Federal Courts and Administrative Law

U.S. District Judge Mustafa Kasubhai in Oregon, a 2023 Biden appointee, granted preliminary relief to hospitals and clinicians on March 24, ruling that Health and Human Services Secretary Robert F. Kennedy Jr. exceeded his authority and skipped required rulemaking when he issued a December declaration labeling 'sex-rejecting procedures' for minors as neither safe nor effective. The lawsuit, brought by 20 Democratic-led states and Washington, D.C., challenges the declaration’s attempt to deem puberty blockers, cross-sex hormones and certain surgeries for gender dysphoria in minors as failing 'professionally recognized standards of health care.' Kasubhai rejected the administration’s claim that the document was merely a nonbinding policy statement and said HHS was effectively using a 'break it and see' approach inconsistent with the rule of law, while denying the government’s motion to dismiss. The ruling temporarily bars the federal government from enforcing the declaration against the plaintiff states’ providers while Kasubhai prepares a written opinion that will spell out his legal reasoning in more detail. The case is an early test of how far the Trump administration can go in reclassifying gender-affirming care through executive action, and it underscores the increasingly central role of federal courts in refereeing medical and cultural fights over transgender youth care.