A federal judge overturned the Trump administration’s policy that threatened to cut Medicare and Medicaid funding to hospitals providing gender-affirming care to minors—but advocates say health centers in Illinois have not resumed services for transgender youth.
The ruling, issued April 18 by U.S. District Judge Mustafa Kasubhai, removes the threat of losing federal funding that added pressure on hospitals after many had already scaled back gender-affirming care. But it does not require providers to resume services.
Asher McMaher, founder and executive director of Trans Up Front Illinois, said the ruling sets an important legal precedent. But services for trans youth remain in limbo.
“We’re not magically seeing hospitals reopen this care,” McMaher said. “We’re not magically seeing hospitals stand up and tell these families to reschedule and come back to them. This is step one—with many more steps to go.”
Other Illinois advocates welcomed the ruling as a legal victory.
Channyn Lynne Parker, CEO of Equality Illinois, said it reinforces that federal agencies cannot bypass science, process and states’ rights to “bully doctors out of caring for their patients.”
She added it’s also a reminder the directive “was never really about medicine—it was about power.”
Ed Yohnka, director of communications and public policy for the. ACLU of Illinois, said the administration’s actions caused real harm to transgender youth and their families.
Yohnka said the group hopes the ruling will “create an environment in which hospitals and clinics will feel empowered to resume” gender-affirming care.
The ruling stems from a lawsuit led by Illinois Attorney General Kwame Raoul and a coalition of 22 states challenging a Dec. 18 declaration warning providers they could lose federal funding for offering gender-affirming care to minors.
The declaration, from Health and Human Services Secretary Robert F. Kennedy, Jr., asserted that certain forms of gender-affirming care were “unsafe and ineffective,” raising the possibility that providers could face penalties under federal health care programs.
In his ruling, Kasubhai, of Oregon, blasted the directive as “one of a long list of examples of how a leader’s wanton disregard for the rule of law causes very real harm to very real people.”
In a statement, Raoul called it a win for the rule of law.
“This is another sharp reminder to the Trump administration that Illinois and our partner states will not stop fighting back against the unlawful and cruel targeting of transgender youth and their medical providers,” Raoul said.
But McMaher said the ruling alone is not enough—and that elected officials must now push hospitals to restore care.
In other states, attorneys general have already taken that step.
In Minnesota, Attorney General Keith Ellison has told providers they should continue offering gender-affirming care despite these federal threats—and some hospitals have since resumed those services.
California Attorney General Rob Bonta also said after the ruling that “providers in California can and should continue to provide the care their patients count on without fear of unjust retaliation.”
McMaher said Raoul and other elected officials in Illinois should follow suit.
Raoul has not issued public guidance urging hospitals to resume gender-affirming care for youth—and his office did not answer questions from Windy City Times about whether he plans to do so, instead highlighting his record defending transgender rights.
“In August 2025, we were proud to co-lead a multistate lawsuit challenging the Trump administration’s unlawful actions targeting providers of medically necessary care for transgender youth,” Raoul’s office said, noting it has also submitted amicus briefs defending transgender rights, including military service, passport access and medical privacy.
McMaher said without clear direction from state leaders, hospitals have little incentive to resume services—meaning the ruling “doesn’t change anything yet.”
“We’re not seeing a follow through,” McMaher said. “We need leaders to pick up the phone and urge hospital systems to reopen their programs so each one of these kids has access to care.”
Representatives from UChicago Medicine, Rush University Medical Center and Lurie Children’s Hospital—which have all suspended gender-affirming care for youth—did not return requests for comment.