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Indiana Law Prohibiting Gender Transition Procedures for Minors Upheld by Appeals Court


The court stated that the plaintiffs did not present evidence to support an injunction.

On Nov. 13, a federal appeals court upheld an Indiana law that prohibits gender surgeries and transition procedures for minors in a split decision.

A majority of a U.S. Court of Appeals for the Seventh Circuit panel stated that a U.S. district judge wrongly concluded that the plaintiffs suing the law would suffer irreparable harm by not having access to puberty blockers and cross-sex hormones if the law remained in place.

According to U.S. Circuit Judge Michael Brennan, the court acknowledged the evidence supporting the effectiveness of medical interventions for treating gender dysphoria but failed to consider other evidence showing that psychotherapy and psychosocial support are also effective treatment options. He wrote in the majority opinion, “It might be different if Indiana prohibited all treatment for gender dysphoria, but the law does not do so.”
In 2023, U.S. District Court Judge James Patrick Hanlon ruled that plaintiffs, who are transgender youth, could face health risks like depression and suicidal thoughts without access to puberty blockers and hormone therapy.

The law signed in 2023 prohibits any medical or surgical procedures aimed at altering or removing physical characteristics typical of an individual’s sex or creating physiological characteristics different from their sex. However, exceptions are made for traditional uses of these procedures.

The appeals court had previously lifted Hanlon’s injunction without issuing an opinion. The majority, in the new decision, expressed that blocking the law, known as SEA 480, would cause significant harm to Indiana and the public interest.

“SEA 480 has been lawfully enacted. Indiana’s voters, through their legislative and executive representatives, have determined that medical interventions are too risky and experimental to be safe for children with gender dysphoria. The people of Indiana have a significant interest in that decision’s effectiveness,” Brennan stated. “Since the plaintiffs have not demonstrated the likelihood of success and their harms are not irreparable, we conclude that Indiana’s interests outweigh their harms.”

The majority also dismissed arguments related to the youths’ constitutional rights, including equal protection rights. Brennan mentioned, “The law prohibits gender transition procedures regardless of the patient’s gender, preventing anyone from receiving the treatment the state chose to regulate, irrespective of their sex. Therefore, gender does not determine the basis for prohibiting treatment.”

U.S. Circuit Judge Kenneth F. Ripple agreed with Brennan.

In a dissent, U.S. Circuit Judge Candace R. Jackson-Akiwumi stated that the law violates the First Amendment by restricting doctors from assisting each other in providing gender transition procedures to minors.

“SEA 480’s aiding and abetting provision,” she explained, “violates the First Amendment as it does not regulate speech integral to unlawful conduct, speech incidental to regulated conduct, or Providers’ pure speech that survives strict scrutiny.”



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