The U.S. District Court for the Western District of Washington issued a temporary restraining order (TRO) prohibiting Executive Branch officials from enforcing or implementing portions of Executive Order 14187, which seeks to defund and criminalize gender-affirming care for transgender individuals aged 18 and younger. As the Court explained in a memorandum opinion supporting the TRO, the Executive Order signed on January 28, 2025, is titled “Protecting Children from Chemical and Surgical Mutilation,” and is one of many initiatives by the Trump Administration targeting transgender individuals. The Executive Order purports to define several forms of gender-affirming medical care for transgender individuals as “chemical and surgical mutilation,” “defund[s]” those treatments by ordering the head of every relevant agency to “immediately … ensure that [medical] institutions receiving Federal research and education grants end” the treatments for individuals aged 18 years and younger (including 18-year-old adults), and directs the Attorney General to prioritize enforcement of federal criminal “protections against female genital mutilation.”
On February 7, 2025, the States of Washington, Oregon, and Minnesota, and three physicians suing under pseudonyms filed a lawsuit challenging the Executive Order and sought a temporary restraining order to prevent ongoing irreparable harm. Altshuler Berzon LLP filed an amicus brief in support of the plaintiffs’ TRO motion on behalf of Service Employees International Union (SEIU). The amicus brief emphasized the irreparable harms to healthcare providers caused by the Executive Order and placed the Order into the larger context of the Trump Administration’s discriminatory attacks on transgender individuals and violations of basic separation of powers principles.
The District Court issued a TRO followed by a memorandum opinion holding that plaintiffs are likely to succeed on all three of their claims: (1) the Executive Order violates the separation of powers by usurping Congress’s spending clause power; (2) the Order violates the equal protection requirements of the Fifth Amendment by unlawfully discriminating on the bases of both transgender status and sex; and (3) the Order violates the Tenth Amendment by purporting to criminalize medical treatments, usurping the States’ reserved powers to regulate the practice of medicine. The Court also held that healthcare providers and their patients in the plaintiff States would suffer irreparable harm without a TRO.