.
A federal judge in Seattle granted a preliminary injunction on Friday, preventing the government from withholding federal funds from hospitals in four states that provide gender-transition treatments for individuals under 19. This ruling is a setback for a significant aspect of the Trump administration’s broader initiative to restrict the formal acknowledgment of transgender identities.
Judge Lauren J. King had previously issued a temporary restraining order in February, concluding that the states and doctors challenging the administration were likely to succeed in arguing that President Trump’s plan violates constitutional principles. The injunction issued on Friday indicated that the government faces considerable legal hurdles to implement its plans.
Judge King stated that Trump’s directive potentially breaches the separation of powers between the executive and legislative branches, as well as equal protection guarantees under the Fifth Amendment for youth in need of gender-related medical treatments. However, she rejected the states’ challenge concerning a section of the order that instructs the Justice Department to investigate providers under a law prohibiting female genital mutilation, noting that “no credible threat of prosecution exists” in these instances.
“This ruling is not about the policy objectives that President Trump aims to pursue; it is about upholding the structural integrity of the Constitution by ensuring that executive action respects congressional authority,’’ Judge King remarked. “This decision maintains a vital system of checks and balances deemed ‘essential to the preservation of liberty’” by the nation’s founders.
The injunction issued by Judge King, who was appointed by former President Joseph R. Biden Jr., pertains exclusively to medical providers in Washington, Oregon, Minnesota, and Colorado—states that have joined forces with three physicians from the University of Washington School of Medicine to file the lawsuit.
In a separate case, a judge in Maryland has temporarily ordered the Trump administration to maintain federal funding for all providers nationwide offering youth gender medicine. A more comprehensive ruling is anticipated in that case before the emergency order expires next week.
This ruling is the second preliminary injunction in ongoing legal challenges against Mr. Trump’s attempts to prevent government entities and taxpayer-funded organizations from supporting gender transition or recognizing individuals based on their gender identities. Last month, another federal judge obstructed Mr. Trump’s order to withhold gender-transition medical care for federal inmates and to house transgender women alongside male prisoners.
The administration aims to exclude transgender women and girls from competing in women’s sports, prohibit openly transgender individuals from serving in the military, cease recognizing transgender identities on passports, and eliminate references to gender identity within executive departments and agencies.
The medical treatment order, titled “Protecting Children From Chemical and Surgical Mutilation,” asserts that its purpose is to shield young individuals from potential long-term consequences that they might regret after undergoing these treatments. It mandates that agencies withhold funding from medical providers offering puberty blockers, hormone therapy, and surgeries to individuals under 19 for gender transition.
Following the issuance of the order, several hospitals halted these treatments, and the lawsuit indicates that others may follow suit. A White House press release from early February claimed that the order was “already achieving its intended effect,” citing multiple announcements from hospitals.
Judge King’s injunction also prohibits the government from enforcing aspects of a previous order from Mr. Trump that states grant funding for research or education is not to endorse “gender ideology,” which it defines as the “false claim that males can identify as and thus become women and vice versa.”
Young individuals pursuing transition treatments in many Republican-led states have increasingly found it necessary to seek care in other locations. Since 2021, as the debate deepens over the appropriateness of medical transition for minors, 24 states have enacted bans on such treatments. In December, the Supreme Court heard oral arguments concerning a Tennessee law that prohibits transition treatments for minors, with indications that the justices may favor upholding that law.
In recent years, various European nations have restricted these treatments following scientific evaluations, while the American Academy of Pediatrics has announced it is conducting its own assessment of the data. Nevertheless, the academy, along with most significant medical organizations in the U.S., continues to advocate for youth gender medicine as effective in alleviating the psychological distress often reported by young transgender individuals when their physical appearance does not align with their gender identity.
Mr. Trump’s directive aims to exert financial pressure on clinics, primarily in Democrat-led states, that persist in providing these treatments.
In her ruling, Judge King indicated that the states demonstrated they would forfeit hundreds of millions in federal funding, leading to “devastating repercussions for a wide range of medical research and treatments,” if the injunction were not granted. She further emphasized that transgender youth denied access to these treatments would suffer “dire harms.”