Federal judge blocks Georgia from enforcing ban on hormone therapy for transgender minors

A federal judge has put Georgia’s ban on hormone treatments for transgender minors on hold. Ross Williams/Georgia Recorder

Georgia families contemplating hormone therapy for their minor transgender children will have more time to make a decision after a federal judge temporarily blocked Georgia’s ban on the treatments Sunday.

Georgia’s Senate Bill 140 went into effect July 1, preventing doctors from prescribing estrogen or testosterone to transgender people under 18, with exceptions for minors who had already started treatment before that date. Another exemption allows doctors to use sex hormones to treat minors for other reasons.

A group of Georgia families brought the case, saying that the law would prevent them from getting the treatment their childrens’ doctors recommend. The families say their children have been dealing with gender dysphoria for years and they want to begin hormone treatments on a timeline recommended by their doctors.

One mother, identified pseudonymously as Emma Koe, said her family is considering moving out of the state if her 12-year-old daughter is denied treatment.

“After the passage of this law, I felt defeated,” she said. “Many people seem to feel like being transgender is a choice, but my husband and I would never have chosen this for our child—we simply want our daughter to be alive and thriving.”

The law’s Republican backers said the measure was necessary to prevent children from undergoing irreversible treatment, but U.S. District Judge Sarah Geraghty sided with a group of Georgia families who said the law violates the Equal Protection Clause of the Fourteenth Amendment by discriminating on the basis of sex.

Geraghty quoted a Florida ruling striking down a similar ban on the same basis:

“Consider an adolescent, perhaps age 16, that a physician wishes to treat with testosterone. Under the challenged statute, is the treatment legal or illegal? To know the answer, one must know the adolescent’s sex. If the adolescent is a natal male, the treatment is legal. If the adolescent is a natal female, the treatment is illegal. This is a line drawn on the basis of sex, plain and simple.”

The state argued a different point of view, citing a Tennessee case in which a panel of judges allowed a ban on gender-affirming care to go forward. The judges in that case ruled that the Tennessee law was acceptable because it banned hormone treatments equally for both boys and girls.

Geraghty was not convinced by that argument.

“Respectfully, however, this Court is unpersuaded by this aspect of (the Tennessee case). To talk about SB 140 this way is merely to redescribe it in ostensibly neutral terms; the substance of the law is unaltered.”

Geraghty also cast doubt on the state’s arguments that the law serves a legitimate interest in protecting children from a procedure they described as unproven, which they said could lead to regrets later in life.

The broadly accepted standard of care for transgender minors can include doctor-guided hormone therapy in conjunction with social transitioning, which can include changing the child’s name, pronouns and style of dress.

The plaintiff’s witnesses argued that all medical procedures come with some risk, but it is part of a doctor’s job to weigh the risks with the benefits and offer treatments in their patients’ best interest.

Twenty medical organizations filed briefs with the court supporting the current standards, including the American Pediatric Association, The American Academy of Child & Adolescent Psychiatry and the Association of American Medical Colleges.

The state presented witnesses who argued against the mainstream opinion, but Geraghty was again skeptical.

“There is a notable inconsistency between, on the one hand, Defendants’ experts’ insistence on a very high threshold of evidence in the context of claims about hormone therapy’s safety and benefits, and on the other hand their tolerance of a much lower threshold of evidence for claims about its risks, the likelihood of desistance and/or regret, and their notions about the ideological bias of a medical establishment that largely disagrees with them,” she wrote. “That is cause for some concern about the weight to be assigned to their views, although the Court does not doubt that those they express are genuinely held.”

LGBTQ advocates say laws like SB 140 are part of a national campaign targeting transgender youth. According to the Human Rights Campaign, 21 states including Georgia have passed laws banning gender-affirming care for minors. With Geraghty’s ruling, those laws are under court injunction in six of those states.

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