Arkansas State Capitol – Photo: HAL333, via wikimedia
A federal appeals court has upheld an order blocking an Arkansas law that sought to bar transgender youth from accessing gender-affirming health care treatments, and penalize doctors who prescribe such interventions.
On Thursday, the 8th U..S. Circuit Court of Appeals upheld a lower court’s injunction blocking the state from enforcing the law after four transgender youths, their parents, and two doctors filed suit, arguing that the ban violates transgender youths’ right to free speech (including self-identification) and equal protection under the law, infringes on their parents’ right to decide what sort of care they receive, and violates physicians’ free speech rights by preventing them from recommending the treatments that are best for their patients.
In its ruling, the appeals court found that, “[b]ecause the minor’s sex at birth determines whether or not the minor can receive certain types of medical care under the law,” the ban discriminates on the basis of sex. As such, the law will continue to be blocked while case is decided on its merits.
The lower court judge who issued the injunction last year, U.S. District Judge James Moody, Jr., of the Eastern District of Arkansas, is slated to hear oral arguments on October 17 on whether the law should be permanently blocked, reports Politico.
The law, passed on largely party-line votes in the Republican-led state House and Senate, was initially vetoed by Gov. Asa Hutchinson last year over concerns that the law — which also allows health insurers to deny coverage for any transition-related care, even for adults — was overly broad, infringed on parental rights, and failed to exempt youth who were already receiving care, further disrupting their treatments. But Republicans overrode Hutchinson’s veto, prompting the plaintiffs to sue. Seven days before the law was slated to go into effect, Moody issued his injunction preventing the law from being enacted.
Multiple medical groups, including the American Medical Association, oppose the ban and have argued that transition-related treatments can be safely administered. LGBTQ advocates and civil rights advocates noted that, in addition to potentially being unconstitutional, the law would harm transgender youth, potentially exacerbating their gender dysphoria and leading to depression, anxiety, and suicidal ideation.
But Arkansas Attorney General Leslie Rutledge, arguing on behalf of the state and the state medical board, argued that the state has the authority to regulate medical practices, especially those that could be potentially harmful. Rutledge also argued that the restriction on transgender health care is needed to protect transgender youth from making rushed or uninformed decisions about their health that they may later regret if they choose to pursue “irreversible” hormone therapy or surgery.
LGBTQ advocates celebrated the 8th Circuit’s decision, hailing it as a victory not only for the plaintiffs, but all transgender youth.
“Today, the 8th Circuit Court of Appeals affirmed that no child should be denied medical care they need,” Holly Dickson, the executive director of the ACLU of Arkansas, said in a statement. “We are relieved for trans youth. Research shows that denying gender-affirming care to transgender youth contributes to depression, isolation, eating disorders, self-harm, and suicide. Transgender people deserve the right to live healthy lives without fear and discrimination. It’s time for the Arkansas Legislature to protect trans kids, not target them.”
“This is a critical victory for transgender adolescents in Arkansas, their families, and their medical providers,” Chase Strangio, the deputy director for Transgender Justice at the ACLU’s LGBTQ & HIV Project, said in a statement. “The 8th Circuit was abundantly clear that the state’s ban on care does not advance any important governmental interest and the state’s defense of the law is lacking in legal or evidentiary support. The state has no business categorically singling out this care for prohibition. We know adolescents thrive with this care, support, and love, and we’re determined to keep fighting until this baseless law is permanently struck down.”
Similar laws seeking to restrict access to gender-affirming care by youth have passed in Tennessee and Alabama, although the Movement Advancement Project, a pro-LGBTQ think tank, has noted that the specific language in Tennessee’s law — which bans hormone therapy for “prepubertal minors” — is based on a flawed understanding of transgender health care, and may allow minors who have already started puberty (as standards of care generally recommend) to begin receiving hormone therapy. The Alabama law has since been blocked from being enforced by a federal judge.
The state of Arizona passed a similar law that only restricts surgical interventions for transgender youth, but does not ban hormones or puberty blockers. Meanwhile, the state of Texas has encouraged state agencies to investigate families with transgender youth for “child abuse” if their children access gender-affirming care. While courts have allowed investigations to resume in general, two separate injunctions have been issued blocking state agencies from going after specific families who claimed they were targeted by the Texas Department of Family and Protective Services.
Federal Judge Victoria Calvert has permanently blocked a portion of Georgia’s law banning prisoners from receiving gender-affirming care, ruling on Dec. 3 that the state’s blanket ban on hormone therapy violates the Eighth Amendment’s prohibition on cruel and unusual punishment.
Signed by Gov. Brian Kemp in May and implemented in July, the law bars prisoners from receiving hormone therapy or other treatment for gender dysphoria -- even when a doctor deems it medically necessary. It prohibits the state from funding such care and blocks transgender inmates from paying for it themselves. Non-transgender prisoners, however, may still receive hormone therapy and other gender-affirming treatments so long as the care is not related to gender transition.
A federal judge says she plans to issue a preliminary injunction blocking a Trump administration policy that would cut funding for sex education programs, including so-called "gender ideology." The announcement came during a conference call with state attorneys and federal officials.
Earlier this year, President Donald Trump issued an executive order barring schools from engaging in what it calls the "social transition" of transgender youth -- meaning any recognition of gender identity as distinct from biological sex, including using a student’s chosen name or pronouns or making accommodations based on gender identity.
U.S. Catholic bishops have voted to bar Catholic hospitals from providing transgender patients with gender-affirming care, including hormones and surgical procedures.
The vote, taken last week during the U.S. Conference of Catholic Bishops' plenary assembly in Baltimore, updates the "Ethical and Religious Directives for Catholic Health Care Services," the Church's rulebook governing medical procedures it deems immoral.
The directives spell out how Catholic-affiliated hospitals and staff should respond to medical situations that may clash with personal religious beliefs or Church teaching on issues like end-of-life care, contraception, abortion, or gender identity.
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