Robert F Kennedy Jr, the health secretary, overstepped his power when he declared that gender-affirming treatments are unsafe, a federal judge has ruled.

In a blow to the Trump administration’s attempts to limit access to gender transition procedures, Judge Mustafa Kasubhai ruled Thursday that Kennedy did not go through the proper procedures when issuing his 12-page declaration last December.

The declaration called treatments like puberty blockers, hormone therapy and surgeries unsafe for children and adolescents with gender dysphoria and warned that doctors providing such care could be excluded from federal health programs like Medicare and Medicaid.

But in a court in Eugene, Oregon, Kasubhai granted relief to doctors providing the treatment. He also dismissed the government attempts to dismiss the case, which was brought by 21 states and Washington DC. The plaintiffs had sued Kennedy on the alleged grounds that his declaration was inaccurate and unlawful

“Today’s win breaks through the noise and gives some needed clarity to patients, families, and providers,” Letitia James, the Democratic New York attorney general who led the lawsuit, said in a statement on Thursday’s ruling. “Healthcare services for transgender young people remain legal, and the federal government cannot intimidate or punish the providers who offer them.”

At the end of a six-hour hearing, Kasubhai ruled that Kennedy had flouted standard procedures before publishing the declaration and said the issue raised questions about democracy, the New York Times reported.

“The notion that ‘I will go forward and issue a declaration and see if we can get away with it’ is not a principle of governance that adheres to the overarching commitment to a democratic republic that requires the rule of law to be regarded and respected and honored as a sacred,” he said.

It was the second negative ruling Kennedy and the Department of Health and Human Services had suffered this week after a judge in Boston temporarily blocked several of the health secretary’s vaccine policy changes.