Transgender youth in Kentucky have few options to access gender-affirming care, advocates say, after a federal appeals court allowed the state to continue to enforce its ban on care for minors before it comes to a final decision.
On Monday, in a 2-1 decision, a three-judge panel from the 6th U.S. Circuit Court of Appeals in Cincinnati maintained that Kentucky can still enforce its ban. This is the second time the 6th Circuit has ruled in favor of barring transgender youth from accessing medically necessary care after the same judges allowed a similar ban on gender-affirming care for minors to go into effect in Tennessee in July.
The court’s decision is the latest blow to trans rights in Kentucky, though the 6th Circuit is expected to present its final ruling on the bans in both Kentucky and Tennessee by Sept. 30.
Kentucky’s ban on gender-affirming care for minors is just one portion of S.B. 150, a sweeping anti-trans law that is one of the most extreme in the nation. In May, the American Civil Liberties Union, joined by seven transgender youth and their families, sued the state to block the law, arguing that it violates people’s constitutional and parental rights to make medical decisions.
The state’s ban on access to hormone therapy and puberty blockers for youth prevailed even though Democratic Gov. Andy Beshear vetoed the legislation and it was initially blocked by U.S. District Judge David Hale.
Other parts of S.B. 150 — including a portion that bars trans students from using bathrooms and locker rooms that align with their gender identities and another that allows teachers to refuse to use a student’s preferred pronouns — have already gone into effect.
“Families are having to make awful decisions about whether or not to stay in their homes, where they cannot access this care.”
– Chris Hartman, director of Fairness Campaign
Chris Hartman, the director of Fairness Campaign, a Louisville-based LGBTQ+ advocacy organization, said he wasn’t surprised by the court’s decision, given the outcome in Tennessee.
“The Sixth Circuit has rarely been friendly to LGBTQ+ issues. It’s sadly a wait and see game. Unfortunately, one of these cases is likely going to end up at the Supreme Court at some point in time,” Hartman said to HuffPost. “But in the meantime, families are bereft of the care that they need right now.”
Trans youth in Tennessee who are currently receiving treatment are allowed to continue to do so until March 2024. In Kentucky, however, transgender youth will have to immediately stop or significantly reduce the amount of hormone therapy and puberty blockers they’re receiving.
Oliver Hall, who directs the trans health program at Kentucky Health Justice Network, said some health care providers may be too uncertain to continue administering any gender-affirming care to trans youth, even at reduced levels.
“The bill was written so quickly and unclearly, some providers likely don’t know about this option, and those that do likely still see continuing that care to be a threat to their license,” Hall said. “So regardless, there are many trans youth that are suddenly without care.”
Silas Walker/Lexington Herald-Leader/Tribune News Service via Getty Images
Preventing trans youth from taking hormone blockers or hormone replacement therapy for long periods of time can have “detrimental effects” on their physical and mental health, Hall said. Young people who are taking hormone blockers will be forced to undergo the kind of puberty characteristic of their sex assigned at birth, and those on hormone therapy may see some of their sought-after physical and mental changes reversed.
Many Kentucky families are traveling north to Ohio or Illinois to try to establish care with doctors out of state, Hartman said. Some families are only able to take their children to other states if they receive travel grants from organizations like the Campaign for Southern Equality.
“Families are having to make awful decisions about whether or not to stay in their homes, where they cannot access this care, or leave permanently and uproot their family and move to another state or seek out the costly and time-consuming process of receiving gender-affirming care from another state,” Hartman said. “None of these are good options.”
At least 20 states have restricted or banned gender-affirming care for transgender minors this year, though most states are facing litigation. In June, a federal judge ruled that Arkansas’ first-in-the-nation ban on gender-affirming care was unconstitutional.
Currently, 1 in 3 trans children lives in a state where there is a ban on gender-affirming care, according to the Movement Advancement Project, a nonprofit that tracks LGBTQ+ state policies.