Federal Judge James Patrick Hanlon issued an injunction on Friday, pausing the ban on gender-affirming health care. Photo by Whitney Downard from Indiana Capital Chronicle

By Whitney Downard
Indiana Capital Chronicle

INDIANPOLIS — A federal judge issued a preliminary injunction Friday afternoon mostly blocking a ban on gender-affirming care for Hoosier youth diagnosed with gender dysphoria. Without action, the law would have taken effect July 1.

The ruling bars the state from enforcing a prohibition on medical interventions used in transgender health care, such as puberty blockers or hormone replacement therapies. However, U.S. District Court Judge James Patrick Hanlon upheld the ban on surgical procedures, which previous Statehouse testimony and court filings indicated weren’t occurring on minors in Indiana.

Hanlon, who serves in the Southern District, was nominated by former President Donald Trump.

The injunction applies to all Hoosier children, not just the four transgender youth involved in the lawsuit. More than 900 youth have sought gender-affirming services at the Riley Children’s Hospital in Indianapolis, many of whom received puberty blockers or hormonal therapies.

“Today’s victory is a testament to the trans youth of Indiana, their families, and their allies, who never gave up the fight to protect access to gender- affirming care and who will continue to defend the right of all trans people to be their authentic selves, free from discrimination,” said Ken Falk, who represented the transgender youth. “We won’t rest until this unconstitutional law is struck down for good.”

Falk is the legal director of the American Civil Liberties Union of Indiana (ACLU).

Attorney General Todd Rokita’s office said the partial injunction is a disappointment but not the end of the story.

“The Court openly acknowledges evidence showing the safety and effectiveness of puberty blockers and hormone therapy are uncertain and unsettled. It also recognizes that the State has shown there are good reasons for regulating gender transition procedures for minors,” the release said. “So, our office will continue to defend the democratically passed laws of the Indiana General Assembly, and we will continue to fight for the children.”

Injunction, Courtroom Background

Gov. Eric Holcomb signed House Enrolled Act 480 in April after Republican lawmakers passed it. The ACLU quickly filed suit, and Hanlon heard arguments on Wednesday from both the ACLU and the state.

Hanlon, in his ruling, said the plaintiffs demonstrated “some likelihood of success” in their arguments that the ban violated equal protection rights, specifically because the prohibition allows the treatments to continue so long as children don’t have a gender dysphoria diagnosis.

In other words, “sex is the determining factor as to whether a treatment is prohibited,” Hanlon wrote, noting that the law prohibits someone from altering or removing physical characteristics that are typical for one’s sex.

“Sex-based classifications are… central to (Senate Enrolled Act) 480,” Hanlon continued. “But it does not prohibit a person from seeking to ‘alter or remove’ a characteristic or feature typical of the opposite sex.”

Hanlon’s ruling mirrors similar decisions in other states that have pursued a ban on gender-affirming care. In his ruling, he emphasized that each side agreed about the need for more research on the long-term effects of gender-affirming care.

Plaintiffs and the state both introduced a bevy of experts who offered conflicting research, muddling Hanlon’s attempts to determine a level of scientific scrutiny. He acknowledged that defendants, led by Solicitor General Thomas Fisher, had introduced evidence that documented lower fertility and bone density in some transgender people.

Because of the uncertainty, the state argued it had an interest in regulating the procedure. But Hanlon said the state hadn’t demonstrated “an ‘exceedingly persuasive justification,’” to allow the ban to advance.

“… there’s evidence that puberty blockers and cross-sex hormone therapy reduces distress for some minors diagnosed with gender dysphoria,” Hanlon said. “The risk or irreparable harm therefore supports a preliminary injunction.”

However, Hanlon did note that more information could come from a trial, including the cross examination of witnesses.