OAKLAND — California Attorney General Bonta today issued guidance for healthcare facilities and providers regarding gender-affirming care following the U.S. District Court for the District of Oregon’s ruling blocking U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr.’s December 18, 2025, declaration (Kennedy Declaration). The Kennedy Declaration claims that gender-affirming care fails to meet professionally recognized standards of care and that, as such, HHS may disqualify any doctors or hospitals that provide such care from federal healthcare programs like Medicare and Medicaid. In today’s guidance, Attorney General Bonta re-affirms that gender-affirming care remains legal in California.  

“The district court has rightfully ruled to block the Trump Administration’s unlawful attempt to de-legitimize and restrict access to gender-affirming care,” said Attorney General Bonta. “This ruling protects transgender Americans’ rights to receive crucial care from providers they trust without unfair roadblocks. Gender-affirming care remains legal, and Trump’s proposed rules targeting providers of gender-affirming care are just that: proposals. If the Administration tries to advance those proposals, we will fight to ensure they do not go into effect either. Right now, providers in California can and should continue to provide the care their patients count on without fear of unjust retaliation. We will continue to safeguard the law and protect the ability of transgender individuals to prosper as their authentic selves.”

On December 23, 2025, Attorney General Bonta joined a coalition of 18 other attorneys general and one governor in filing a lawsuit challenging the Kennedy Declaration. 

On April 18, 2026, the district court published a written decision holding that the Kennedy Declaration is unlawful under the Administrative Procedure Act and has no legal effect. The district court issued a permanent injunction prohibiting HHS from enforcing the Kennedy Declaration or any materially similar policy that supersedes states’ professionally recognized standards for gender-affirming care. 

In the decision, the district court explained the many ways that the Kennedy Declaration violates the law. The court observed that it could “scarcely recall an [Administrative Procedure Act] action that has come before it in which the agency’s action was so clearly unlawful,” noting “that in the area of administrative law, a consistent theme has emerged in which agencies under the current administration have adopted a ‘break it and see if they can get away with it’ approach.” The court concluded that “Defendants have failed to invoke any statutory authority that authorizes the Kennedy Declaration, much less an ‘unmistakably clear’ one that would be required to supplant states’ authority to regulate medical conduct.” 

Background

Attorney General Bonta is committed to defending transgender individuals’ right to safely access medically necessary gender-affirming care and to protecting medical providers’ ability to continue providing medically necessary care for their patients. In August 2025, Attorney General Bonta co-led a multistate coalition in filing a lawsuit that challenges the Trump Administration’s executive order attempting to restrict the provision of medically necessary gender-affirming care for individuals under the age of 19 by threatening providers with civil and criminal prosecution under specious legal theories. In late 2025, he filed amicus briefs opposing the U.S. Department of Justice’s subpoenas for private medical records, including patient records, related to gender-affirming care at Children’s Hospital Colorado, Boston Children’s Hospital and Children’s Hospital of Philadelphia. Earlier this year, he joined a coalition of 19 attorneys general in filing amicus briefs opposing efforts by the U.S. Federal Trade Commission to undermine the independence of scientific organizations that support medically necessary gender-affirming care.