President Donald Trump’s order threatening to block federal funding for hospitals providing gender-affirming care for transgender youth is now indefinitely on hold under a Seattle judge’s order late Friday.
U.S. District Court Judge Lauren King’s preliminary injunction is the first in the country applying to the executive order. It comes two weeks after she issued a 14-day pause on the president’s directive. The injunction is not nationwide and only blocks the executive order’s enforcement in four states involved in the lawsuit, including Washington.
King, a Biden appointee, filed the order late Friday night, just hours before her temporary pause was set to lapse.
“The Court’s holding here is not about the policy goals that President Trump seeks to advance; rather, it is about reaffirming the structural integrity of the Constitution by ensuring that executive action respects congressional authority,” King wrote. “This outcome preserves an enduring system of checks and balances that the Founders considered to be ‘essential to the preservation of liberty.’”
The injunction aligns with all of the states’ requests, except it doesn’t block one section of the executive order on Department of Justice enforcement of federal law barring female genital mutilation. King ruled the states don’t have standing to challenge that provision “because no credible threat of prosecution exists.”
Washington, Oregon and Minnesota, with three anonymous doctors representing themselves and their patients, initially brought the lawsuit against the Trump administration. Colorado has since joined, as well.
“The president’s disregard for the Constitution is obvious and intentional,” Washington Attorney General Nick Brown said in a statement late Friday. “But once again, states and the courts have stepped up to affirm the rule of law and the values that hold us together as a nation.”
Another judge in Maryland had issued a temporary restraining order in a similar case. This week, that judge extended his block to next Wednesday. Plaintiffs there have asked for a preliminary injunction similar to Washington’s.
Trump’s executive order, entitled “Protecting Children from Chemical and Surgical Mutilation,” states “it is the policy of the United States that it will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another.”
Trump’s order seeks to end grants to hospitals and medical schools providing gender-affirming care to young people under age 19.
The states, led by Washington, argue the order is unconstitutional.
They say the order violates the equal protection guarantee in the 5th Amendment to the U.S. Constitution, and the 10th Amendment by trying to dictate state medical care.
Withholding funding already appropriated by Congress would also violate the separation of powers, the states argued.
The Department of Justice, on the other hand, notes the order instructs agencies to act “consistent with applicable law,” so it can’t be illegal. The administration’s attorneys also say the equal protection arguments fail because the president is “safeguarding children from potentially dangerous, ineffective, and unproven treatments.”
One of the doctors wrote in court filings that after King issued the two-week temporary restraining order earlier this month their coworkers cried “tears of joy.”
“I have been carrying the heavy weight of knowing that my patients could lose their health care at any moment. I have seen many of my colleagues struggle as their institutions chose to shutter their gender-affirming care programs as a result of the Executive Order,” the physician wrote. “After the TRO was issued, I felt like I could finally breathe again.”
Gender-affirming care for youth can include puberty blockers, hormone therapy and surgery. Trump has long argued, with little evidence, that young people regret transitioning. Advocates counter that families don’t take lightly the decision to get such care.
The president’s order calls gender-affirming treatment a “dangerous trend” that will be a “stain on our Nation’s history.”
King asked Department of Justice attorney Vinita Andrapalliyal point-blank what gender dysphoria is. After some back-and-forth, Andrapalliyal acknowledged “that is a condition.”
“You have no reason to dispute the scientific legitimacy of this diagnosis, correct?” King said.
The executive order is part of a broader effort by the Trump administration to limit how transgender people participate in American society.
Other orders aim to ban trans women from playing women’s sports, prohibit transgender people from serving in the military and direct incarcerated transgender women to be transferred to men’s prisons. Trump has also declared the federal government would only recognize two sexes.
King’s injunction will remain in effect until the case is resolved. If the Justice Department appeals, the 9th U.S. Circuit Court of Appeals would have jurisdiction. Democratic presidents appointed a majority of the circuit court’s judges.
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