Federal judge hears bid to block Indiana’s ban on gender-affirming care for minors

A federal judge in Indianapolis made no immediate ruling after hearing about 90 minutes of arguments from the Indiana attorney general’s office and the American Civil Liberties Union of Indiana, which is seeking a preliminary injunction that would stop the law from taking effect July 1. The group filed its lawsuit, on behalf of four transgender patients and an Indiana doctor who provides transgender medical treatment, within hours after Republican Gov. Eric Holcomb signed the bill April 5.

The lawsuit says the ban violates the U.S. Constitution’s equal protection guarantees as well as federal laws regarding essential medical services, and wrongly prohibits Indiana doctors from communicating with out-of-state doctors about gender-affirming care for their patients younger than 18.

Ken Falk, the ACLU of Indiana’s legal director, argued that the law interferes with what major medical organizations endorse as proper treatments for young people diagnosed with “gender dysphoria,″ or distress caused when gender identity doesn’t match a person’s assigned sex.

“We think this is a clear violation of parental rights,” Falk told U.S. District Court Judge James Patrick Hanlon.

Indiana’s ban was enacted amid a national push by Republican-led legislatures to curb LGBTQ+ rights. At least 20 states have now enacted laws restricting or banning gender-affirming medical care for transgender minors after Missouri’s governor signed that state’s bill into law last week.

Indiana’s Republican-dominated Legislature approved the ban this spring after contentious hearings that primarily featured testimony from vocal opponents, with many arguing the gender-affirming care lessened the risk of depression and suicide among transgender youth.

Experts say allowing children to express their gender in a way that matches their identity is beneficial. Transgender medical treatment for youths, such as puberty blockers — fully reversible prescription medication — has been available in the United States for more than a decade. Research suggests that transgender youth and adults are prone to stress, depression and suicidal thoughts, and the evidence is mixed on whether treatment with hormones or surgery resolves those issues.

Guidelines from leading authorities on gender-affirming medical care say surgery generally should be reserved for adults, with exceptions for older teens who meet certain criteria.

Bill sponsor Republican Rep. Joanna King of Middlebury said the ban would “protect our children from irreversible, harmful, life-altering procedures.”

A top attorney for the state told Hanlon that risks from gender-affirming treatments during puberty such as future fertility, bone strength, brain development and possible reversibility had not been adequately studied by scientists.

Such factors make it within the state Legislature’s authority to decide “we don’t want our children to be part of this grand experiment,” Indiana Solicitor General Thomas Fisher said.

“This is a matter of regulatory judgement,” Fisher said.

Lawsuits have been filed in several states against transgender treatment bans. Federal judges have blocked enforcement of laws in Alabama and Arkansas, and Oklahoma has agreed to not enforce its ban while opponents seek a temporary court order blocking it.

The Indiana law would immediately ban gender-affirming surgeries while trans youth taking medication to transition would have until Dec. 31 to stop. Doctors who violate the ban could be disciplined by the state medical licensing board.

Hanlon, a former President Donald Trump appointee, acknowledged the law was set to take effect soon but didn’t specify a timing to release his decision. Hanlon in 2021 issued an order blocking an Indiana law that would have required doctors to tell women undergoing drug-induced abortions about a disputed treatment for potentially stopping the abortion process.

Falk, the ACLU’s attorney, said it was “vitally important” for the judge to put the law on hold as it threatens the treatment for hundreds of young people across Indiana.

“People are talking about moving out of the state,” Falk said after the hearing. “People are desperate to try and get care.”