ATLANTA (CN) — A federal judge will consider whether to block a Georgia law that bans most gender-affirming surgeries and hormone replacement therapies for people people under 18 who have been diagnosed with gender dysphoria.
The law, Senate Bill 140, went into effect last month after being passed this year by the state’s Republican-majority General Assembly and signed by Republican Governor Brian Kemp.
Similar laws that restrict or ban gender-affirming medical care to minors have been enacted across 19 other states as well. With most of them currently facing lawsuits, the rise of such laws have spurred a national debate between medical science and morality. They've also raised concerns over the rights of parents to make medical decisions for their children, which largely fueled the Georgia lawsuit.
Brought by parents of four transgender children, who the court has allowed to proceed under pseudonyms, and TransParent, an organization that supports parents and caregivers of transgender children, the lawsuit asks the judge to permanently block the law. It was filed in the Northern District Court of Georgia on their behalf by the Southern Poverty Law Center, the American Civil Liberties Union of Georgia and the Human Rights Campaign Foundation.
The families claim the law not only violates parents’ rights to make medical decisions for their children, but is unconstitutional under the 14th Amendment by denying transgender youth “essential, and often lifesaving, medical treatment based on their sex and on their transgender status.” They also argue that the state has no rational or compelling basis behind enacting the ban.
Defendants in the case include Caylee Noggle, the commissioner of the Georgia Department of Community Health and its nine board members, as well as the 16 governor-appointed members of the Georgia Composite Medical Board.
“They cannot show that the alleged right to cross-sex hormones for minors experiencing gender dysphoria is deeply rooted in our history and traditions,” attorney Jeffrey Harris from Virginia-based firm Consovoy McCarthy wrote in a brief for the state health officials opposing the plaintiffs' request for a preliminary injunction.
“Nor can plaintiffs show that the law discriminates on the basis of sex, since the law applies to all minors evenhandedly regardless of their sex, and individuals who identify as transgender are not a suspect class.”
The state argues the law aims to protect Georgia’s children from “controversial and experimental treatments that risk long-term, irreversible consequences to their health.”
During Thursday’s hearing on the temporary restraining order and preliminary injunction request before U.S. District Judge Sarah Geraghty, counsel representing the parents brought a pediatric endocrinologist and a pediatrics and adolescent medicine specialist to the stand to testify that such medical treatments are safe, established and necessary for treating minors with gender dysphoria.
Both medical professionals testified that providing treatment to minors is critical to help them live a happy and healthy life and to prevent them from suffering from extreme depression, anxiety, self-harm and suicide.
Attorneys for the state, however, were quick to point out some of the risks and permanent effects of hormone replacement therapies, such as breast development and the associated risks of breast cancer in those assigned the male gender at birth, and effects on fertility.
They also questioned the validity of the research on providing gender-affirming care to adolescents that the medical experts spoke of, because much of it is based on observational studies versus randomized control trials. There are also very few studies that have followed minors receiving gender-affirming care into adulthood.
Doctor Meredithe McNamara said that this is because running placebo trials would be difficult, as it would be too obvious to participants which ones received the hormone treatments and which did not.
“Many treatments are based on very low quality evidence, but the benefits of the care are tremendous,” said McNamara.
State attorneys also did not shy away from asking the witnesses about the $350 to $400 each of them are being paid per hour to testify in the plaintiffs' defense and in similar cases across the country.
The American Academy of Pediatrics and several national and state medical and mental health organizations filed an amicus curiae brief in support of the parent’s injunction request. They argue that the treatment protocols for gender dysphoria are laid out in established, evidence-based clinical guidelines.
“For adolescents with persistent gender dysphoria that worsens with the onset of puberty, gender-affirming care may include medical interventions to align their physiology with their gender identity,” the groups said in their amicus brief.
“Empirical evidence indicates that gender-affirming care, including gender-affirming medical interventions provided to carefully evaluated patients who meet diagnostic criteria, can alleviate clinically significant distress and lead to significant improvements in the mental health and overall well-being of adolescents with gender dysphoria.”
The hearing will continue Friday with more witnesses on both sides. Judge Geraghty did not signal whether she will issue a ruling from the bench or at a later date.
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