Georgia families considering hormone therapy for their transgender minor children will have more time to make a decision after a federal judge on Sunday temporarily blocked Georgia's ban on the treatments.
Georgia Senate Bill 140 went into effect on July 1 and prohibits doctors from prescribing estrogen or testosterone to transgender people under 18, except for minors who had already begun treatment before that date. Another exemption allows doctors to use sex hormones to treat minors for other reasons.
A group of Georgia families filed suit, saying the law would prevent them from receiving treatment recommended by their children's doctors. The families say their children have struggled with gender dysphoria for years and they want to begin hormone treatment on the schedule recommended by their doctors.
A mother identified by the pseudonym Emma Koe said her family is considering moving out of state if her 12-year-old daughter is denied treatment.
“After this law was passed, I felt defeated,” she said. “Many people seem to feel that being transgender is a choice, but my husband and I would never have chosen that for our child – we just want our daughter to live and thrive.”
The law's Republican supporters said the measure was necessary to prevent children from being subjected to irreversible treatment, but U.S. District Judge Sarah Geraghty sided with a group of Georgia families who said the law violated the Equal Protection Clause of the Fourteenth Amendment by discriminating on the basis of sex.
Geraghty cited a Florida ruling that struck down a similar ban on the same basis:
“Imagine a teenager, perhaps 16 years old, who a doctor wants to treat with testosterone. Is the treatment legal or illegal under the contested law? To find out the answer, you have to know the gender of the young person. If the young person is a male by birth, the treatment is legal. If the young person is a woman giving birth, the treatment is illegal. This is simply a line drawn based on gender.”
The state took a different position, pointing to a Tennessee case in which a panel of judges approved a ban on gender-affirming care. The judges in the case ruled that Tennessee's law was acceptable because it banned hormone treatments equally for boys and girls.
Geraghty was not convinced by this argument.
“However, with all due respect, this court is not persuaded by this aspect (of the Tennessee case). Talking about SB 140 in this way is simply redefining it in seemingly neutral terms; the content of the law remains unchanged.”
Geraghty also questioned the state's arguments that the law serves a legitimate interest in protecting children from a procedure they described as unproven and that could lead to regret later in life.
The generally accepted standard of care for transgender minors may include medical hormone therapy in conjunction with social transition measures, which may include changing the child's name, pronouns, and clothing style.
The plaintiff's witnesses argued that all medical procedures involve some degree of risk, but that a doctor's job is to balance the risks with the benefits and provide treatments in the best interests of his patients.
Twenty medical organizations have filed briefs with the court supporting the current standards, including the American Pediatric Association, the American Academy of Child & Adolescent Psychiatry and the Association of American Medical Colleges.
The state presented witnesses who argued against mainstream opinion, but Geraghty was again skeptical.
“There is a striking discrepancy between, on the one hand, the defendant's experts' insistence on a very high threshold of evidence in relation to claims about the safety and benefits of hormone therapy and, on the other hand, their tolerance of a much lower threshold of evidence for claims about its risks, the likelihood of failure to do so and/or regret and their ideas about the ideological bias of a medical establishment that largely disagrees with them,” she wrote. “This raises some concern about the weight given to their views, although the court has no doubt that the views they express are in fact held.”
LGBTQ advocates say laws like SB 140 are part of a national campaign targeting transgender youth. According to the Human Rights Campaign, 21 states, including Georgia, have passed laws banning gender-specific care for minors. With Geraghty's ruling, those laws are subject to court injunction in six of those states.
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