Minnesota Attorney General Keith Ellison and a coalition of 22 states secured a written federal court order on April 21 blocking an effort by the U.S. Department of Health and Human Services (HHS) to restrict healthcare providers from offering gender-affirming care to youth. The decision follows a lawsuit filed in December 2025 against HHS Secretary Robert F. Kennedy, Jr., challenging his declaration that threatened providers of such care and sought to limit access for young people.
The issue is significant as it addresses whether federal agencies can override state authority regarding standards of medical care, particularly in the area of treatment for transgender adolescents. The court’s order permanently prevents HHS from enforcing or reissuing the declaration, protecting both patients and healthcare providers from what plaintiffs described as unlawful federal intervention.
In its written order, the court stated: “Unserious leaders are unsafe. There is nothing more serious than our leaders’ dedication to the rule of law so that we might maintain the integrity of our constitutional democracy. This case highlights a leader’s unserious regard for the rule of law… Secretary Kennedy’s unlawful declaration harmed children. This case illustrates that when a leader acts without authority and in the absence of the rule of law, he acts with cruelty.” The ruling emphasized that Secretary Kennedy failed to follow proper procedures for issuing new rules and instead caused “chaos and terror” by threatening immediate funding cuts.
Attorney General Ellison said: “Gender-affirming care is healthcare, and only patients and doctors, and parents when appropriate, should be making those decisions… I’m gratified that the court’s written order and judgment so soundly reject the extraordinary steps the Trump Administration took to skirt the rule of law… It’s particularly important that the court took the step of permanently blocking Kennedy and HHS from trying anything like this in the future.” According to Ellison’s office, five days after HHS issued its declaration labeling certain forms of gender-affirming care as “unsafe,” Minnesota joined other states in suing on grounds including lack of legal authority by HHS.
A federal judge granted summary judgment for Ellison’s coalition at a March hearing, initially issuing an oral ruling before expanding on its reasoning in writing on April 18. The final order vacates Kennedy’s declaration entirely; declares that HHS cannot unilaterally set national standards overriding state rules; prohibits exclusionary action against providers; and blocks similar attempts by federal officials moving forward.
Attorneys general from California, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York, Oregon (where suit was filed), Rhode Island Vermont Washington Wisconsin—and Pennsylvania’s governor—joined Minnesota in this litigation.
