Federal Judge Blocks Part of Indiana’s Ban on Gender Transition Procedures

Activists against the use of gender-transition treatments and procedures on minors demonstrate outside of Boston Childrens Hospital in Boston on Sept. 18, 2022. (Joseph Prezioso/AFP via Getty Images)

A federal judge has issued a preliminary injunction halting part of Indiana’s ban on gender transition procedures for minors, pending the outcome of a legal challenge.

U.S. District Court Judge James Patrick Hanlon, who was appointed by former President Donald Trump, blocked the enforcement of provisions in the bill that prohibited puberty blockers and cross-sex hormone therapy for minors.

Hanlon also blocked the portion of the law that prevented doctors from discussing these treatments with physicians in other states.

Plaintiffs Lacked Standing

However, Hanlon allowed the ban on gender reassignment surgery to remain in place, writing in his ruling that the plaintiffs lacked standing “to challenge that ban because gender reassignment surgeries are not provided to minors in Indiana.”

The American Civil Liberties Union (ACLU) filed the lawsuit on behalf of four minors, their parents, and a doctor, claiming that the new law violated federal requirements under the Medicaid Act and the Affordable Care Act, as well as the U.S. Constitution.

In his ruling, Hanlon acknowledged Indiana’s strong interest in enforcing democratically enacted laws and recognized the state’s reasons for regulating gender transition procedures for minors. Nevertheless, he determined that the plaintiffs had demonstrated a likelihood of success in showing that the law would violate their equal protection and free speech rights.

“Still, Plaintiffs have carried their burden of showing some likelihood of success on their claims that [the law] would violate their equal protection rights under the Fourteenth Amendment and free speech rights under the First Amendment,” Hanlon wrote in his ruling (pdf).

Entitled to a Preliminary Injunction

Hanlon concluded that the broad ban on gender transition procedures did not sufficiently align with the state’s interests, thus entitling the plaintiffs to a preliminary injunction.

“Under the evidence available at this preliminary stage, there is not a ‘close means–end fit’ between the State’s important reasons for regulating the provision of gender transition procedures to minors and [the law’s] broad ban of those procedures,” the ruling continued. “So, when the State’s interests are weighed against the likelihood that Plaintiffs will be able to show that [the law] would violate their constitutional rights and the risk of irreparable harm, Plaintiffs are entitled to a preliminary injunction.”

Indiana Attorney General Todd Rokita’s spokesperson said in comments to The Hill that the state would defend its laws and “fight for the children.”

“The Court openly acknowledges evidence showing the safety and effectiveness of puberty blockers and hormone therapy are uncertain and unsettled,” the spokesperson said. “It also recognizes that the State has shown there are good reasons for regulating gender transition procedures for minors.”

Gender Transition Bill

The legislation at issue prohibits physicians or practitioners from providing “gender transition procedures” to individuals under the age of 18, even with parental consent. It also prohibits them from assisting or enabling others in providing gender reassignment to minors.

The bill defines gender transition procedures as “any medical or surgical service that seeks to surgically alter or remove healthy physical or anatomical characteristics or features that are typical for the individual’s sex,” including the removal of breasts or genitals.

Republican Indiana lawmakers sought to enact this bill amid a national push by GOP-led legislatures to protect minors from the potentially irreparable harm they say these gender transition procedures can cause. However, opponents of such bans frame these bills as curbing LGBT rights.

The approval of the ban followed heated hearings in which opponents argued that such procedures reduce the risk of depression and suicide among transgender youth.

Proponents of such bans, including individuals who have regretted undergoing such gender transition procedures as minors, say they and their parents were pressured into consenting.

Recent reporting by The Daily Wire has raised questions about whether some health care providers are “rubber stamping” diagnoses of gender dysphoria. This diagnosis, which represents a person feeling distressed at their body not matching their gender identity, is needed for insurance coverage of transition procedures.

Indiana’s law, signed by Republican Gov. Eric Holcomb on April 5, was initially scheduled to take effect on July 1. However, the preliminary injunction now prevents its enforcement until the legal challenge is resolved.