A federal court in Arkansas struck down an Arkansas law on Tuesday that banned gender-affirming care for transgender youth, finding the ban was unconstitutional. The law, Act 626, banned gender-affirming care for transgender youth and punished doctors that referred patients to such care. The ruling is the first case about gender-affirming care to reach a final decision.

Opponents of the law celebrated the US District Court for the Eastern District of Arkansas’s decision, with Deputy Director for Transgender Justice at the ACLU’s LGBTQ & HIV Project Chase Strangio saying:

This ruling offers an enormous relief to transgender youth and their families across Arkansas and across the country. In state after state, transgender people are being forced to fight for our most basic rights, including access to the health care many of us need to live. This victory shows that these laws, when tested by evidence, are indefensible under any standard of constitutional review.

In his decision, Judge James Moody, Jr. said that Act 626 violated the First Amendment of the US Constitution, as well as the Equal Protection and Due Process clauses of the Fourteenth Amendment. Act 626 violated doctor’s First Amendment right to free speech by limiting their ability to refer patients to safe and necessary medical care in line with their professional judgment. It violated the Equal Protection clause on two fronts: by determining what medical care is available to people based on their sex at birth, and by discriminating against transgender people. The interests asserted by the state of Arkansas, like protecting youth or ensuring medical safety, did not pass the heightened scrutiny that applies in cases of sex and gender discrimination.

The Due Process clause protects certain liberty rights. Moody noted that parents’ rights to raise their children are one of the most recognized and protected liberty rights. In this case, he ruled that parents “have a fundamental right to seek medical care for their children and, in conjunction with their adolescent child’s consent and their doctor’s recommendation, make a judgment that medical care is necessary.” Act 626 violated the Due Process clause because it interfered with parents of transgender youth’s ability to seek medical care for their children.

Moody rejected many of Arkansas’s arguments about the need for caution when it comes to transgender medical care, saying that “there is no evidence that the Arkansas healthcare community is throwing caution to the wind when treating minors with gender dysphoria.”

Parents and transgender youth expressed relief, with Dylan Brandt, a 17-year-old transgender boy from Arkansas and the lead plaintiff, saying:

I’m so grateful the judge heard my experience of how this health care has changed my life for the better and saw the dangerous impact this law could have on my life and that of countless other transgender people. My mom and I wanted to fight this law not just to protect my health care, but also to ensure that transgender people like me can safely and fully live our truths.

The Arkansas legislature passed Act 626 in 2021. It was the first law in the country that targeted gender-affirming care for transgender youth. The then-Governor Asa Hutchinson vetoed the bill, expressing concerns about government interference in healthcare. In an op-ed after legislators overrode his veto, Hutchinson explained that the law “puts the state as the definitive oracle of medical care, overriding parents, patients and health-care experts.”

A number of states followed Arkansas’s lead in passing bills targeting gender-affirming care and transgender youth. The degree of legislation targeting transgender people and the LGBTQ+ community more broadly led a prominent LGBTQ+ rights group to declare a state of emergency.

Moody’s decision adds to LGBTQ+ advocates’ recent victories in court, including temporary injunctions against similar laws in Indiana and Florida. “This decision sends a clear message,” said Executive Director of the ACLU of Arkansas Holly Dickson. “Fear-mongering and misinformation about this health care do not hold up to scrutiny; it hurts trans youth and must end.”