Indiana’s ban on “gender-affirming care” for minors will remain in force, a federal appeals court has ruled, reversing a lower court decision that put the law on hold.
The appellate court’s decision comes just weeks before the United States Supreme Court is set to hear arguments in a similar case challenging Tennessee’s transgender care ban under the Equal Protection Clause.
“Protecting minor children from being subjected to a new and heavily challenged medical treatment is a legitimate end,” the appeals court said earlier this week. And “because the state believes puberty blockers are dangerous when prescribed to stop puberty’s natural course and hormone therapy is dangerous when prescribed cross-sex, limiting access for those purposes is reasonable.”
Indiana enacted its transgender care ban in April 2023. The law forbids doctors from prescribing puberty blockers and hormone therapy to children under 18. Sex-change surgeries for minors are also prohibited by the statute.
The ACLU immediately challenged the law last year on behalf of a group of transgender families, arguing it was unconstitutional under the Equal Protection Clause. It convinced the federal district judge to block it before it went into effect, and Indiana appealed. Mary covered the initial stay of the lower court’s order here.
In its 2-1 decision on Wednesday, the Seventh Circuit Court of Appeals said the district court “clearly erred” when it blocked the law.
The families were unlikely to succeed on their claims that the ban discriminates based on sex, it held.
“The only way SEA 480 implicates sex at all is that the medical treatment at issue is sex specific—it denies each sex access to the other’s hormones.”
The law blocks access to sex-change treatments equally:
The Indiana law bars gender transition procedures regardless of whether the patient is a boy or a girl: Nobody may receive the treatment the state has chosen to regulate. … The law does not create a class of one sex and a class of another and deny treatment to just one of those classes.
In other words, the law doesn’t discriminate based on sex merely by referencing “sex.”
The court was also loath to second-guess the state legislature: “Courts have long permitted states to hold closely the power to regulate the practice of medicine. This power is strongest when the safety and effectiveness of the treatment is uncertain, as is true here,” the court observed. “SEA 480 is a duly enacted law. Indiana’s voters have decided, through their representatives, legislative and executive, that medical interventions are too risky and novel to be safe treatments for children with gender dysphoria.”
The case now goes back to the district court to decide, under the scrutiny of judges who have just made clear it should never have been brought in the first place: The parties, they said, should have taken their grievance “to the people of Indiana—not the courts.”
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