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UPDATE: A judge blocked part of Kentucky’s gender-affirming medical care ban. What happens next?

Christy and Max Davis hold signs showing support for trans rights, including a sign that says: "Gender-affirming care saves lives." They came to the Kentucky Capitol in March to protest a bill that would prevent trans children like Max, an 11-year-old trans boy who lives in Louisville, from receiving gender-affirming medical care.
Jess Clark
Louisville Public Media
Christy and Max Davis came to the Kentucky Capitol in March to protest a bill that would prevent trans and nonbinary children from receiving certain types of gender-affirming medical care. Max is an 11-year-old trans boy from Louisville.

Transgender people and their allies celebrated a judge’s decision to temporarily block a state ban on gender-affirming hormone therapy for trans patients under 18 years old. Now the next phase of the lawsuit can begin.

This story briefly mentions suicidal thoughts. If you or someone you know is struggling with thoughts of suicide, you can reach the National Suicide Prevention Lifeline by phone at 988, or online at https://988lifeline.org/.

If you’re looking for transgender peer support, you can reach the Transgender Wellness Coalition online at transwellnesscoalition.org. You can also contact the Trevor Project, which provides free, confidential counselors who specialize in helping LGBTQ youth.

Because of Wednesday’s ruling, Senate Bill 150’s ban on certain gender-affirming medical treatments can’t go into effect until the legality of those restrictions is decided.

Republican Attorney General Daniel Cameron filed an appeal Thursday over the U.S. district court decision to stop the ban with a temporary injunction. He hopes a U.S. appeals court will reverse course.

This week's ruling was welcome news to Alexander Griggs, a transmasculine man who serves as executive director of the local organization Transcending Stigma and as outreach coordinator for the Fairness Campaign.

“I am extremely excited that it went through,” Griggs said of the current, temporary injunction against the law. “This is going to be a monumental help for the mental health of gender-expansive kids all over the state.”

Through Transcending Stigma’s mentorship program, he said he personally knows several gender-expansive kids whose parents “are relieved and overjoyed at the fact that they will be able to continue to seek gender-affirming care in Kentucky for their children.”

Research shows trans people who've received gender-affirming care have seen reductions in suicidal thoughts and in depression.

“Not all gender-expansive people experience gender dysphoria. But for those of us that do, it can be crippling,” Griggs told LPM News. “In my own life, gender-expansive, gender-affirming care has made all of the difference between … pretty much my entire life of fighting suicidal ideation to like a light switch of, all of a sudden, ‘I want to live.’”

The Republican-led Kentucky Legislature enacted SB 150 in March. Similar anti-trans legislation passed other states’ GOP-controlled legislatures this year, too, and have been challenged in federal court like Kentucky’s law is right now.

The ACLU of Kentucky seeks to overturn the part of SB 150 that prohibits trans kids from receiving gender-affirming hormone therapy, including estrogen or testosterone treatment as well as medication that delays puberty.

It is not challenging the law’s prohibition against gender-affirming surgery for trans kids, nor is it challenging restrictions the law places on public schools that negatively affect transgender students. Experts say it’s already vanishingly rare for a minor to get any form of gender-affirming surgery.

There’s a chance SB 150’s ban on hormone therapy won’t ever take effect, based on what U.S. District Court Judge David Hale wrote in Wednesday’s ruling.

The plaintiffs in the case — which include several trans children and their parents — argue the restrictions are unconstitutional, and Hale said they showed a “strong likelihood of success.”

He also indicated that various arguments Cameron made in support of SB 150 are weak.

“Doctors currently decide, based on the widely accepted standard of care, whether puberty-blockers or hormones are appropriate for a particular patient,” Hale wrote. “Far from ‘protecting the integrity and ethics of the medical profession’ … SB 150 would prevent doctors from acting in accordance with the applicable standard of care.”

The ACLU’s communications director, Angela Cooper, said Wednesday’s ruling is “very hopeful” for the plaintiffs as they move to the next phase of their lawsuit and argue the merits of the arguments.

“The judge seems to feel that we have an extremely strong case,” Cooper said. “Our legal arguments are solid. The opposition’s legal arguments are not. They are based in fiction and fear-mongering, and I believe that our legal team will prevail.”

Cameron — who’s defending SB 150 in court and also is running for governor this fall — criticized Wednesday's ruling.

“Today’s misguided decision by a federal judge tramples the right of the General Assembly to make public policy for the commonwealth,” Cameron said in a statement late Wednesday afternoon.

He called SB 150 a “commonsense law that protects Kentucky children” and claimed hormone treatments “threaten the safety of minors.”

Some Republican state legislators made similar claims when they passed SB 150 into law.

However, a wide range of medical professionals say hormone therapy can be safely provided to minors and is only authorized after careful consultations between a trans child, their parents and their health care providers.

In Wednesday’s ruling, the judge noted that the prohibited treatments “have a long history of safe use in minors for various conditions.”

“Based on the evidence submitted, the Court finds that the treatments barred by SB 150 are medically appropriate and necessary for some transgender children under the evidence-based standard of care accepted by all major medical organizations in the United States,” Hale wrote.

State Sen. Max Wise, a Republican from Campbellsville, criticized Hale’s ruling in a statement Thursday. He was SB 150’s lead sponsor.

“Unfortunately, in these litigious times, legislation reflecting the will of Kentucky residents that protects our most vulnerable is met with activist roadblocks seeking to undermine the law,” Wise said. “I strongly disagree with this misguided opinion that reads more as a medical opinion on policymaking than sound jurisprudence.”

When he helped get SB 150 enacted this spring, he was running for lieutenant governor alongside then-gubernatorial candidate Kelly Craft. Craft lost the Republican primary for governor to Cameron in May.

Although the state’s ban on hormone therapy is blocked for now, Madelyn Spalding — the assistant director of development for Louisville Youth Group — said the political impact of SB 150 already has hurt trans people.

“Even debating the rights of trans people so openly — and being able to spread misinformation and propaganda that’s contrary to science — is having the effect of terrorizing trans people in the state,” she said.

While young trans Kentuckians’ access to gender-affirming medical care may ultimately be determined in court, Spalding said community support for trans people of all ages will remain accessible through initiatives like the Trans Wellness Coalition and Louisville Youth Group.

“Wellness is holistic care, so a big part of that is support and having community,” said Spalding, who is a trans woman. “There are little pockets of support all over.”

This story was updated.

Support for this story was provided in part by the Jewish Heritage Fund.

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Morgan is LPM's health reporter. Email Morgan at mwatkins@lpm.org.