The US of Appeals for the Seventh Circuit on Wednesday vacated an injunction against an Indiana law prohibiting gender-affirming care for minors, allowing the law to take effect.

In a split decision, the majority stated that the lower US district court erred in issuing the injunction because plaintiffs failed to show “irreparable harm” if the law took full effect. The majority supported their decision by stating that while the district court “was correct to recognize the record evidence supporting the effectiveness of medical interventions to treat gender dysphoria, the court failed to even discuss other record evidence establishing that psychotherapy and psychosocial support are also effective treatment options.” As a consequence of the viability of alternative treatments, the injunction was improper.

The majority also rejected the plaintiffs’ claim that the law violates their Fourteenth Amendment rights to equal protection under the law based on sex. The judges stated that because the law “bars gender transition procedures regardless of whether the patient is a boy or a girl,” no discrimination on the basis of sex could occur.

The dissenting judge wrote that the law’s impact on medical providers in Indiana raises major concerns. The law prohibits physicians from providing gender-affirming care and also prohibits physicians from “aiding and abetting” other physicians from “doing the same.” According to the dissent, the limitations placed on physicians by the law violate their First Amendment free speech rights by restricting their ability to communicate with patients, other Indiana physicians, and out-of-state physicians regarding medical care

Gender-affirming care bans have been allowed to take effect in Florida, Oklahoma, and other mostly Republican-led states despite studies showing the bans have severe impacts on transgender youth.

The US Supreme Court is set to rule on the legality of gender-affirming care bans, with oral arguments scheduled next month.