A lawsuit filed on behalf of HIV medical experts asks a judge to halt new federal rules that would restrict healthcare available to low-income transgender people living with HIV.
If the new guidelines are implemented, HIV care providers that receive federal funds, including through the popular Ryan White HIV/AIDS Program, “may not acknowledge, affirm or respect the identities of transgender people, and may not use federal funding in a way that promotes so-called ‘gender ideology,’ including through the provision of gender-affirming medical care [including hormone therapy],” according to the text of the lawsuit.
The case was filed June 10 by LGBTQ and HIV advocacy group Lambda Legal and Herbert Smith Freehills Kramer LLP on behalf of the American Academy of HIV Medicine (AAHIVM), the HIV Medicine Association (HIVMA) the International Association of Providers of AIDS Care (IAPAC) and two individual healthcare providers.
NEW CASE: Lambda Legal is suing the Trump administration to defend against threats to the Ryan White HIV/AIDS Program! This week, the federal government released new guidelines that impose severe restrictions on the nation’s largest federal program dedicated exclusively to HIV treatment and care.
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— Lambda Legal (@lambdalegal.org) June 10, 2026 at 4:19 PM
As the lawsuit states, the Trump administration’s new guidelines “risk exacerbating the HIV epidemic by making it less likely that transgender patients will engage with HIV care, reducing adherence to HIV treatment regimens, and increasing the likelihood of HIV transmission in the broader community.”
“In one sweeping move, the Trump administration is attempting to rewrite a public health program in a way that excludes patients who depend on it,” said Jose Abrigo, senior attorney and HIV project director at Lambda Legal, in a press release about the case. “The Ryan White Program is a success precisely because of the way it has been structured. 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.”
The lawsuit also alleges that the new White House guidelines are discriminatory and illegal. According to the press release, the federal health department guidelines impose “funding conditions that conflict with the Ryan White HIV/AIDS Program statute.… The complaint also challenges the restrictions as arbitrary and capricious, alleging that the agencies failed to provide a reasoned explanation for the policy change and did not adequately consider its impact on patients, providers and public health outcomes. In addition, the lawsuit asserts that the Notices of Funding Opportunity violate the plaintiffs’ First Amendment rights by compelling them to adopt the government’s position regarding transgender people. The complaint further alleges that the restrictions discriminate against transgender people in violation of the equal protection component of the Fifth Amendment. The plaintiffs ask the court to block enforcement of the funding restrictions and ensure that the Ryan White HIV/AIDS Program continues to operate in accordance with federal law.”
The federal Ryan White HIV/AIDS Program provides HIV services for low-income people by funding cities, counties, states and local community-based organizations that provide HIV care, treatment, prevention and essential services.
The Ryan White HIV/AIDS Program is administered by the HIV/AIDS Bureau within the Health Resources and Services Administration (HRSA), which is part of the Department of Health and Human Services (HHS). Health Secretary Robert F. Kennedy Jr. leads the HHS and its many agencies, including the Centers for Disease Control and Prevention and the Food and Drug Administration.
“Four-in-ten AAHIVM members rely on Ryan White funding, and of those, 40% voluntarily report providing gender-affirming medical care. The actual number of clinics providing those services is potentially even higher,” added Bruce Packett, executive director of the American Academy of HIV Medicine, in the press release. “Gender-affirming medical care is not a peripheral service meant to be offered when the political headwinds allow for it. Under Ryan White’s own framework, it is a core medical service; it is primary healthcare that is evidence-based, medically necessary, and, in many cases, lifesaving.”
Transgender people living with HIV rely on Ryan White services at higher rates due to barriers in accessing insurance and care and being disproportionately low-income, explains Lambda Legal. Providers have found that access to gender-affirming medical care supports patient engagement in treatment and ongoing care.
The Ryan White Programs has been highly successful, with over 90% of clients reaching an undetectable status. Nationally, about 67% of people diagnosed with HIV were undetectable in 2023. In addition, nearly half of Americans diagnosed with HIV receive care through Ryan White; in 2024, a total of 601,853 clients received services from providers funded by Ryan White, the most ever served in the agency’s 35-year history, according to a recent report on the program.
The report also showed that 47% of Ryan White clients are 50 or older, 75% are members of racial or ethnic minorities and nearly 50% are covered by Medicaid and/or Medicare. Of note, the report did not include data on LGBTQ people—including transgender people—who are living with HIV and receiving Ryan White support, although this population is disproportionately affected by the epidemic.
Despite the program’s success, the Trump White House and Republican leaders in Congress aim to gut federal HIV funds. For more, see “If Congress Ends Ryan White HIV Services, How Many Americans Will Contract HIV?” (The answer: Researchers predict a 49% spike in cases—or 75,000 excess HIV diagnoses—by 2030.)
The federal actions underlying this lawsuit are just one way the White House and national health departments have been targeting transgender people. In December, Secretary Kennedy said the government would withhold federal payments to any hospital offering gender-affirming care for children.
Advocates worry that if this pattern of federal discrimination isn’t stopped, it will extend beyond transgender health issues. For example, in the future, all people living with HIV or anyone seeking abortion care could be targeted, as could immigrants, members of the LGBTQ community and other minority populations. A related concern is that citizens’ private medical records could be shared with federal regulators seeking to identify their targets.
