Tennessee Ban on Gender-Affirming Care for Minors Upheld by Appeals Court

Gender-affirming care has been banned for the first time with the endorsement of a federal court. Transgender youth in Tennessee can now be barred from using hormone therapy or puberty blockers following a decision by a federal appeals panel.

In Cincinnati, the U.S. Court of Appeals for the Sixth Circuit issued a ruling almost two weeks after a district judge temporarily blocked the ban on hormone therapy and puberty blockers for minors, the New York Timesreports.

After considering a broader appeal, the judges will decide whether to suspend the law before September 30 temporarily, they said.

As legislators across the country debate transgender care for minors, the judges suggested that these decisions should be left up to individual states, echoing the U.S. Supreme Court’s decision in the Dobbs case last year which removed the constitutional right to abortion.

The appeals court decision cited Dobbs repeatedly.

“Given the high stakes of these nascent policy deliberations — the long-term health of children facing gender dysphoria — sound government usually benefits from more rather than less debate, more rather than less input, more rather than less consideration of fair-minded policy approaches,” the court wrote.

“To permit legislatures on one side of the debate to have their say while silencing legislatures on the other side of debate under the U.S. Constitution does not further these goals,” chief judge Jeffrey Sutton continued.

A last resort for thousands of young transgender people, their families, and allies has been to turn to the courts to block sweeping legislation targeting gender-affirming care.

Judges have temporarily or permanently blocked these laws from being enforced because of constitutional violations and arguments that they discriminate against transgender people.

Several conservative-led states are enacting laws to restrict LGBTQ+ rights and healthcare access, highlighting how uncertain the medical and political landscape is for transgender youth. Many families and healthcare providers across 20 states have had to move to gain access to gender-affirming medical care because of bans or restrictions.

The Republican supermajority in Tennessee’s legislature mobilized for such a law as its first order of business and designated it S.B. 1. As a result of the law, doctors will no longer be able to provide transition care for new patients, and current patients will not be able to receive care after March 2024.

Just days before the law was supposed to take effect on July 1, Judge Eli J. Richardson ruled to preserve patient access temporarily.

However, in issuing a statewide decision, Richardson overstepped his authority, according to Sutton.

“Life-tenured federal judges should be wary of removing a vexing and novel topic of medical debate from the ebbs and flows of democracy by construing a largely unamendable federal constitution to occupy the field,” Sutton wrote in his opinion.

Several other judges have already ruled against similar bans in other states, so he left the panel an out, writing, “These initial views, we must acknowledge, are just that: initial. We may be wrong.”

Legal groups representing transgender Tennessean youth, their parents, and a doctor penned a joint statement calling the ruling “beyond disappointing and a heartbreaking development.”

“As we and our clients consider our next steps, we want all the transgender youth of Tennessee to know this fight is far from over, and we will continue to challenge this law until it is permanently defeated and Tennessee is made a safer place to raise every family,” the alliance, which includes the American Civil Liberties Union and the ACLU of Tennessee, said.

It is now up to the appeals panel to make a permanent decision while the district court wrestles with whether the law itself is constitutional.