Providing Gender-Affirming Care to Youth Is Now a Felony After Judge Rules Law Can Go Into Effect

Oklahoma can enforce its law banning and criminalizing gender-affirming care for trans minors while a suit against it is heard, a federal court ruled Thursday.

The U.S. District Court for the Northern District of Oklahoma, in an order made public Friday, declined a request from five families with transgender children and one health care provider to issue a preliminary injunction that would block the law’s enforcement while their suit proceeds. Under an agreement between their lawyers and Oklahoma officials, the law was on hold until the court could rule on the preliminary injunction request.

Judge John F. Heil III said the plaintiffs had not shown that they were likely to succeed in proving that the law violated the due process and equal protection clauses of the Fourteenth Amendment to the U.S. Constitution. He wrote that the law allows gender-affirming care at a later age, and making distinctions based on age is permitted by the Constitution. He also cited a recent appellate court ruling saying states had a legitimate interest in regulating this care and that legislatures, not courts, are the appropriate venue for debates on the matter.

“This an area in which medical and policy debate is unfolding and the Oklahoma Legislature can rationally take the side of caution before permitting irreversible medical treatments of its children,” Heil wrote.

Oklahoma Gov. Kevin Stitt, a Republican, signed Senate Bill 613, the gender-affirming care ban, into law May 1. It bars health care professionals from providing hormones, puberty blockers, and surgeries to people under 18 for the purpose of gender transition. Without the agreement reached between the plaintiffs’ lawyers and the state, it would have taken effect immediately, although young people already receiving hormones or puberty blockers have six months in which to cease treatment. Penalties for violation include felony charges, revocation of license, and civil lawsuits, which can be brought by a parent or guardian.

Lawyers representing the plaintiffs said they will appeal. “This is a devastating result for transgender youth and their families in Oklahoma and across the region,” said a joint statement from Lambda Legal, American Civil Liberties Union, the ACLU of Oklahoma, and the law firm Jenner & Block. “Denying transgender youth equality before the law and needlessly withholding the necessary medical care their families and their doctors know is right for them has caused and will continue to cause serious harm. But this is not the end. We are appealing this decision that is completely out of step with all other federal trial courts and that ignores the overwhelming evidence that gender-affirming medical care is safe and effective evidence-based care. We will continue our fight in defense of our clients and the constitutional rights of transgender people in Oklahoma and across the country.”

The case is Poe v. Drummond, the latter being Oklahoma Attorney General Gentner Drummond.

Twenty-one states ban all or most gender-affirming care for trans youth. Several federal trial courts have temporarily blocked these bans with preliminary injunctions, but some appeals courts have lifted them. The U.S. Court of Appeals for the Sixth Circuit recently did so, ruling that Kentucky and Tennessee could enforce their bans while lawsuits against them proceed.

Federal district courts in Alabama, Arkansas, Florida, and Indiana have also issued injunctions against bans on gender-affirming care, and the court in Arkansas has gone a step further by striking down that state’s law, the first ruling on such a law’s merits. The Arkansas attorney general is appealing. The U.S. Court of Appeals for the Eighth Circuit ruled Friday that the full court, rather than the usual panel of three judges, will hear the Arkansas appeal.

However, in the Alabama case, a three-judge panel of the U.S. Court of Appeals for the 11th Circuit has lifted the injunction, allowing the law to be enforced. The plaintiffs have asked the full court to review the decision. Since the 11th Circuit also includes Georgia, a federal district judge in that state has lifted her injunction against its gender-affirming care restrictions because of the circuit's ruling.