Court Upholds Block of Arkansas’s Ban on Gender-Affirming Care for Trans Youth

The ban discriminates against transgender children in the state "on the basis of sex," the appellate court said.

A three-judge panel on the 8th U.S. Circuit Court of Appeals has upheld a ruling that was issued by a lower court last year, blocking a statewide ban of gender-affirming care in Arkansas.

The ruling means that an injunction on the law will remain in place and that transgender children in the state can continue to receive gender-affirming care from their doctors. Such care generally includes therapy and, in some cases, the use of safe, reversible medication like puberty blockers — the prescription of which the state had attempted to criminalize.

The law also banned the use of certain medications that are rarely, if ever, used in care for transgender children, and made it illegal to perform gender-affirming surgery on children in Arkansas — despite the fact that medical providers in the state never offered such surgeries to people under the age of 18.

The law passed in 2021 and was initially vetoed by Republican Gov. Asa Hutchinson, but the GOP-controlled state legislature overrode his veto shortly after. Federal Judge James M. Moody Jr. issued an injunction in July 2021, blocking the law’s enforcement until it could be further litigated. (Due to the ongoing challenges to Moody’s ruling, that court hearing won’t take place until October at the earliest.)

The appellate court ruled on Thursday to uphold Moody’s injunction.

“Because the minor’s sex at birth determines whether or not the minor can receive certain types of medical care under the law, Act 626 discriminates on the basis of sex,” the court said in its ruling.

Transgender activists praised the ruling, including ACLU lawyer Chase Strangio.

“The Eighth 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,” Strangio said. “The state has no business categorically singling out this care for prohibition.”

Arkansas was the first state in the U.S. to ban gender-affirming care for minors. Since then, 14 additional states have instituted similar bans or are currently considering doing so. There is widespread medical consensus against such bans, and medical associations have noted that for many trans youth, access to gender-affirming care is life-saving.

“It is well documented that TGNB [transgender or nonbinary] adolescents and young adults experience anxiety and depression, as well as suicidal ideation, at a much higher rate than their cisgender peers…In contrast, numerous research studies have found that gender-affirming care leads to improved mental health among TGNB youth,” wrote Kareen M. Matouk and Melina Wald, researchers at the Columbia University Department of Psychiatry, earlier this year.