Doctors ask judge to halt Trump policy targeting trans people living with HIV

The nation's leading HIV medical organizations sued the Trump administration on Wednesday, accusing federal officials of jeopardizing care for transgender people living with HIV and undermining one of the most successful public health programs in American history.

The lawsuit, filed in the U.S. District Court for the District of Massachusetts, challenges new federal restrictions that bar recipients of Ryan White HIV/AIDS Program funding from using those funds for gender-affirming medical care. The plaintiffs — major HIV physician groups, healthcare providers, and medical associations — argue the administration is using an anti-trans policy agenda to fundamentally reshape a program that serves more than half of all people living with HIV in the United States.

Unlike many recent legal challenges brought by LGBTQ+ advocacy organizations, this lawsuit comes from HIV doctors and providers who argue the restrictions could damage a public health system that has helped achieve viral suppression rates above 90 percent among patients receiving care.

"The Ryan White Program is a success precisely because of the way it has been structured," Jose Abrigo, senior attorney and HIV Project director at Lambda Legal, said in a statement. "It has for three decades been a safe haven for people living with HIV, grounded in clinical judgment and comprehensive patient needs. These restrictions interfere with that framework and place transgender patients at risk of losing access to care."

Related: American Medical Association Strengthens Support for Gender-Affirming Care

Congress created the Ryan White Program in 1990 as the federal government's primary safety net program for low-income people. The program was born from the AIDS crisis, when LGBTQ+ communities — particularly gay men and transgender women — were disproportionately affected by a disease that was initially met with indifference from political leaders and public institutions. The complaint notes that the program was specifically designed to provide comprehensive care and address barriers that keep vulnerable patients from remaining in treatment.

According to the lawsuit, the administration's new policy stems from grant conditions issued by the Health Resources and Services Administration in March and Notices of Funding Opportunity released Sunday. Together, the policies prohibit Ryan White providers from using federal funds for gender-affirming medical care and, according to the complaint, require providers to comply with restrictions targeting what the administration calls "gender ideology."

The plaintiffs include the American Academy of HIV Medicine, the HIV Medicine Association, the International Association of Providers of AIDS Care, Boston physician Dr. Jennifer Brody, and Oregon nurse practitioner Christopher Fox. Together, the organizations represent tens of thousands of HIV clinicians and healthcare professionals nationwide.

The lawsuit argues the restrictions contradict years of federal guidance. In 2021, HRSA explicitly informed providers that Ryan White funds could support gender-affirming care and described such care as "an important strategy to effectively address the health and medical needs of transgender people with HIV." Federal health officials previously recognized that access to gender-affirming care helps transgender patients engage in HIV treatment, remain in care, and achieve viral suppression.

Related: Texas doctor accused of providing gender-affirming care to youth committed 'no legal violations'

The stakes are particularly high for transgender women, who experience some of the highest HIV rates in the country. The complaint cites federal data estimating that approximately 14 percent of transgender women in the United States are living with HIV, while studies in some major cities have found rates exceeding 40 percent. Black transgender women face especially severe disparities.

Plaintiffs filed both a complaint and a motion for preliminary injunction, asking the court to immediately block enforcement of the restrictions while the litigation proceeds. They allege violations of the Administrative Procedure Act, the Affordable Care Act, the First Amendment, and the Fifth Amendment's equal protection guarantee.

“ Policies that exclude already vulnerable communities from medically necessary care threaten progress toward ending the HIV epidemic,” said Dr. José M. Zúñiga, President and CEO of the International Association of Providers of AIDS Care.