Last August, the American Academy of Pediatrics renewed its guidance supporting the use of puberty blockers, hormone therapy, and other medical care for transgender children and teens. At a time when trans issues have moved to the center of the culture wars, the AAP—the main medical association representing US pediatricians, with 67,000 members—said its action was aimed at supporting trans minors amid new waves of anti-trans laws. Now, Republican officials from 21 states have accused the medical group of violating state consumer protection laws by supporting gender-affirming care for trans youth.