This story has been updated with additional reporting.
A group of Republican state lawmakers have asked the Trump administration to investigate the Oregon Health Authority while claiming officials are concealing the extent to which minors undergo gender-affirming surgery.
Seven House members on Monday sent a letter to U.S. Attorney General Pam Bondi in an effort to help her in a closely watched federal court battle over gender-affirming care.
The letter could have implications nationally in the debate over care that many describe as life-saving for young people experiencing gender dysphoria. It also could have broader effects on spending for the 1.4 million low-income Oregonians who receive coverage through the Medicaid-funded Oregon HealthPlan. Already, state officials have been bracing for cuts as Congressional Republicans push for them.
“I just think the hammer is going to come down on Oregon,” state Rep. Ed Diehl, a Stayton lawmaker who signed the letter, told The Lund Report.
In January, Oregon and three other states filed a suit challenging an executive order issued by the Trump administration to withhold federal research funding from hospitals that provide gender-affirming care to minors. A federal judge temporarily blocked the order last month, and Bondi has appealed.
The letter claims that the state’s suit filed against Trump relied on a “specious” claim that genital surgeries are not performed on minors to treat gender dysphoria.
“To the extent that we do a better job of keeping people healthy, they are going to use less care in the emergency room or in the hospital setting.”
The letter also calls for a broader federal investigation of Oregon Health Plan spending on abortion, needle-exchanges intended to reduce disease, air conditioners intended to help vulnerable people during heat waves and programs helping low-income people with food as well as housing costs to help prevent homelessness.
Those programs already have been approved by the federal government, so in effect the letter urges the Trump administration to take a second look.
Blair Stenvick, spokesperson for LGBTQ advocacy group Basic Rights Oregon, told The Lund Report in an email that the litter is "an attempt from a minority party in Oregon to muddy the waters and detract from what this issue is really about: Whether we want private medical decisions made by individuals, families and doctors, or if we want an over-reaching government making those choices for us."
Gov. Tina Kotek’s office, the Oregon Department of Justice, the Oregon Health Authority and did not immediately respond to requests for comment from The Lund Report.
Letter seeks to tip federal court case
Oregon and other states have enacted laws in recent years intended to ensure that transgender people, including minors, can obtain care. These states have become a destination for families seeking care for their transgender children. Trump was elected to the White House after campaigning to end gender-affirming care for minors.
Diehl said Oregon’s status as a refuge for gender-affirming care has already put the state on the Trump administration’s radar, and he is anticipating an investigation. He said lawmakers made sure the letter was put into “the right hands” at the White House.
The lawmakers wrote they were offering information to help Bondi fight the lawsuit brought by four state attorneys general, including Oregon.
The states’ lawsuit defends care for gender dysphoria, a condition marked by an incongruence between a patient’s biological sex and their innate gender identity, as medically appropriate. That care, the lawsuit states, includes puberty-delaying medications and hormone therapy, but “genital surgery is not performed on transgender minors.”
The Oregon lawmakers’ letter cited an analysis compiled by a conservative medical advocacy group that opposes transgender care for minors called Do No Harm. It claims 26 genital surgeries were performed on minors in Oregon between 2019 and 2023.
The letter also includes a memo provided by the Oregon Health Authority in response to a request from lawmakers last year. The memo does not detail how many minors received genital surgery, but it does appear to indicate that at least 102 individuals between the ages of 12 and 17 received some form of gender-affirming surgical procedure covered by the Medicaid-funded Oregon Health Plan between 2015 and 2022. The procedures included tissue transfer, face feminization and chest surgeries.
“I just think the hammer is going to come down on Oregon.”
Diehl said state officials “were not being forthright” in their lawsuit. He also said that he and other Republican lawmakers do not believe that Medicaid can legally be used for these procedures.
The letter cited state officials’ decision to not publish a draft report conducted by Oregon Health & Science University researchers that found a “paucity” of evidence for some gender-affirming procedures. Officials’ decision to halt the report cited lawmakers’ approval of an expansion of coverage for gender-affirming care to include those procedures.
Diehl and other lawmakers this year sponsored a bill directing the commission to evaluate evidence for gender-affirming treatment, but it has died in the House
Other state representatives who signed the letter include Court Boice of Gold Beach, Virgle Osborne of Roseburg, Dwayne Yunker of Grants Pass, Boomer Wright of Coos Bay, Darin Harbick of Rainbow and Werner Reschke of Malin.
Expansion of Medicaid defended
Oregon has received federal approval to spend Medicaid funds on air conditioners, food and housing to improve the health of low-income people covered by the program. Republican lawmakers have criticized the spending as an unjustified expansion of the program beyond its original intent.
During a legislative hearing last month, Diehl said the spending raises questions when the Oregon Health Plan already struggles to provide adequate behavioral health services.
State Rep. Rob Nosse, a Portland Democrat who chairs the House health committee, responded to Diehl during the hearing saying that the federal government allows Oregon to spend Medicaid funds on air conditioners, food and housing because they keep people healthy.
“To the extent that we do a better job of keeping people healthy, they are going to use less care in the emergency room or in the hospital setting,” he said.