The Supreme Court of Texas prepares to hear oral arguments on Senate Bill 14, a prohibition on gender-affirming care for transgender youth, on January 30, 2024.
The Supreme Court of Texas prepares to hear oral arguments on Senate Bill 14, a prohibition on gender-affirming care for transgender youth, on January 30, 2024.  Mikala Compton/American-Statesman/USA Today Network

The Texas Supreme Court ruled Friday to allow the state’s ban on nearly all gender-affirming care for minors to remain in effect.

In an 8-1 decision, the all-Republican court overturned a lower court’s order that blocked implementation of the law, known as Senate Bill 14, while a challenge to its constitutionality was heard. The ruling marks the court’s second opinion in favor of the same law in a year after it allowed the ban to take effect as scheduled in September.

The law bars Texas health care providers from providing gender transition surgeries, puberty-blocking medication or hormone therapies to those under 18, although exceptions are provided for intersex patients.

The ban was passed by the state’s Republican-controlled legislature in May 2023 after days of protest and procedural delays by Democrats, which led to a provision that allowed those who had started receiving treatment to “wean off.” Under the law, which was signed last June, health care providers who offer such care would have their license revoked.

Texas’ ban is similar to restrictions in nationwide as GOP-led states have moved to curb gender-affirming care for minors, expressing concerns over the long-term effects of such treatment — though major medical associations have deemed it clinically appropriate. More than 20 states have enacted restrictions on gender-affirming care for minors.

LGBTQ advocacy groups slammed the ruling Friday, with Lambda Legal — one of the parties involved in the original lawsuit against the bill — saying, “It is impossible to overstate the devastating impact of this ruling.”

“Instead of leaving medical decisions concerning minor children where they belong, with their parents and their doctors, the Court here has elected to let politicians — in blatant disregard for the overwhelming medical consensus — determine the allowed course of treatment, threatening the health and the very lives of Texas transgender youth,” Karen Loewy, senior counsel for Lambda Legal, said in a statement, vowing to “continue to fight” against such measures.

Has reached out to Texas GOP Gov. Greg Abbott’s office for comment on the decision.

Gender-affirming care for minors has become a political flashpoint, with Democrats criticizing Republicans for introducing record number of anti-LGBTQ bills and arguing that medical decisions regarding minors should be left to their parents. The Biden administration directly challenged Tennessee’s ban on gender-affirming care for minors, and the US Supreme Court announced this week that it will hear the appeal, which will determine whether states can restrict such care.