Judge Blocks Trump’s Plan to End Funds for Trans Youth Health Providers in 4 States

A federal judge in Seattle issued a preliminary injunction late Friday blocking the government from withholding federal funds from hospitals in four states that offer gender-transition treatment for people under 19. The decision dealt a setback to a key part of the Trump administration’s broad effort to limit the official recognition of transgender identity.

The judge, Lauren J. King, had issued a temporary restraining order in February, finding that the states and doctors suing the administration would most likely prevail in their claim that President Trump’s plan is unconstitutional. The injunction on Friday night signaled that the government will need to overcome substantial legal challenges to carry it out.

Judge King said that Mr. Trump’s order likely violates the separation of powers between the executive branch and Congress, and the Fifth Amendment’s equal protection guarantees to youth seeking gender-related treatments. But she denied the states’ challenge of a section of the order directing the Justice Department to investigate providers under a law that bans female genital mutilation, stating that “no credible threat of prosecution exists” in such cases.

“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,’’ Judge 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 by Judge King, an appointee of former President Joseph R. Biden Jr., applies only to medical providers in Washington, Oregon, Minnesota and Colorado, the states that brought the suit along with three doctors affiliated with the University of Washington School of Medicine.

In a separate lawsuit, a judge in Maryland has temporarily instructed the Trump administration to keep federal funding in place for all providers in the country who offer youth gender medicine. A more considered ruling is expected in that case before its emergency order expires next week.

The ruling is the second preliminary injunction in a string of legal challenges to Mr. Trump’s effort to block government agencies and taxpayer-funded institutions from supporting gender transition, or from recognizing people based on their gender identities. Last month, another federal judge blocked Mr. Trump’s directive to withhold gender-transition medical treatment for federal prisoners and to house transgender women inmates with men.

The administration has sought to bar transgender women and girls from competing in women’s sports, to bar openly transgender people from serving in the military, to no longer reflect the gender identities of transgender people on passports, and to bar references to gender identity in executive departments and agencies.

The order on medical treatments, titled “Protecting Children From Chemical and Surgical Mutilation,” states that the goal is to protect young people from long-term effects that may cause them to regret undergoing the treatments. It directs agencies to withhold funds from medical providers that offer puberty blockers, hormone therapies and surgeries to people under 19 for the purpose of gender transition.

After it was issued, several hospitals stopped providing the treatments, and the lawsuit says that others may begin doing the same. A White House news release from early February stated that the order was “already having its intended effect,” and cited several announcements from hospitals.

Judge King’s injunction also blocks the government from carrying out parts of an earlier order Mr. Trump issued directing that grant funding for research or education does not support “gender ideology,’’ which it defines as the “false claim that males can identify as and thus become women and vice versa.”

Young people seeking transition treatments in most Republican-led states have already had to travel elsewhere to receive them. Since 2021, amid an intensifying fight over when medical transition is appropriate for young people, 24 states have banned the treatments for minors. In December, the Supreme Court heard oral arguments in a case involving a Tennessee law that prohibits transition treatments for minors, and the justices appeared to lean toward upholding that state’s law.

In recent years, several European countries have limited the treatments after scientific reviews, and the American Academy of Pediatrics has said that it was conducting its own review of the evidence. But the academy and most major medical groups in the United States continue to endorse youth gender medicine as effective in relieving the psychological distress that many young trans people say they experience when their bodies do not reflect their internal sense of gender.

Mr. Trump’s order is an effort to place financial pressure on clinics, largely in Democrat-led states, that continue to provide the treatments.

In her order, Judge King wrote that the states had shown that they would lose hundreds of millions of dollars in federal funding, as well as “devastating consequences for all manner of medical research and treatment,” in the absence of an injunction. She also said that transgender youth deprived of the treatments would experience “dire harms.’’