Federal court reverses course & allows Tennessee’s trans healthcare ban to go into effect

A U.S. appeals court has allowed Tennessee’s ban on gender-affirming healthcare for minors to go into effect. The law bans doctors from providing puberty blockers and hormone therapy to anyone under the age of 18. It also forces young people who are already receiving gender-affirming care to end their treatment by March 31, 2024.

In a Saturday ruling, the U.S. Court of Appeals for the Sixth Circuit voted 2-1 to overturn a lower court ruling that blocked the state from enforcing the law while a court challenge against its constitutionality proceeds, Reuters reported.

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In his decision, Chief Judge Jeffrey Sutton wrote that the state legislature is better equipped to decide how to regulate “new medical treatments” rather than the courts. Sutton also wrote that the Food and Drug Administration (FDA) hadn’t approved the use of puberty blockers and hormone therapy to treat gender dysphoria, making the drugs potentially unsafe.

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However, these medications have been used for decades to treat childhood medical conditions like endometriosis, prostate cancer, and early-onset puberty. While the FDA hasn’t approved the drugs to treat gender dysphoria, many medications are used “off-label” for different medical purposes without endangering patients.

“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,” Sutton wrote.

Lambda Legal and the American Civil Liberties Union (ACLU) sued Tennessee in April, stating that its law discriminates against transgender people based on their sex, violating the Constitution’s Equal Protection Clause.

While Sutton disagreed with this assertion, Appeals Court Judge Helene White wrote in her dissent that she agreed that the law likely violates the Equal Protection Clause since the medications in question are given to cisgender children. Gender-affirming medications are considered safe and essential to trans youth by major medical groups, including the American Academy of Pediatrics, the American Medical Association, and the Endocrine Society.

The appeals court lifted the lower court’s injunction but set an expedited deadline for determining the law’s constitutionality to be settled by September 30.

In a statement, the ACLU wrote, “This ruling is beyond disappointing and a heartbreaking development for thousands of transgender youth, their doctors, and their families. 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.”

Judges have also blocked similar bans in Florida, Arkansas, Indiana, Kentucky, Alabama, and Oklahoma. In late June, a federal court upheld a Tennessee state law preventing trans people from correcting the gender marker on their birth certificates.