Judge Blocks Trump Trans Ban Nationwide, Slams Reliance On Cass Review

The ruling applies nationwide, and should allow hospitals that temporarily paused care to resume.

Photo by Wesley Tingey on Unsplash

Today, a federal judge in the United States District Court for the District of Maryland blocked the enforcement of President Donald Trump’s executive order prohibiting gender-affirming care for individuals under 19. The preliminary injunction applies nationwide, marking a stark contrast to an earlier lawsuit filed by Minnesota, Oregon, and Washington, which only secured protections in those three states.

The executive order, titled “Protecting Children from Chemical and Surgical Mutilation,” lacked a clear enforcement mechanism, relying instead on vague threats to strip federal funding from noncompliant institutions. In response, Judge Brendan A. Hurson, a Biden appointee, issued a clear order halting all enforcement efforts and mandating the reimbursement of any federal funds that had been withheld.

The initial complaint, PFLAG v. Trump, was filed on February 4, weeks after Trump issued a wave of executive orders targeting transgender rights. Brought by Lambda Legal and the American Civil Liberties Union, the lawsuit names multiple federal officials as defendants. The plaintiffs include several anonymous families whose children would have been denied gender-affirming care under the order, as well as legal adults who also fall within its scope.

The complaint outlines the devastating impact of the ban, arguing that it would deprive countless transgender people of life-saving healthcare, jeopardizing both their physical and mental well-being. It also highlights the unlawful nature of Trump’s actions, which bypassed the legislative process entirely and consolidated power within the executive branch.

Judge Hurson largely sided with the plaintiffs in his full decision, stating that they have demonstrated a "strong likelihood that they will succeed on the merits of all three claims that are the subject of their motion for a preliminary injunction." He further ruled that Trump’s actions are explicitly unconstitutional, citing legal precedents from the Clinton administration.

"Plaintiffs have also shown they will face irreparable harm if the challenged portions of the Executive Orders are not enjoined because they have shown a strong likelihood of success on their constitutional claims… and also because they have provided unassailable documentation that they are suffering from 'diminished access to high-quality health care suited to [their] needs,'" Hurson wrote.

Hurson methodically dissects the arguments presented by both the plaintiffs and the defendants, drawing from judicial precedent to underscore the Trump administration’s lack of legal standing to enforce its executive orders on transgender healthcare. He concludes that Trump’s actions violate Articles I and II of the Constitution, calling them a blatant attempt to sidestep the legislative process established by the Founding Fathers.

The ruling also dismantles the administration’s post-hoc justifications for the executive orders, finding that their cited sources fail to support the sweeping policy changes. In some cases, Hurson notes, the studies cited are so flawed that they cannot be used to justify meaningful policy decisions. In one section, Hurson slams the government’s reliance on the Cass Review, noting that it “does not even support a complete ban on gender-affirming care for minors.” He also cites another judge that stated the review is “unfounded” and “lacks clinical experience or research qualifications.”

Excerpt from judicial decision

The judge further rejects the administration’s request for a limited injunction, stating that "a more limited injunction would allow the coercive impact of the challenged portions of the Executive Orders to persist and would effectively deny the named Plaintiffs the relief they seek."

“Again, the court has ruled to ensure hospitals, doctors, and healthcare professionals in our communities can continue the work to keep our families healthy. Transgender people and their supportive parents and families are good and decent people who deserve the freedom to be themselves and to thrive. PFLAG National and our vast network of chapters, members, and supporters will continue to ensure that love leads in this fight for justice for transgender people,” said Brian K. Bond, Chief Executive Officer of PFLAG National in a statement emailed to Erin in the Morning.

“Today’s decision provides relief to transgender young people, their families, and their medical providers who have been thrown into chaos by this administration,” said Joshua Block, Senior Staff Attorney for the ACLU’s LGBTQ & HIV Project in a separate statement emailed to Erin in the Morning. “This order from President Trump is a direct effort to threaten the well-being of transgender people while denying them equal protection under the law, enacted by coercing doctors to follow Trump’s own ideology rather than their best medical judgment. As Judge Hurson has said himself, it is hard to fathom a form of discrimination more nefarious than that which pretends the group of people being targeted doesn’t even exist.”

These legal decisions have had an immediate and far-reaching impact on gender-affirming care nationwide. While many hospitals initially complied with Trump’s executive order, swift judicial intervention and mass protests forced many to reverse course, resuming care for those under 19. Time and again, collective action has proven effective in challenging institutional complicity—just as protesters at the University of Cincinnati successfully fought back against a restrictive bathroom ban, mass resistance is making it harder for anti-LGBTQ+ policies to take hold. The fight ahead will be long, but these victories make one thing clear: the future is not hopeless.