Appeals court rejects challenge to Tennessee, Kentucky gender-affirming care bans

A federal appeals court ruled late Thursday that bans on gender-affirming care for minors can continue in Tennessee and Kentucky. 

The appeals court ruling overturns injunctions from lower courts earlier this year that blocked the sections of the states’ laws regarding gender-affirming care, citing sex discrimination.

The court’s 2-1 decision states that Tennessee and Kentucky lawmakers made “precise cost-benefit decisions” in instituting the bans and “did not trigger any reason for judges to second-guess them.”

Both bans were passed by Republican legislatures in the states. Kentucky’s ban was vetoed by Gov. Andy Beshear (D) in March, but the veto was overridden.

“Prohibiting citizens and legislatures from offering their perspectives on high-stakes medical policies, in which compassion for the child points in both directions, is not something life-tenured federal judges should do without a clear warrant in the Constitution,” Judge Jeffrey Sutton wrote in his opinion.

At least 22 states have implemented bans on gender-affirming care and other transgender care for minors, nearly all of which have been challenged in court. Bans on gender-affirming care have been stopped by courts in Arkansas, Alabama, Indiana and Florida, mostly on procedural grounds. 

LGBTQ advocates criticized the ruling, but committed to pressing on in legal challenges against the laws.

“We’re disappointed with the court’s ruling,” Corey Shapiro, legal director for the ACLU of Kentucky, said in a statement. “The majority ignored the extensive evidence from the actual medical experts and the trial court who all agreed that this care is medically necessary, effective, and appropriate.” 

“While it is disheartening that the panel believes it is constitutional for the government to prohibit transgender youth from accessing such necessary health care, this is only a temporary setback,” he added.

Tennessee Attorney General Jonathan Skrmetti, a major advocate for his state’s ban, called the ruling a “win for democracy.” 

“Decisions that are not clearly resolved by the Constitution should be resolved by the people through their elected representatives,” he said.