A federal appeals panel on Saturday said a Tennessee law that would ban hormone therapy and puberty blockers for transgender youth could go into effect, marking the first time a federal court has allowed a law banning transition care to take full effect in the United States.

The ruling, issued by a divided three-judge panel of the US Court of Appeals for the Sixth Circuit in Cincinnati, comes less than two weeks after a district court temporarily blocked the ban on hormone therapy and puberty blockers. The judges, who will now consider a wider appeal of the law’s temporary hold, said a final decision would come before September 30.

The decision is a telling blow to transgender youth, their families and their allies, who have leaned on the nation’s judiciary as a last resort to block a series of sweeping laws aimed at transitioning care, legislation they say would be harmful to young people’s health. .

Until the ruling Saturday, judges were forced by the argument that the laws are discriminatory against transgender people and violated the Constitution, deciding whether to temporarily or permanently block their implementation.

The decision also underscores how tenuous and uncertain the medical and political landscape is for transgender youth and their families, as conservative-led states have enacted a series of laws designed to curb LGBTQ rights and access to health care. Twenty states have passed bans or restrictions on transition-related medical care, leaving many families and medical providers to consider moving their homes and practices for access to that care.

In Tennessee, the Republican supermajority of the Legislature rallied around such a law, calling it SB 1 as a sign of its importance to the lawmakers’ agenda. Once in effect, the law prevents doctors from starting transitional care for new patients and ending existing care for current patients by March 2024.

But just days before the law was set to take effect on July 1, Judge Eli J. Richardson of the Middle District of Tennessee decided to temporarily preserve access to hormone therapy and puberty blockers, although he allowed the law’s ban on transitions to go into effect. operations for minors.

But the appeals panel, led by Chief Justice Jeffrey S. Sutton, found that Judge Richardson had gone too far in issuing a statewide ruling and questioned whether the challengers would prevail with their argument that the law violated constitutional rights.

“Life-long federal judges should be wary of removing a vexing and novel topic of medical debate from the ebbs and flows of democracy by constructing a largely unamendable federal constitution to occupy the field,” wrote Judge Sutton, who was called to the court of former president George W. Bush and became chief justice in 2021. He also argued that the State Parliament had the standing to regulate such treatment.

He offered a caveat, however, especially since several other judges have decided to rule against similar bans in other states. He wrote that “these initial views, we must admit, are just that: initial. We may be wrong.”

His decision was joined by Justice Amul Thapar, who was called to his seat by former President Donald J. Trump.

Chief Justice Helene N. White, who was also confirmed to her seat on the court during the presidency of George W. Bush, said she narrowed the scope of the injunction by temporarily blocking the law from taking effect, rather than overturning it altogether. But unlike the other judges on the panel, she said she believes the law is likely unconstitutional by discriminating on the basis of sex.

In her opinion, where she both agreed and disagreed with the majority, she also emphasized that the decision was only preliminary.

But Republicans, who framed the law as a necessary mechanism to protect children from risky medical treatment, celebrated the panel’s decision on Saturday.

“The case is far from over, but this is a big victory,” said Jonathan Skrmetti, the attorney general of Tennessee, in a statement, predicting that the state will likely win its broader defense of the law.

In a joint statement, legal groups challenging the ban on behalf of transgender Tennessee youth, their parents and a doctor called the decision a “beyond disappointing and heartbreaking development.”

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

The appeals panel will now consider a more permanent decision on the temporary ruling, while the district court hears arguments on the constitutionality of the underlying law.

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