In the United States, a coalition of 19 states and the District of Columbia initiated a legal action against the U.S. Department of Health and Human Services (HHS) on December 20, 2025. The lawsuit was prompted by a declaration from HHS, which stated that certain gender-affirming treatments, including puberty blockers, hormone therapy, and surgeries, are unsafe and ineffective for children and adolescents experiencing gender dysphoria. This legal action was filed in the U.S. District Court in Eugene, Oregon, and is viewed as part of an ongoing conflict regarding the administration's stance on transgender healthcare for minors. The HHS declaration has significant implications for healthcare providers, as it warned that practitioners could be excluded from federal health programs such as Medicare and Medicaid if they were to provide gender-affirming care. The lawsuit contends that this declaration is not only inaccurate but also unlawful, and it aims to halt its enforcement. New York Attorney General Letitia James, who is leading the lawsuit, asserts that the Secretary of HHS cannot unilaterally alter medical standards simply by publishing a document online. The basis of HHS's declaration stems from a peer-reviewed report suggesting that greater emphasis should be placed on behavioral therapy rather than broad access to gender-affirming care for youth. This report questioned the established standards for treating transgender youth put forth by the World Professional Association for Transgender Health, raising concerns about adolescents' ability to provide informed consent for life-altering treatments. The medical community, including significant medical organizations such as the American Medical Association, has heavily criticized this report, emphasizing their opposition to any restrictions on transgender care for young individuals. The recent announcement by HHS came amidst a multifaceted approach to limit access to gender-affirming healthcare for children and adolescents, which is part of ongoing efforts from the administration to restrict transgender rights on a national level. Despite these federal moves, many major medical providers have begun to limit gender-affirming care for young patients in response to the political climate, even in states where such care is legally protected. Overall, the legal battle highlights the tensions between federal government policies and advocates who maintain that gender-affirming care is essential for the well-being of transgender youth.