FAQ: Ryan White HIV/AIDS Program and Gender-Affirming Medical Care Bans

This lawsuit challenges the federal government’s decision to incorporate certain discriminatory policies in the Ryan White HIV/AIDS Program, adding new conditions on Ryan White Program funding. These conditions prohibit funding recipients from acknowledging, affirming, or respecting transgender people’s identities, and using federal funding in a way that promotes so-called “gender ideology,” which includes the provision of gender-affirming medical care. Because of that, providers and institutions that receive Ryan White funding cannot recognize and affirm transgender people living with HIV, interfering with their ability to provide comprehensive healthcare for people living with HIV. In short, the federal government’s actions in adding these conditions threaten the Ryan White Program’s longstanding mission to end the HIV epidemic.

Through this lawsuit, the plaintiffs ask the court to strike down these unlawful conditions and to stop the government from imposing and enforcing the policy while the case proceeds.

The Administration recently added new restrictions to Ryan White HIV/AIDS Program funding in multiple ways.

First, the Administration implemented the discriminatory policy by issuing new FY 2026 HRSA General Terms and Conditions (“Updated FY2026 General Terms”) that apply broadly to funding administered by the Health Resources and Services Administration (“HRSA”), including Ryan White funding. The Updated FY2026 General Terms impose restrictions and create uncertainty regarding the ability of providers to continue delivering comprehensive, affirming care to transgender people living with HIV.

Second, the Administration implemented the discriminatory policy by adding new conditions to Notices of Funding Opportunity (NOFOs) for certain Ryan White Program funding streams, including funding under Parts B Supplemental, C, D, and F of the Ryan White Program. These conditions prohibit recipients from promoting so-called “gender ideology,” including by using federal funds to support, facilitate, or provide certain forms of gender-affirming medical care. The restrictions also extend beyond medical care to encompass how providers acknowledge and interact with transgender patients, including the use of a patient’s name and pronouns consistent with their gender identity. Essentially, these conditions create a situation where providers and institutions must choose between serving transgender people with HIV and accepting Ryan White funding.

The Administration has tried to incorporate its discriminatory policy across the whole Ryan White HIV/AIDS Program. These restrictions threaten care throughout the entire Ryan White Program ecosystem, which funds the majority of HIV care throughout the United States, including comprehensive health services for people living with HIV.

As outlined in the complaint, the restrictions disrupt established models of HIV care that have been developed over decades and have successfully improved health outcomes and kept people engaged in their treatment.

Transgender people living with HIV often rely on integrated care that addresses both HIV treatment as well as their other healthcare needs. Restricting providers’ ability to offer comprehensive care will make it harder for some patients to access and remain engaged in HIV treatment. In other words, if people living with HIV are not treated in accordance with evidence-based practices and cannot come to Ryan White clinics for gender-affirming care, they might discontinue HIV treatment completely.

No. In addition to prohibiting the provision of gender-affirming medical care through the Ryan White Program, the challenged conditions could affect broader aspects of patient-provider communication and the ability of providers to deliver affirming care to transgender patients.

The lawsuit raises several legal claims, including allegations that:

• The challenged restrictions exceed the federal government’s authority under the Ryan White HIV/AIDS Program.
• The restrictions are arbitrary and capricious, meaning the government put these conditions in place without a rational explanation grounded in fact.
• The restrictions are illegal because they conflict with federal statutes, such as laws that prohibit discrimination in healthcare.
• The restrictions violate the U.S. Constitution, including equal protection and free speech principles.

The court has not yet ruled on any of these claims.

Through the lawsuit, the plaintiffs have asked the court to strike down the challenged conditions completely as they apply to the Ryan White Program. The plaintiffs have also asked the court to issue a preliminary injunction, which would temporarily block the discriminatory policy while the lawsuit proceeds. A preliminary injunction is designed to preserve the status quo and prevent irreparable harm before the court reaches a final decision on the merits.

The lawsuit specifically asks the court to protect the healthcare providers participating in this lawsuit and the members of the medical organizations that are plaintiffs in the lawsuit, the Academy of HIV Medicine, the HIV Medicine Association, and the International Association of Providers of AIDS Care.

If the court grants it, a preliminary injunction would generally remain in place until the court issues a further order, the main issues of the case are resolved, or an appellate court stays (i.e., pauses) or modifies the injunction.

The federal district court in Massachusetts has scheduled a hearing to discuss the plaintiffs’ request for preliminary relief, and potentially the timeline of the case, for July 9, 2026.

The case will then continue according to the court’s orders.

The court sets the timing. The court will decide at or sometime after the hearing on the motion.

If the court grants an injunction, it will also decide: (1) who is protected by the injunction, (2) what government actions are put on pause while the case continues, and (3) how long the injunction will continue.

Whether there is a preliminary injunction or not, the court will continue to evaluate the legal arguments in the lawsuit, which can take months or longer, before ultimately deciding the main issues of the case.

If the court decides not to pause the new policies with a preliminary injunction, that does not mean the plaintiffs will lose the overall case. The court would still take the time to consider the claims and defenses through the regular litigation process, relying on a more complete record of the facts.