A federal appeals court on Tuesday lifted an injunction against Arkansas’ ban on gender-affirming health care for transgender minors, clearing the way for the law to be enforced for the first time since its passage four years ago.
The 8-2 decision from the 8th U.S. Circuit Court of Appeals followed a request last month from Arkansas Attorney General Tim Griffin, who cited the U.S. Supreme Court’s June ruling upholding a similar Tennessee law. Federal judges had previously blocked both the Tennessee and Arkansas measures.
The Arkansas law, known as the Save Adolescents From Experimentation Act or Act 626 of 2021, prohibits the use of puberty blockers, hormone therapy and gender-affirming surgeries for minors diagnosed with gender dysphoria. The measure was the first of its kind in the nation, and more than two dozen states have since enacted similar bans.
Four families of transgender minors, represented by the American Civil Liberties Union of Arkansas, sued to block the law before it took effect. U.S. District Judge James Moody granted a preliminary injunction in July 2021 and, after an eight-day trial, struck down the law in June 2023, finding it violated the First and Fourteenth Amendments. Moody concluded the measure discriminated based on sex, infringed on parents’ rights to make medical decisions for their children, and unconstitutionally restricted physician speech.
The appeals court disagreed, ruling that the law regulates medical procedures based on age and type of treatment, not sex. The panel said rational-basis review a standard that asks whether a law is rationally related to a legitimate governmental interest applied in the case and found the law met that standard. The court also concluded that parents do not have unlimited authority over their children’s medical decisions and that the law’s restrictions on physician referrals fall within the state’s authority to regulate professional conduct.
Griffin praised the ruling in a statement, calling it a recognition of the state’s interest in “protecting the physical and psychological health of children.” At a news conference, Griffin said he expects the appeals court to issue its mandate within the next couple of weeks, allowing enforcement to begin.
State Rep. Robin Lundstrum and Sen. Alan Clark, the law’s lead sponsors, also welcomed the decision. Lundstrum said lawmakers acted to protect children and credited colleagues for voting to override then-Gov. Asa Hutchinson’s veto in 2021. Clark said his opposition to gender-affirming care for minors was informed by his experience as a youth pastor.
The ACLU of Arkansas called the decision “tragically unjust” and said it would continue to fight the law. Executive Director Holly Dickson said the group is considering next steps and emphasized support for transgender Arkansans.
Three of the four minors involved in the case have since turned 18, while the youngest plaintiff has moved with family to another state. Two Arkansas Children’s Hospital physicians who treat transgender minors also joined the lawsuit, testifying that they do not perform or refer patients for genital or breast surgeries.
Arkansas lawmakers in 2023 also approved a separate measure allowing malpractice lawsuits for up to 15 years against doctors who provide gender-affirming care to minors. In 2025, the Legislature expanded the law to include mental health providers.
For the complete story on these latest changes visit this article with The Arkansas Advocate.
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