Much of Ind.'s Ban on Gender-Transition Care Blocked

A federal judge issued an order Friday stopping an Indiana ban on puberty blockers and hormones for transgender minors from taking effect as scheduled July 1.

The American Civil Liberties Union of Indiana sought the temporary injunction in its legal challenge of the Republican-backed law, which was enacted this spring amid a national push by GOP-led legislatures to curb LGBTQ+ rights.

The order from U.S. District Court Judge James Patrick Hanlon will allow the law's prohibition on gender-transition surgeries to take effect. Hanlon's order also blocks provisions that would prohibit Indiana doctors from communicating with out-of-state doctors about gender-transition care for their patients younger than 18.

The ACLU filed the lawsuit within hours after Republican Gov. Eric Holcomb signed the bill April 5. The challenge, on behalf of four youths undergoing transgender treatments and an Indiana doctor who provides such care, argued the ban would violate the U.S. Constitution's equal protection guarantees and trampled upon the rights of parents to decide medical treatment for their children.

Indiana's Republican-dominated Legislature approved the ban after contentious hearings that primarily featured testimony from vocal opponents, with many arguing the gender-transition care lessened the risk of depression and suicide among young people diagnosed with "gender dysphoria,″ or distress caused when gender identity doesn't match a person's assigned sex.

Hanlon, who was appointed by former President Donald Trump, wrote that he was blocking the law from taking effect because its opponents had demonstrated potential irreparable harm to those undergoing treatment and shown "some likelihood of success" in arguments that it was unconstitutional.

The ACLU had provided "evidence of risks to minors' health and well-being from gender dysphoria if those treatments can no longer be provided to minors — prolonging of their dysphoria, and causing additional distress and health risks, such as depression, posttraumatic stress disorder, and suicidality," Hanlon said. "While the State has identified legitimate reasons for regulation in this area, the designated evidence does not demonstrate, at least at this stage, that the extent of its regulation was closely tailored to uphold those interests."

ACLU leaders hailed the ruling as a victory in the fight "to defend the right of all trans people to be their authentic selves, free from discrimination."

"We won't rest until this unconstitutional law is struck down for good," Ken Falk, the ACLU of Indiana's legal director, said in a statement.

At least 20 GOP-led states have now enacted laws restricting or banning such medical treatments for transgender minors after Missouri's governor signed that state's bill into law last week. Lawsuits have been filed in several states against transgender treatment bans. Federal judges have also blocked enforcement of laws in Alabama and Arkansas, and Oklahoma has agreed to not enforce its ban while opponents seek a temporary court order blocking it.

Indiana bill sponsor state Rep. Joanna King, R-Middlebury, said as the ban was debated that it would "protect our children from irreversible, harmful, life-altering procedures."

Republican state Attorney General Todd Rokita's office said in a statement it was disappointed in the decision but that "we will continue to fight for the children." The statement said the ruling "recognizes that the State has shown there are good reasons for regulating gender-transition procedures for minors."

The office didn't say whether it would attempt to appeal the injunction before July 1. Provisions of the law that were blocked gave trans youth taking medication to transition until Dec. 31 to stop.

A top attorney for the state told Hanlon during a court hearing on Wednesday that risks from gender-transition treatments during puberty such as future fertility, bone strength, brain development, and possible reversibility had not been adequately studied by scientists.

Such factors make it within the Legislature's authority to decide "we don't want our children to be part of this grand experiment," Indiana Solicitor General Thomas Fisher said.

Though guidelines from leading authorities on gender-transition medical care already say surgery generally should be reserved for adults, with exceptions for older teens who meet certain criteria, the Indiana law calls for an immediate ban on gender-transition surgeries.

The provisions of the law banning gender-transition surgeries for minors in Indiana will have no immediate impact. Hanlon wrote in his ruling that no medical providers in the state may perform those procedures on people younger than 18.

Representatives from Indiana University Health Riley Children's Hospital, the state's sole hospital-based gender health program, told legislators earlier this year that for patients who are minors, doctors do not perform genital surgeries or provide those surgery referrals. IU Health was not involved in the ACLU's lawsuit.