A federal judge in Arkansas struck down a state law Tuesday that bans medical treatment for children and teens seeking gender transitions, blocking what had been the first in a wave of such measures advocated by conservative lawmakers across the country.
The case had been closely watched as a major test of whether bans or harsh restrictions on transitional care for minors, which have since been enacted by 19 other states, could withstand legal challenges by civil liberties groups and activists. . It’s the first ruling to broadly block such a statewide ban, though judges have stepped in to temporarily delay similar laws from taking effect.
In his 80-page ruling, Judge James M. Moody Jr. of the US District Court in Little Rock said the law discriminated against transgender people and violated the constitutional rights of doctors. He also said that the state of Arkansas had failed to substantiate a number of his claims, including that the care was experimental or carelessly prescribed to adolescents.
“Instead of protecting children or safeguarding medical ethics, the evidence showed that prohibited medical care improves the mental health and well-being of patients and that, by prohibiting it, the state undermines the interests it claims to promote,” the letter wrote. Judge Moody. who was nominated by President Barack Obama.
“Furthermore,” he wrote, “the various claims underlying the state’s arguments that the law protects children and safeguards medical ethics fail to explain why only gender-affirming health care, and all gender-affirming health care of gender, it is indicated for the prohibition”.
The challenge to the law, which was filed by the American Civil Liberties Union of Arkansas and named several transgender children and a doctor as plaintiffs, argued that the ban violated the constitutional rights of transgender people to equal protection, the rights of parents to make appropriate medical decisions for their children and the right of physicians to refer patients for medical treatment.
The decision was hailed as a significant victory for the LGBTQ community, providing a dose of certainty for transgender youth in Arkansas who had worried for nearly two years about losing access to puberty blockers and hormones. The ruling applies only to the Arkansas law, which Judge Moody had temporarily blocked just days before it took effect in July 2021.
Tim Griffin, the state’s attorney general, said he would appeal the decision, saying the judge had brushed aside concerns that the treatments were risky and unproven.
Gov. Sarah Huckabee Sanders, a Republican, backed the plans for an appeal, declaring that “this is not ‘care,’ this is activists pushing a political agenda at the expense of our children.”
The case in Arkansas has drawn attention because the decision is the first on an issue that legal scholars say will seep through the courts for years and could go all the way to the Supreme Court. “This is the beginning of what will likely be a major national multi-state court battle over transgender rights,” said Joshua M. Silverstein, a law professor at the University of Arkansas in Little Rock.
Danielle Weatherby, a law professor at the University of Arkansas whose research has focused on legal issues facing transgender people, said the ruling “sets the tone that, especially in a conservative state like Arkansas, legislatures can’t just pass laws that infringe the rights of citizens”. constitutional rights.”
The Arkansas law was intended to prevent doctors from giving hormone therapy or puberty blockers to transgender people under the age of 18, and also prohibited gender transition surgeries. Physicians who provide transitional care may lose their licenses or be subject to civil litigation under the law. They also would not be allowed to refer patients out of state for such care, and private insurers could refuse to cover transgender care for patients of any age.
The authors of the law argued that it was necessary because “the risks of gender transition procedures far outweigh any benefits at this stage of the clinical study on these procedures.”
But opponents said the reasoning challenged the position taken by much of the medical establishment, including the American Medical Association, which has criticized bans such as government intrusion into treatments that are medically necessary. Experts say that withholding attention from gender transition can have dangerous consequences, including worsening distress for young people who are already at higher risk of mental disorders and suicide.
The Williams Institute, an LGBTQ research organization based at the University of California, Los Angeles, School of Law, estimated that there are 1,800 transgender youth in Arkansas In Little Rock, Arkansas Children’s Hospital’s Gender Spectrum Clinic sees fewer than 300 patients; does not perform surgical procedures for gender transitions.
Judge Moody, who was overwhelmingly confirmed by the Senate in 2014, repeatedly cited scientific evidence outlined by opponents of the law, as well as hours of testimony from doctors and transgender children and their families who described the painstaking decision-making process before transitional care began.
“There is no evidence that the Arkansas health care community is eschewing caution in treating children with gender dysphoria,” he wrote, adding that “the state has failed to demonstrate that its interests in the safety of adolescents of Arkansas’ gender transition procedures or the medical community’s ethical decline are compelling, genuine, or even rational.”
The legislation had initially been vetoed by then-governor Asa Hutchinson, a surprising rebuke from a Republican who dismissed it as “well-intentioned” but “misplaced.” But the veto was overridden by the Republican majority in the legislature.
Hutchinson, now a Republican presidential candidate who has cast himself as a traditional conservative alternative to former President Donald J. Trump, has stood by his veto, arguing that the law interferes with the rights of parents to decide what is better for your children.
The criticism has not intimidated lawmakers eager to cut minors’ access to gender transition treatments; some states have included even more restrictive measures than Arkansas in their bans. Alabama, for example, passed a law criminalizing transitional care management and threatens providers with up to 10 years in prison.
The laws are part of a broader campaign by Republican lawmakers that have focused on issues of gender and identity. Lawmakers have sought legislation that excludes transgender students from participating in school sports, requires them to use bathrooms and locker rooms that align with the gender listed on their birth certificates, and restricts what can be taught in classrooms about identity. of gender and sexual orientation.
Last month, Nebraska became one of the latest states to add restrictions on transitional care for minors, and in Texas, Gov. Greg Abbott signed legislation to make the state the largest to ban hormone and puberty blocking, as well as surgeries, for transgender children. A law signed in May by Florida Gov. Ron DeSantis went further, requiring adults seeking gender transition care to sign consent forms written by the state medical board and prohibiting nurse practitioners and physician assistants from prescribing hormone treatments for adult transgender patients.
But the legislation has sparked a corresponding flurry of legal challenges. In Alabama, a federal judge has blocked the state from enforcing parts of a law that make it a felony to prescribe hormones or drugs that block puberty while the court challenge continues. And in Florida, a federal judge recently issued a searing rebuke of that state’s law, writing that the families who sued over the ban “would likely prevail” on their argument that it was unconstitutional and that “the rules were a political exercise, not good medicine.”
In Arkansas, Ms. Sanders, a Republican who succeeded Mr. Hutchinson, signed a bill in March that significantly expanded ability of patients to sue transitional care providers. According to the law, which will take effect this summer, a patient would have a window of 15 years after reaching the age of 18 to take legal action; Generally, in Arkansas, a person has two years after an injury to file medical malpractice claims.
That legislation came while the state awaited Judge Moody’s decision. In a trial that included eight days of testimony, he heard from state witnesses who questioned the health consequences of transitional treatments, as well as the scientific data cited in support of such care.
There were also testimonials from transgender children and the clinicians who worked with them, who described the transformative benefit of care that was delivered responsibly and from a broad medical evidence base. At least one teen testified that the realistic alternative would be to leave Arkansas.
“I am so grateful that the judge listened to my experience of how this medical care changed my life for the better and saw the dangerous impact this law could have on my life and the lives of countless other transgender people,” said Dylan Brandt, a transgender . adolescent and plaintiff in the case, In a statement issued by the ACLU