Federal Appeals Court Upholds Arkansas Ban on Transgender Treatments for Minors

Federal Appeals Court Upholds Arkansas Ban on Transgender Treatments for Minors

A full panel of the U.S Court of Appeals for the Eighth Circuit has upheld Arkansas’ ban on transgender treatments for minors.

The court’s ruling follows the U.S. Supreme Court’s landmark decision in U.S. v. Skrmetti, upholding a similar ban in Tennessee, as we reported here this past June.

Yesterday, over a partial dissent, the federal appeals court held that the Arkansas ban doesn’t discriminate based on sex. Its distinctions are based on age and medical procedure, the en banc panel concluded, echoing the Supreme Court’s reasoning in Skrmetti.

Guided by Skrmetti, the judges declined to “second-guess” Arkansas lawmakers: “The Supreme Court leaves wide discretion for medical legislation to the more politically accountable bodies, especially in areas of medical uncertainty,” they stated, quoting the June decision.

The Arkansas “SAFE” Act prohibits doctors and healthcare professionals from providing “gender transition procedures” to minors, including puberty blockers and hormone therapy. Sex-change surgeries on children under 18 are also prohibited by the Act.

A group of plaintiffs, including four minors, their parents, and two healthcare professionals, sued to block enforcement of the Act, arguing it violated their constitutional rights under the Equal Protection Clause, the Due Process Clause, and the First Amendment. In 2023, the district court agreed and permanently blocked the law. The State and the Arkansas Medical Board appealed.

The appellate court rejected their Equal Protection claim. “Like the Tennessee law, the Act prohibits providing medical treatment for certain purposes, and these prohibitions apply even if one switches the sex of a hypothetical minor. Thus, the Act does not discriminate on the basis of sex,” the court concluded.

Notably, the Eighth Circuit also rejected the minors’ argument that the Arkansas ban runs afoul of the Supreme Court’s fraught ruling in Bostock v. Clayton. In Bostock, the Court held that an employer who fires an employee for being gay or transgender violates Title VII’s prohibition on discharging an individual “because of ” their sex.

However, in Skrmetti, the high court made crystal clear it had not yet decided whether its reasoning in Bostock reaches beyond the Title VII employment context. Regardless, the appeals court concluded that applying Bostock would not change the outcome in this case because the law doesn’t discriminate based on sex to begin with.

Nor did the statute discriminate based on transgender status. “The Act, like the Tennessee law, regulates a class of procedures, not people,” the court held.

Because the ban doesn’t discriminate based on sex, the court applied the rational basis test to conclude the Act is rationally related to the state’s legitimate interest in protecting the well-being of minors, passing constitutional muster under the Equal Protection Clause.

One argument that had not come up in Skrmetti was raised by the healthcare professionals, who claimed the State ban violated their free speech rights under the First Amendment. The court rejected it. A referral for treatment is not part of the “speech process,” it reasoned. Any restriction on speech is “plainly incidental” to the Act’s regulation of conduct.

Additionally, the parents argued that the Act violated their rights to make medical decisions for their children. However, those rights aren’t absolute, the court stated, and don’t include a right to exempt their children from regulations reasonably prohibiting gender transition procedures.

“It does not violate this Nation’s historical concept of ordered liberty for the people of Arkansas, through their legislature, to prohibit physicians from providing gender transition procedures for minors,” the court concluded.

The court’s ruling reverses the trial court’s injunction blocking the Act’s enforcement, sending it back for further proceedings.

It follows last week’s Tenth Circuit decision rejecting a challenge to Oklahoma’s ban on transition procedures, also relying on Skrmetti.

Arkansas was the first state to pass a “gender-affirming care” ban for minors, followed by 25 others, most recently New Hampshire, the first state in New England to ban the life-altering treatments.

Yesterday’s decision was applauded across X:

BREAKING: 8th Circuit Court of Appeals OVERTURNS woke ruling, UPHOLDING Arkansas law banning the chemical and surgical castration of children.

HUGE WIN pic.twitter.com/pstwzZjl6r

— Libs of TikTok (@libsoftiktok) August 12, 2025

WINNING IN ARKANSAS! 🎉

The 8th Circuit Court of Appeals has upheld the Arkansas law banning the chemical & surgical castrations of children!

Save the children! 🇺🇸 pic.twitter.com/qOxYDo2Dq5

— Gays Against Groomers (@againstgrmrs) August 12, 2025

The U.S. Court of Appeals for the Eighth Circuit has reversed the injunction in Brandt v. Griffin, which means the SAFE Act, which bans gender transition procedures for minors, can be enforced once the mandate issues.

I applaud the court’s decision and am pleased that children… pic.twitter.com/W3fgqIwRxV

— Attorney General Tim Griffin (@AGTimGriffin) August 12, 2025

Great news for the human rights and natural rights of children and families! https://t.co/wy40Sisc2c

— Harmeet K. Dhillon (@HarmeetKDhillon) August 12, 2025

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