A teenager who lives in Hillsborough County is starting puberty.
Although she had been prescribed puberty blockers from her medical provider, a federal rule that took effect Oct. 13 is now preventing her from receiving treatment.
Kylie Koe, listed under a pseudonym, belongs to one of four New Hampshire families who sued the Trump administration for a rule that pulls Medicaid funding for some transgender young people seeking gender-affirming care.
On Friday, an attorney from GLBTQ Legal Advocates and Defenders Law argued on behalf of the families, asking the federal district court to grant a preliminary injunction to preserve their children’s medical care as the case continues. A resolution could take years.
“These young people won’t be in the same position that they’re in now,” said GLAD Senior Staff Attorney Chris Erchull.
The rule in question bars Medicaid and Children’s Health Insurance Program (CHIP) benefits from being used on behalf of transgender youth to pay for gender dysphoria treatment and medication.
Erchull argued the rule was a huge departure from past practice and that the Centers for Medicare & Medicaid Services (CMS) should not be allowed to determine which categories of care not to cover. The lawsuit argues that the consequences of ending Medicaid coverage will be devastating for families that cannot afford to pay privately and that “the harm is imminent, concrete, and irreparable.”
In New Hampshire, gender-affirming care for new patients under 18 years old was banned in 2025. The plaintiffs in the case are covered under the continuing care clause. Erchull said the ruling in the case will not affect the ban, but that GLAD Law will continue to advocate for transgender youth across the state.
“It’s a slow fight on a lot of fronts, but the federal government’s interference here is just a huge aspect of what is affecting young people,” Erchull said.
Attorney Stephen Tagert, representing the federal government, argued the administration had gone through the necessary processes to get to the final rule. He said the medical procedures have irreversible consequences that the federal government has deemed not beneficial for young people.
He said it’s not about the specific diagnosis but, rather, about the type of procedure.
Tagert cited Armstrong v. Exceptional Child Center, a case that determined there is no private right of action under the Medicaid Act, saying the decision gives the Centers for Medicare and Medicaid Services the authority to decide what it can and cannot cover.
Following the hearing, Erchull said he felt Judge Steven J. McAuliffe seemed to understand the significance of the decision for the four families.
“The judge seemed to get that this administration is acting lawlessly once again by claiming it has authority that it doesn’t,” Erchull said.
The timeline for the injunction decision is not yet known. Erchull said he has seen judges take several weeks to issue a decision, but he hopes McAuliffe understands the urgency of the situation.
The lawsuit was filed by GLAD Law, the National Center for LGBTQ Rights, the ACLU of New Hampshire and Robinson + Cole.
