Court halts Tennessee's ban on gender affirming care, at least for now

A federal judge has blocked part of Tennessee's new law banning transgender medical care for minors from going into effect on July 1, ahead of a full trial scheduled for early 2024.

In a late Wednesday ruling, Judge Eli Richardson issued an order blocking the state from enforcing a ban on gender-affirming medications such as puberty blockers and hormone therapies. Under the order, Tennessee can enforce its ban on gender transition surgical procedures, with Richardson finding that none of the plaintiffs were planning to pursue surgery as minors. 

The injunction is temporary, pending a complete trial on the lawsuit, but Richardson's opinion indicated Tennessee officials have so far failed to make a convincing case on the constitutionality of the law, which General Assembly Republicans moved quickly to pass earlier this year.

In his ruling, Richardson said he doesn't take "lightly" the decision to block a state from enforcing a law.

"The legislative process, however, is not without constraints," Richardson said. "If Tennessee wishes to regulate access to certain medical procedures, it must do so in a manner that does not infringe on the rights conferred by the United States Constitution, which is of course supreme to all other laws of the land. With regard to SB1, Tennessee has likely failed to do just this."

Tennessee families and doctors first sued Tennessee in April, and weeks later the Department of Justice joined the lawsuit to challenge the pending law that was passed amid conservative backlash to a Nashville gender-affirming care clinic that treated some high-risk adolescents.

Plaintiffs include Nashville residents Samantha and Brian Williams and their 15-year-old transgender daughter L.W.; Rebecca Roe and her 15-year-old son Ryan; and the anonymous parents of a 12-year-old son. The plaintiffs also include Memphis-based Dr. Susan Lacy, who provides gender-affirming care for her patients.

 "We don’t want to leave Tennessee, but this legislation would force us to either routinely leave our state to get our daughter the medical care she desperately needs or to uproot our entire lives and leave Tennessee altogether," Samantha Williams said in court filings. "No family should have to make this kind of choice.”

The law, passed in February, would prohibit people under age 18 from receiving puberty blockers, hormone therapies or surgical procedures. If allowed to go into effect on July 1, it would ban new prescription of medications while allowing current patients to wean off the medications by next March.

Tennessee officials had argued this step-down period negated the need for a temporary injunction, but Richardson didn't find the state's initial arguments compelling.

The plaintiffs argued they will suffer psychological, emotional and physical harm if they can longer access treatment for their gender dysphoria, claims Richardson found were supported by medical evidence on the record.

Richardson's ruling did not block a clause in the law allowing people who received gender-affirming treatment as minors to sue parties for authorizing the care. Bill sponsors initially included language to categorize parents seeking such treatments for their kids as abuse or neglect, but that section was later stripped from the bill as it made its way through committees.

Major U.S. medical associations, such as the American Medical Association and the American Academy of Pediatrics, have supported gender transition health care as evidence-based medicine.

Tennessee's law mirrors a slew of similar legislation in other states, many of which have also been challenged in court over the issue. Earlier this month, a federal judge in Arkansas completely struck down a similar law, while judges in Kentucky and Florida have issued preliminary injunctions in ongoing cases that closely resemble the Tennessee lawsuit.

More:How the 14th Amendment is changing the fight for gender-affirming care for minors

Richardson alluded to these cases in his filing, acknowledging his ruling would like "stoke the already controversial fire" surrounding transgender rights in America.

"The Court, however, does not stand alone in its decision," Richardson said. "As repeatedly emphasized above, several federal courts across the country have been confronted with laws that mirror SB1 in material respects. To the Court’s knowledge, every court to consider preliminarily enjoining a ban on gender-affirming care for minors has found that such a ban is likely unconstitutional. And at least one federal court has found such a ban to be unconstitutional at final judgment. Though the Court would not hesitate to be an outlier if it found such an outcome to be required, the Court finds it noteworthy that its resolution of the present Motion brings it into the ranks of courts that have (unanimously) come to the same conclusion when considering very similar laws.