On April 18, 2026, U.S. District Judge Mustafa T. Kasubhai issued a 49-page summary judgment voiding HHS Secretary Robert F. Kennedy Jr.'s declaration banning federal funding for pediatric gender-affirming care. The opinion opens with the line: “Unserious leaders are unsafe.” The judge ruled that Kennedy had acted with “wanton disregard” for the law and that his declaration “causes very real harm to very real people.”
The Kennedy Declaration, issued December 18, 2025, claimed pediatric gender-affirming care was “neither safe nor effective” and warned that any health system providing such care would be cut off from Medicare and Medicaid. Because nearly all major U.S. hospitals depend on those programs, the declaration functioned as a national ban. Within eight days, the HHS general counsel, Mike Stuart, began referring health systems to the HHS inspector general for violating the new policy.
At least 40 health systems halted gender-affirming care under the threat. Oregon and 21 other states sued. The federal government argued in court that the Kennedy Declaration was merely “an individual's personal opinion” — an argument Kasubhai called “a bald-faced lie” and an attempt to “bully or gaslight” the court.
The judge ruled the declaration “clearly unlawful” because it violated administrative law and the Medicare statute that forbids federal officials from exercising “any supervision or control over the practice of medicine or the manner in which medical services are provided.” Kasubhai also enjoined the administration from implementing similar policies under any other names.
This is the second major court loss for Kennedy's HHS agenda. In March 2026, a federal judge blocked his overhaul of the childhood vaccine schedule as “arbitrary and capricious.” His Replimune cancer drug rejection was met with public refutation by oncologists who say two of his factual claims are false.
Shannon Minter of the National Center for LGBTQ Rights called the ruling “incredibly powerful” and “far-reaching.” Khadijah Silver of Lawyers for Good Government — who uses they/them pronouns — said they were “so overwhelmingly ecstatic” they “couldn't actually process” that the ruling “was real life.” Following the preliminary injunction in March, Children's Minnesota had already resumed care. Children's Hospital Colorado, which had ceased care under federal pressure, is now in litigation before the Colorado Supreme Court.