Federal Court Greenlights Indiana’s Law Banning Gender Transition Procedures for Minors

A federal court is allowing the Hoosier State to ban gender transition procedures for minors. The Seventh U.S. Circuit Court of Appeals issued an order on Tuesday staying a preliminary injunction that a U.S. District Court judge had granted last year against Indiana Senate Bill (S.B.) 480. The circuit court’s order allows S.B. 480, signed into law last year by Governor Eric Holcomb (R), to finally take effect, prohibiting gender transition procedures for minors. The court heard oral arguments regarding the preliminary injunction earlier this month and promised that an “opinion from this court will follow” Tuesday’s order.

S.B. 480 explicitly bans “any medical or surgical service, including physician’s services, practitioner’s services, inpatient and outpatient hospital services, or prescribed drugs related to gender transition” performed on or prescribed to minors. The legislation allows for civil penalties against any “physician or practitioner” who violates the law or “aids or abets another physician or practitioner” in violating the law.

The legislation was approved by Indiana’s state Senate in February of 2023 and by the state House of Representatives in March. Holcomb signed the bill into law in early April. Originally, the legislation was slated to take effect July 1, allowing until the end of December for physicians who were already being prescribing puberty blockers or hormone drugs to minors to end the regimens.

“Indiana law always has a vested interest in the well-being of our children,” state Republicans explained before passing the bill. “Given the irreversibility and unproven science surrounding these treatments, it is appropriate to address this issue at the state level. … The mental and emotional effects of undergoing these procedures are still being studied, and there is a lot that scientists still don’t understand.” They added, “For this reason, other countries around the world are scaling back the use of gender transition procedures on children.”

For his part, Holcomb explained when signing the bill into law, “There has and will continue to be debate within the medical community about the best ways to provide physical and mental health care for adolescents who are struggling with their own gender identity, and it is important that we recognize and understand those struggles are real.” He added, “Permanent gender-changing surgeries with lifelong impacts and medically prescribed preparation for such a transition should occur as an adult, not as a minor.”

But just days after the bill became a law, the American Civil Liberties Union (ACLU) filed a lawsuit against the state to block the law, alleging that it violated the U.S. Constitution, the Medicaid Act, and the Affordable Care Act. The ACLU claimed that the law “prohibits essential medial services that would otherwise be authorized and reimbursed by Medicaid.” In June, Trump-appointed U.S. District Court Judge James Patrick Hanlon placed a partial preliminary injunction on the legislation, allowing the ban on gender transition surgeries to proceed but blocking the legislation’s remaining provisions.

Hanlon wrote, “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.” Instead, he claimed that denying children access to puberty blockers and hormone drugs may result in “prolonging of their dysphoria, and causing additional distress and health risks, such as depression, posttraumatic stress disorder, and suicidality.”

However, as Indiana’s senate Republicans noted, experts are still studying the long-term effects of gender transition procedures, including their potential benefit and the harm they may cause, especially to children. One such expert, Dr. Jennifer Bauwens, director of the Center for Family Studies at Family Research Council, explained, “Despite claims to the contrary, these procedures are often not reversible, and they are not evidence-based.” Emphasizing the irreversible nature of gender transition procedures, she continued, “Research has not shown that these procedures are effective in accomplishing their purpose, which is to improve the patient’s mental health. They violate the most fundamental principle of medical ethics: ‘First, do no harm.’”

Given Tuesday’s order, there are now 23 states which have restricted or banned gender transition procedures for minors: Alabama, Arkansas, Arizona, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, South Dakota, Tennessee, Texas, Utah, and West Virginia. Additionally, a growing number of European nations have begun restricting or ending gender transition procedures for minors, including France, Sweden, Finland, and the U.K.