A federal appeals court panel has upheld Indiana’s ban on sex-change operations and hormone drugs for minors, including things like administering puberty blockers, cross-sex hormones and cosmetic irreversible surgeries.
A three-judge panel of the U.S. 7th Circuit Court of Appeals ruled 2-1 Wednesday to reverse a lower court decision against Senate Enrolled Act 480, which passed in April 2023.
Circuit Judge Michael Brennan, a Trump appointee, authored the majority opinion, concluding that “there is no evidence that SEA 480 is a pretext designed to discriminate against transgender people.”
“The law allows mental health care, does not limit an adult’s access to gender transition treatment, and does not prohibit treatment focused on non-medical affirmation of the individual’s gender identity,” wrote Brennan.
“It is focused on the medically induced part of a gender transition, which is the part of the transitioning process Indiana believes is too dangerous and novel to be left unregulated.”
Brennan wrote that protecting minors “from being subjected to a new and heavily challenged medical treatment is a legitimate end.”
“The law applies to minors only. And because the state believes puberty blockers are dangerous when prescribed to stop puberty’s natural course and hormone therapy is dangerous when prescribed cross-sex, limiting access for those purposes is reasonable,” he continued.
Circuit Judge Candace Jackson-Akiwumi, a Biden appointee, authored the dissenting opinion, arguing that “the majority opinion cannot save SEA 480 from falling short of what the First Amendment requires.”
In particular, Jackson-Akiwumi took issue with the law’s provision prohibiting Indiana-based providers from helping patients get the banned hormones, drugs and procedures from out-of-state facilities.
“My colleagues appear moved by the good intentions that Indiana contends underpin SEA 480’s aiding and abetting provision. But it is axiomatic that a state cannot ensnare free speech just because it means well,” wrote Jackson-Akiwumi.
“If I reached the constitutional question, I would hold that SEA 480’s aiding and abetting provision violates the First Amendment because it does not regulate speech integral to unlawful conduct; it does not regulate speech incidental to regulated conduct; and it does not regulate Provider-Plaintiffs’ pure speech in a manner that survives strict scrutiny.”
The Alliance Defending Freedom, a conservative legal organization that filed an amicus brief in support of the state law, celebrated the ruling.
“Indiana rightly enacted a law that protects the health and welfare of all children — supporting their natural biological development and ensuring that children experiencing gender dysphoria have a chance for comprehensive healing and compassionate mental health support,” ADF Senior Counsel Jonathan Scruggs said in a statement.
“These procedures have devastated countless lives, which is why countries that were previously leaders in so-called ‘gender affirming’ care are reversing course and curtailing these experimental efforts to alter children’s bodies. The 7th Circuit was on solid ground to uphold Indiana’s law that allows children to receive the help they need — safely.”
In passing SEA 480, Indiana became one of about two dozen states to pass laws prohibiting sex-change drugs and operations for youth experiencing gender dysphoria.
The measure was challenged by the American Civil Liberties Union, which filed a complaint in April 2023 on behalf of four trans-identified minors, their families, a doctor and a health care clinic.
“This law would be devastating to trans youth and their families, causing them serious injuries and forcing those who can, to uproot their lives and leave the state to access the gender-affirming care they need,” said Ken Falk, ACLU of Indiana legal director, in a statement at the time.
“We’re suing to stop this cruel and unconstitutional law from taking effect and inflicting further harm on these children and their families.”
