Two Federal Courts Issue Injunctions Temporarily Blocking Trump’s Executive Order Restricting Access to Gender Affirming Care

On January 28, 2025, President Trump issued Executive Order 14187, directed at limiting gender-affirming care provided to children and teenagers under the age of nineteen, alerting that the federal government “will not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another,” and “will rigorously enforce all laws that prohibit or limit” gender-affirming care. Last week, two separate federal courts issued temporary restraining orders temporarily suspending the federal government’s ability to enforce part of E.O. 14187.

E.O. 14187 takes aim at gender-affirming care, which the Trump administration has termed “chemical and surgical mutilation” and defined to include the use of puberty blockers, sex hormones, and surgical procedures to aid in aligning an individual’s appearance “with an identity that differs from his or her sex.” The order contains several provisions targeted at limiting access to gender-affirming care, including delegitimizing research from the World Professional Association for Transgender Health; limiting access to funding; directing the Secretary of HHS to “take all appropriate actions” with respect to certain laws, programs, issues, and documents (such as Medicare and Medicaid and the DSM); limiting insurance coverage for gender-affirming care for federal employee insurance programs; and directing the DOJ to prioritize enforcement and investigations relating to gender-affirming care.

Section 4 of E.O. 14187, which targets federal funding for medical institutions, has the potential to have the most immediate impact on healthcare providers—and their patients—nationwide. Specifically, Section 4 directs the heads of all executive departments and agencies that provide research or education grants to medical institutions to “immediately take appropriate steps to ensure that institutions receiving Federal research or education grants end the chemical and surgical mutilation of children.”

In the week after the issuance of E.O. 14187, PFLAG, Inc. and the American Association of Physicians for Human Rights, Inc. d/b/a GLMA: Health Professionals Advancing LGBTQ Equality filed suit in the United States District Court for the District of Maryland, and states of Washington, Minnesota, and Oregon filed suit in the United States District Court for the Western District of Washington, each seeking injunctions to block Section 4 of E.O. 14187 on the grounds that it is unconstitutional and contrary to the laws of the United States. Both courts agreed that the issuance of temporary injunctions was warranted, which will be in effect for fourteen days each unless extended by the courts. The temporary injunctions were issued on February 13, 2025, and February 14, 2025, meaning the Trump administration is blocked from enforcing Section 4 of E.O. 14187 until at least February 28, 2025.

Because the Trump administration cannot take steps to end funding to institutions that provide gender-affirming care in accordance with Section 4 while an injunction is in place, providers may continue to operate as normal without risk to federal funding. Shipman & Goodwin is closely monitoring these cases and will provide updates if these injunctions are extended or if preliminary or permanent injunctions are entered.

Connecticut-based providers should also be aware of shield laws that provide protections against out-of-state investigations and prosecutions, professional discipline, civil liability, and for professional liability insurance. Connecticut shield laws apply to both reproductive and gender-affirming care, protecting medical providers who choose to continue to provide gender-affirming care even in the face of actions by the Trump administration, such as E.O. 14187.

Consistent with these shield laws, Connecticut Attorney General William Tong joined fourteen other attorneys general to reaffirm commitments to protecting access to gender-affirming care, issuing a collective statement, stating that “gender-affirming care is essential, life-saving medical treatment that supports individuals in living as their authentic selves,” and committing “to enforce state laws that provide access to gender-affirming care, in states where such enforcement authority exists.”

As new developments arise, we will continue to provide updates to both our Dobbs Decision Resource Center and our Executive Orders Resource Center. In the meantime, please contact one of the lawyers in Shipman’s Health Law practice group if you have questions or need risk management guidance as the landscape of healthcare law continues to change.