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Indiana’s gender-affirming care ban for transgender youth takes effect after higher court’s ruling

By Lauren Chapman

Posted February 28, 2024

The decision Tuesday does not stop the underlying case, which was granted class action certification in January. A bench trial is tentatively set for April 2025. (Lauren Chapman/IPB News)

The 7th Circuit Court of Appeals struck down an injunction on Indiana’s gender-affirming care ban for Hoosiers younger than 18. The law now takes effect immediately.

However, the decision Tuesday does not stop the underlying case, which was granted class action certification in January. A bench trial is tentatively set for April 2025.

A lower court judge had previously blocked parts of the state’s law, SEA 480. It bans medicinal and surgical gender-affirming care for transgender youth in Indiana and prevents providers from “aiding and abetting” parents seeking that treatment outside of the state.

Gender-affirming care is health care that encompasses mental, social, medicinal and surgical care designed to treat gender dysphoria. And gender dysphoria is a clinically significant distress experienced by people whose gender assigned at birth and gender identity don’t match — though not all transgender people experience gender dysphoria.

In response to the order, the ACLU of Indiana — which represents transgender youth, their parents and gender-affirming care providers in the lawsuit — called it “beyond disappointing.”

The injunction had halted the law’s ban on medicinal care and limitations on provider referrals.

But, with the law in effect, transgender youth no longer have access to puberty blockers. The law originally built in a six-month window for those on hormone replacement therapies – also known as HRT. The cut-off in the law for those therapies was Dec. 31, 2023.

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The lower court’s injunction stopped short of halting the state’s ban on gender-affirming surgeries. Transgender youth in Indiana already do not have access to gender-affirming surgeries because it goes against national guidance for those under 18. During testimony on the measure and in court documents, gender-affirming care providers said minors are not offered gender-affirming surgeries, as it would go against national and international guidance.

Part of the ACLU’s core argument is that the law discriminates against transgender Hoosiers, as the same therapies now banned in the state are available to cisgender teens.

For example, puberty blockers are banned as gender-affirming care for Hoosier youths with gender dysphoria, but are still available to children experiencing precocious puberty. A cisgender teenage girl in Indiana may receive a gender-affirming surgery like a breast augmentation, but the same procedure — which would go against national guidance on age-appropriate care — is banned for a transgender teenage girl.

The vast majority of medical organizations support gender-affirming care, and there is national and international guidance on age-appropriate interventions for transgender youth.

The language of Indiana’s ban shares parallel language with Arkansas’s ban. It was also blocked by a federal judge, along with similar bans in Idaho and Montana.

Lauren is our digital editor. Contact her at lchapman@wfyi.org or follow her on Twitter at @laurenechapman_.