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Texas Supreme Court Refuses to Block Ban on Certain Medical Care for Trans Minors

The court said the ban does not infringe on parents’ right to choose medical care for their children.


The Texas Supreme Court on Friday refused to block the state’s ban on certain medical treatments, including puberty blockers, for transgender minors. The 2023 law prohibits, among other things, the use of puberty blockers and hormone therapy when used as gender-affirming care for minors.

Plaintiffs in the case, Texas v. Loe, including parents of trans minors, had asked the all-Republican Texas Supreme Court to reinstate a temporary injunction blocking enforcement of the law. They claim the law deprives parents of their fundamental right to make medical decisions for their children in violation of the Texas Constitution’s due course of law provision.

But the court found the ban does not “sever” parents’ control in making medical decisions for their children or displace them as the ultimate decision-makers. “The law merely restricts the availability of new treatments with which medical providers may treat children diagnosed with a newly defined medical condition, gender dysphoria,” Justice Rebeca Huddle wrote, adding that the Texas legislature “had a rational basis for concluding that the risk of providing these treatments to children solely for the purpose of physically transitioning from their sex at birth was not outweighed by the benefits.”

The decision was 8–1. In her dissent, Justice Debra Lehrmann called the law both “cruel” and “unconstitutional.”

The majority of the court also declined to treat transgender people as a “new protected class” and found that the law does not violate the plaintiffs’ equal protection rights. The ban does not discriminate on the basis of sex because it “treats both males and females receiving treatment for gender dysphoria the same,” the court said.

Physicians who treat transgender minors are also plaintiffs in the suit, claiming the law violates their property interests in their medical licenses and prevents them from exercising their constitutionally protected occupational freedom. The court disagreed, saying that “Texas physicians have no constitutionally protected interest to perform medical practices that the Legislature has rationally determined to be illegal.”

A lower court judge previously ruled that the plaintiffs were likely to succeed on the merits and that a statewide temporary injunction preventing implementation of the ban was necessary to prevent “probable, imminent, and irreparable” injury to transgender children and their families.

Earlier this week, the U.S. Supreme Court agreed to take up a similar case, addressing the question of whether Tennessee’s ban on transgender care for minors violates federal equal protection rights. While the U.S. Supreme Court’s decision will likely determine the protections trans adults and minors have under the U.S. Constitution, that court is not the final decisionmaker on trans rights nationwide. State courts are free to interpret their constitutions, which often offer more avenues to challenge such laws, in a way that allows more expansive and different rights

Trans rights advocates will likely push other states to look more to Lehrmann’s dissent in the Texas case. “The parents at issue are thoughtful, conscientious caretakers who are doing the best they can to deal with serious health conditions with which their children have been diagnosed,” Lehrmann wrote. “The state’s categorical statutory prohibition prevents these parents . . . from developing individualized treatment plans for their children in consultation with their physicians, even the children for whom treatment could be lifesaving.”

Erin Geiger Smith is a writer and editor at the Brennan Center for Justice.

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