Arkansas Ban on Gender-Affirming Care Upheld

Tuesday, August 12, the U.S. Court of Appeals for the Eighth Circuit upheld Arkansas’s ban on gender-affirming care for minors, reversing a lower court’s block of the law in 2023.

Arkansas House Bill 1570 or the “Save Adolescents From Experimentation” Act (SAFE), is among the most restrictive in the United States. The 2021 law forbids gender-affirming medical procedures for transgender people under 18, prevents physicians from prescribing puberty blockers, and prohibits hormone therapy. It also bars formal referrals for such care, creating professional risks for providers and severing a critical link between families and affirming medical guidance.

This is the second occasion that the federal appellate court has weighed in on transgender rights. In June of this year, the Supreme Court upheld United States v. Skrmetti, Tennessee’s fairly identical trans healthcare ban.

Together, these two rulings form a new constitutional groundwork that allows individual states to regulate and prohibit treatments that every major U.S. medical association considers essential for the health and well-being of transgender youth. The Supreme Court found Arkansas lawmakers could view the restrictions as being protective of minors, despite the evidence from the medical community pointing to the opposite.

Leah Litman, a Constitutional law professor, told The Advocate that the ban on transgender youth care is both legally flawed and dangerous. Litman told The Advocate “that the logic collapses under scrutiny” because the very same treatments remain legal for cisgender minors with other conditions, such as precocious puberty, but are banned when prescribed for gender dysphoria. “That’s obviously discrimination on the basis of gender identity,” she says. Litman warned that Skrmetti “opens it up to states saying that adults can also not receive this care,” setting the stage for far broader restrictions. The law also bans the use of insurance and public funds to cover gender transition procedures. Furthermore, doctors who provide treatment in violation of the ban can be sued for damages or sanctioned.

Medical and psychiatric groups like the American Medical Association, the American Psychiatric Association, the American Academy of Child & Adolescent Psychiatry, and the World Health Organization all agree that gender-affirming care is evidence-based and medically necessary for minors. Several studies have demonstrated that depression and anxiety are alleviated in youth when they receive treatment for gender dysphoria.