Rhode Island Attorney General Peter Neronha has joined a coalition of 16 states and Washington seeking to stop the Trump administration from disallowing treatments for transgender youth, including surgeries and drug-based treatments like puberty blockers.
The 111-page complaint filed Friday in U.S. District Court for the District of Massachusetts against President Donald Trump and U.S. Attorney General Pam Bondi targets Executive Order 14,187 — signed by Trump within a week of his taking office — and enforcement actions taken since then by the U.S. Department of Justice (DOJ). The multistate coalition is seeking an injunction to block the order’s enforcement.
The Jan. 28 executive order directed federal agencies to halt funding, insurance coverage, and institutional support for gender-affirming care for individuals under the age of 19. Gender-affirming care can include pharmacological and surgical treatments, or, in the order’s language, “chemical and surgical mutilation.”
The Federal Register titles the executive order as “Protecting Children From Chemical and Surgical Mutilation,” but the multistate suit calls it the “Denial of Care Order” and criticizes it as an unlawful maneuver that intimidates providers and overrides states’ own authority to regulate medical treatments.
On April 22, Bondi issued a directive asking federal prosecutors to investigate providers for off-label use of puberty blockers and hormone therapy, encouraging whistleblower suits, and purging federal acknowledgement of transgender health guidelines from the World Professional Association for Transgender Health (WPATH). The six-page memo also proposed legislation that would enable families to retroactively sue providers for transgender surgeries, with eventual penalties modeled on existing ones for female genital mutilation.
The suit cites a mix of 13 providers, health systems, and insurers nationwide that discontinued, paused, or scaled back gender-affirming care in the wake of Bondi’s order. It also cited California insurer Kaiser Permanente’s announcement that it will stop covering gender-affirming surgeries on Aug. 29, 2025,
“This dangerous trend will be a stain on our Nation’s history, and it must end,” Trump’s executive order reads. “Countless children soon regret that they have been mutilated and begin to grasp the horrifying tragedy that they will never be able to conceive children of their own or nurture their children through breastfeeding.”
Neronha, in a statement Friday, rejected that interpretation.
“Let’s get clear on what gender affirming care is, and what it isn’t,” Neronha said. “Gender affirming care is medically necessary, and in some cases, lifesaving treatment for kids who, with their parents, are just trying to find their way in this world, no different than anyone else.”
“The decision of whether or not a child should receive gender affirming care needs to be made between the child, their family, and their doctor — not the federal government,” Neronha continued. “It isn’t a decision these kids and their families take lightly, it isn’t mutilation, and it isn’t dangerous.”
The lawsuit marks the 32nd multistate lawsuit against the Trump administration that Neronha has led or joined.
Attorneys general involved in the latest lawsuit over gender affirming care include those in California, Connecticut, Delaware, Hawai’i, Illinois, Maine, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, New York and Wisconsin. Also a plaintiff on behalf of his state is Pennsylvania Gov. Josh Shapiro.
The lawsuit cites recent estimates of the trans population in the U.S. as about 1.3 million adults, or 0.5% of the nation’s population. In the age group of 13- to 17-year-olds, that number is proportionally much higher, with about 1.4%, or 300,000 youths, identifying as transgender.
“In all Plaintiff States, residents who are 18 years old are legal adults who have legal authority to make medical decisions for themselves,” the suit reads.
The lawsuit notes that puberty blockers and hormone therapy are prescribed based on clinical appropriateness and a patient’s age, while interventions like chest masculinization, also known as top surgery, are uncommon and reserved for older teenagers and adults. Children who haven’t entered puberty are only recommended for social transition, which can consist of changes in name, pronouns, or clothing, the lawsuit states
The federal narrative, however, cites examples of recipients later regretting their choice, such as the case of Chloe Cole, a California teenager who underwent a double mastectomy at 15 and has since publicly detransitioned. Data from a 2021 meta-analysis of nearly 8,000 patients who received gender-affirming surgery has regret rates of less than 1%.
Included in Neronha’s Friday statement were sentiments of support for the suit from Care New England and the Rhode Island Medical Society.
No hearing date has been scheduled yet, but the case has been assigned to District Judge Angel Kelley in the U.S. District Court for the District of Massachusetts.
This story was originally published by the Rhode Island Current.
