American Academy of Pediatrics v. James Uthmeier

CourtCourt of Appeals for the Seventh Circuit
DecidedJune 22, 2026
Docket26-2238
StatusPublished

This text of American Academy of Pediatrics v. James Uthmeier (American Academy of Pediatrics v. James Uthmeier) is published on Counsel Stack Legal Research, covering Court of Appeals for the Seventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Academy of Pediatrics v. James Uthmeier, (7th Cir. 2026).

Opinion

In the

United States Court of Appeals For the Seventh Circuit ____________________ No. 26-2238 AMERICAN ACADEMY OF PEDIATRICS, Plaintiff-Appellee,

v.

JAMES UTHMEIER, Attorney General of the State of Florida, Defendant-Appellant. ____________________

Appeal from the United States District Court for the Northern District of Illinois, Eastern Division. No.1:26-cv-02401— Matthew F. Kennelly, Judge. ____________________

DECIDED JUNE 22, 2026 ____________________

Before HAMILTON, SCUDDER, and JACKSON-AKIWUMI, Cir- cuit Judges. PER CURIAM. In December 2025, James Uthmeier, the At- torney General of the State of Florida, sued the American Academy of Pediatrics, the World Professional Association for Transgender Health, and the Endocrine Society in Florida state court. General Uthmeier alleged and announced pub- licly that through their policy statements and legal filings sup- porting access to gender-affirming care, the organizations 2 No. 26-2238

violated the Florida Deceptive and Unfair Trade Practices Act, Florida’s Racketeer Influenced and Corrupt Organizations (RICO) Act, and, later, Florida antitrust law. Three months later, General Uthmeier had not yet even served the organiza- tions with process, but the pending case was hanging over those defendants. The American Academy of Pediatrics (AAP), an Illinois non-profit, then sued General Uthmeier in federal court in Illinois. AAP sued under 42 U.S.C. § 1983. It contends that the Florida enforcement action was brought in bad faith in violation of the First Amendment to retaliate against AAP’s advocacy for gender-affirming care. The district court granted AAP’s motion for a preliminary injunction, enjoining General Uthmeier from pursuing his state court action against AAP. General Uthmeier has ap- pealed and moved for a stay of the preliminary injunction pending our full and expedited consideration of his appeal of the preliminary injunction. See Fed. R. App. P. 8. The issue before us is narrow. We do not decide the merits of the preliminary injunction. We consider only whether we should stay the district court’s injunction pending our expe- dited consideration of the appeal. We deny the requested stay pending appeal. We recognize that an injunction against a pending state enforcement action like this raises serious fed- eralism concerns that are the foundation of Younger absten- tion. See Younger v. Harris, 401 U.S. 37 (1971) (reversing injunc- tion against criminal proceeding brought in good faith). The Younger abstention doctrine, however, has always included an exception for proceedings brought in bad faith. Id. at 46–50, citing Dombrowski v. Pfister, 380 U.S. 479 (1965) (reversing de- nial of injunction against criminal proceedings brought in bad faith). In this case, the district court made detailed findings No. 26-2238 3

indicating the Florida proceeding has been brought in bad faith, so that Younger abstention should not apply. The district court also explained why personal jurisdiction and venue in Illinois are supported by law. The district court’s decision finds strong support from de- cisions by both the Fifth Circuit and the D.C. Circuit, decisions with which neither General Uthmeier nor our dissenting col- league engages. See Defense Distributed v. Grewal, 971 F.3d 485 (5th Cir. 2020) (holding that Texas district court should have enjoined bad-faith enforcement action brought in New Jersey by state a orney general); Media Ma ers for America v. Paxton, 138 F.4th 563 (D.C. Cir. 2025) (affirming D.C. injunction against bad-faith investigation by a orney general in Texas). In light of those cases providing legal support for the injunc- tion here, as well as AAP’s factual showings, General Uth- meier has not made the required “strong showings” that he is likely to succeed on the merits of the appeal or that the injunc- tion will cause him irreparable harm while we consider his appeal on an expedited basis. See Nken v. Holder, 556 U.S. 418, 434 (2009). I A The American Academy of Pediatrics is a non-partisan, non-profit organization incorporated and headquartered in Illinois. Founded in 1930, AAP contributes to the develop- ment of pediatric medicine through conducting research, providing educational materials, hosting events for medical professionals, and publishing Pediatrics, a peer-reviewed sci- entific journal. AAP also files amicus briefs, submits 4 No. 26-2238

comments in response to agency rulemaking, and issues pol- icy statements on issues affecting pediatric health. In 2018, AAP published a policy statement titled “Ensur- ing Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents” in the Pediatrics journal. According to its abstract, the policy statement re- views concepts and challenges in the field of gender-affirming care, providing suggestions for pediatric providers that are “focused on promoting the health and positive development” of transgender youth. The policy statement contains an im- portant disclaimer: “The guidance in this statement does not indicate an exclusive course of treatment or serve as a stand- ard of medical care. Variations, taking into account individual circumstances, may be appropriate.” The policy statement provides an overview of various forms of gender-affirming care with an overall supportive tone. It notes that suppression of puberty comes with risks, noting that some research suggests it may have long-term ef- fects on bone metabolism and fertility and observing that the current research is “limited and provides varied results.” The statement favorably summarizes social affirmation, including adapting one’s hairstyle, clothing, and pronouns. The state- ment also describes different types of surgical approaches. It observes that these changes are irreversible and typically are reserved for adults, but that surgery is “occasionally pursued during adolescence on a case-by-case basis.” AAP’s policy statement concludes with several recom- mendations, four of which the district court highlighted as particularly relevant to this case: (1) “that youth who identify as [transgender] have access to comprehensive, gender-af- firming, and developmentally appropriate health care that is No. 26-2238 5

provided in a safe and inclusive space”; (2) “that insurance plans offer coverage for health care that is specific to the needs of youth who identify as [transgender], including coverage for medical, psychological, and, when indicated, surgical gen- der-affirming interventions”; (3) “that pediatricians have a role in advocating for policies and laws that protect youth who identify as [transgender] from discrimination and vio- lence”; and (4) “that the medical field and federal government prioritize research that is dedicated to improving the quality of evidence-based care for youth who identify as [transgender].” AAP affirmed this policy statement in 2023. The statement is freely accessible online. In early December 2025, General Uthmeier filed a lawsuit in a state court in Florida against AAP, the World Professional Association for Transgender Health (WPATH), and the Endo- crine Society. His initial complaint alleged that AAP and its co-defendants violated the Florida Deceptive and Unfair Trade Practices Act by making “immoral, unethical, oppres- sive, and unscrupulous” representations, misleading con- sumers about the safety and reversibility of “sex intervention” treatments in order to advertise memberships, goods, and ser- vices.

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American Academy of Pediatrics v. James Uthmeier, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-academy-of-pediatrics-v-james-uthmeier-ca7-2026.