On February 7, Washington Attorney General Nick Brown filed a multistate federal lawsuit to stymie President Trump's executive order that seeks to end federal funding to medical institutions that provide gender-affirming care. Oregon and Minnesota are the other states involved, and three doctors joined as plaintiffs.

"This order is part of a larger political effort to strip away civil rights from entire communities. The president's cruelty is on full display with this dehumanizing executive order, along with his disdain for the Constitution," Brown said in a press release. "His actions are harming Washington's youth, parents, and healthcare providers."

Trump's executive order, issued on January 28, directs federal agencies to cut off research and education grants to medical institutions, such as hospitals and medical schools, that provide gender-affirming care to people under 19 years of age. It has already had an immediate and severe effect on Transgender and Gender-Diverse people, their families, and their providers.

The states' suit was filed in the US District Court for the Western District of Washington.

Effects of the executive order
The plaintiffs argue that Trump's executive order violates both the Fifth and Tenth Amendments, and that his decision overrules funding Congress has already authorized.

It states that Trump's order will terminate over $1 billion of federal funding to the states' medical schools and hospitals, which is used to research and treat hundreds of conditions, including cancer, AIDS, diabetes, substance use disorder, mental health challenges, autism, and aging, among others.

"The same Order... threatens baseless criminal prosecutions against providers by weaponizing a statute prohibiting female genital mutilation of minors, despite the fact that transgender minors do not receive gender-affirming genital surgery, and despite that statute's exclusive application to 'non-medical' procedures and express exceptions for medical care provided by a licensed practitioner," the complaint reads.

Noting how UW is a "world-class medical school," it further adds that the UW School of Medicine receives about half a billion dollars in federal research and education grants, among others, and that Washington state — which operates the state's Medicaid and public health programs — covers about 1.9 million people. Minnesota does likewise, providing care to approximately 1.3 million people.

The complaint also alleges that Trump's order violates the constitutional separation of powers by usurping Congress's legislative prerogative. It states that no federal funding received by these medical institutions, including the UW School of Medicine, was made with the promise that they would deny gender-affirming care to patients under 19 years of age.

The attorneys general and plaintiffs argue that the order also violates the Tenth Amendment's regulation of medical profession, which is a core and traditional exercise of the states's police powers.

"The President cannot unilaterally, and without and Congressional authorization whatsoever, interfere with the States' prerogatives by criminalizing the provision of safe, effective, and necessary medical care," according to the complaint.

The states' suit also claims that Trump's order violates the principle of equal protection under the Fifth Amendment, since it targets one vulnerable group for mistreatment, stating, "It singles out for restriction and criminalization medical treatment that affirms a patient's gender if inconsistent with that patient's sex. It is an act of malice against transgender and gender-diverse people [and] is not supported by an exceedingly persuasive justification (let alone any legitimate government interest), and this Court should declare it unlawful and enjoin Defendants from implementing and enforcing it."