Montana ban on gender-affirming care for minors temporarily blocked in court
A state district court judge in Missoula has blocked Montana’s ban on medical care for minors with gender dysphoria from taking effect while a lawsuit over its constitutionality continues, finding that the new law appears to have “no rational relationship to protecting children.”
The challenge against Senate Bill 99, a Republican-backed law passed earlier this year and signed by Gov. Greg Gianforte in April, is taking place in the state court system. Other similar laws passed in other states, including Texas and Tennessee, are winding their way through federal courts. The Montana law was slated to take effect Oct. 1.
Advocates for transgender rights, the plaintiffs and their attorneys in the Montana case heralded Judge Jason Marks’ Wednesday decision as critical protection for young people and vowed to continue fighting in court against what they deem discriminatory legislation.
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The 48-page ruling comes a week after both sides appeared in Missoula court to argue over the preliminary injunction, which blocks the state from enforcing the law while litigation proceeds.
There, the plaintiffs argued that SB 99 unconstitutionally violates Montana’s rights to equal protection, the right to parent, the right to privacy, the right to seek and obtain medical care, the right to dignity for patients and freedom of speech for medical providers. Defendants said the law should be enforced as written, asserting the state’s “compelling interest” in protecting the well-being of children.
In his ruling, Marks found that the 2023 Legislature’s record “does not support a finding that SB 99 protects minors,” writing that submitted evidence “suggests that SB 99 would have the opposite effect.” Marks also wrote that the plaintiffs were likely to eventually succeed on the merits of the case, one of the standards for temporarily blocking a law, and that SB 99 could be “unlikely to survive any level of constitutional review.”
He described the medical treatments prohibited by SB 99 as among the options for young people experiencing gender dysphoria, a diagnosed condition caused by a distressing incongruence between a person’s gender identity and the sex they were assigned at birth.
Nodding to the plaintiffs’ arguments, Marks also noted that many of the medications — including puberty blockers for adolescents and cross-sex hormones for teens — are often prescribed to minors to treat other conditions but that SB 99 would bar the provision of the same services for the purpose of treating gender dysphoria.
Defendants advocated for a non-medical “watchful-waiting” approach and suggested that many youths may eventually stop experiencing gender dysphoria without medical intervention, Marks summarized. He also noted that defendants sought to undermine professional medical organizations’ support for gender-affirming care, casting the science as unsettled.
Marks cut through the defendants’ framing of gender dysphoria as a psychological condition not suited for the medical treatments barred by SB 99. That logic, Marks explained, would put transgender minors on uneven footing with their peers.
“Transgender minors seeking the treatments proscribed by SB 99 do so for medical reasons — to treat gender dysphoria — and based on the advice offered by their healthcare providers. Their cisgender counterparts also seek those treatments for medical reasons — such as central precocious puberty, hypogonadism, PCOS — and on the advice of their healthcare providers. Physical conditions, like cysts on ovaries or ataxia, and psychological conditions, like depression or Alzheimer’s disease, are all health issues that may require the aid of a medical professional,” Marks wrote.