A coalition of Democratic-led states has taken the Trump administration to court, accusing federal health officials of attaching unlawful strings to massive public funding programs in a move they say targets transgender Americans.
Twelve states filed a lawsuit in federal court in Rhode Island, arguing that the U.S. Department of Health and Human Services (HHS) is threatening to cut off vast sums of money to states, hospitals, universities, and research institutions unless they comply with new grant conditions rooted in a recent presidential directive. The states contend those conditions would compel discrimination and upend long-standing civil rights protections.
At the heart of the dispute is an executive order signed last year by President Donald Trump directing federal agencies to stop funding what it described as “gender ideology” and to formally recognize only two sexes, male and female. Following that order, health agencies under HHS revised grant terms to require recipients to certify compliance with a narrow interpretation of Title IX, the federal law prohibiting sex discrimination in education.
According to the lawsuit, those revised conditions are not limited to new grants but are being applied retroactively, exposing recipients to canceled funding, demands for repayment, and even civil or criminal penalties for past conduct that was previously permitted.
The states argue that HHS has overstepped its authority by rewriting the rules after funds were already awarded, intruding on Congress’s constitutional power over federal spending and offering no coherent explanation for its abrupt shift in how Title IX is interpreted.
New York’s attorney general, who is leading the challenge, said the policy puts healthcare services, critical research, and education programs at risk, all in service of denying recognition and dignity to transgender people.
Federal health agencies named in the suit include the Centers for Medicare & Medicaid Services and the National Institutes of Health, both of which have adopted the new funding conditions in recent months.
HHS declined to comment directly on the litigation and referred questions to the White House. A spokesperson for the administration defended the policy, saying the government intends to use all available executive authority to prevent federal funds from supporting gender-affirming medical care for minors.
Alongside New York, the states bringing the case include California, Colorado, Delaware, Illinois, Michigan, Minnesota, Nevada, Oregon, Rhode Island, Vermont, and Washington. The lawsuit asks the court to block enforcement of the new grant conditions and to reaffirm limits on executive power over federal funding.
