1. United States
2. Mich.
3. Letter

I am writing to urge you to oppose the Department of Health and Human Services funding conditions that threaten healthcare access for transgender individuals and jeopardize over $300 billion in critical federal funding to states. On January 13, twelve states led by New York Attorney General Letitia James filed a federal lawsuit challenging HHS requirements that force states to certify compliance with a 2025 executive order titled 'Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.' This order directs agencies to recognize sex based solely on biological definitions and reject gender identity as a protected classification under federal civil rights law. These funding conditions apply to essential programs including medical education, public health initiatives, maternal and infant care, disease prevention, and community research. States that refuse to comply face funding termination, clawbacks, and liability under the False Claims Act. This creates an impossible choice between protecting transgender residents under state nondiscrimination laws and maintaining funding for services that millions of people depend on. The policy bypasses the legislative process and formal rulemaking procedures required for major reinterpretations of Title IX. HHS is attempting to retroactively impose ideological conditions on funding agreements that were approved under different legal interpretations, violating the Administrative Procedure Act and constitutional limits on federal spending power. Transgender individuals already face significant barriers to healthcare access. Allowing HHS to weaponize federal funding to force discriminatory policies will cause immediate and irreparable harm to people who rely on federally supported medical services. Healthcare decisions should be made by patients and their doctors, not dictated by federal funding threats. I ask you to publicly oppose these HHS funding conditions and support legislative action to protect transgender healthcare access. Our healthcare system should serve all people with dignity and respect.